Manipulative therapy and exercise can reduce the symptoms of cervicogenic headache, and the effects are maintained.

No abstract

The presence of painful upper cervical joint dysfunction is a diagnostic criterion for cervicogenic headache. This preliminary study investigated whether independent examiners for a planned multicentre study of treatment of cervicogenic headache sufferers would agree on the presence or not of joint dysfunction for inclusion/exclusion of subjects into the trial. Ten subjects with or without neck pain and headache were recruited in each of four centres (total 40 subjects). Examiners manually assessed subjects' upper cervical regions in a single blind manner. There was excellent to complete agreement between each pair of examiners on which subjects should be allowed to enter the study and 70 per cent agreement between examiners on the two most dysfunctional joints in symptomatic subjects. There can be confidence that an homogenous headache group will enter the planned trial.

Quadriceps atrophy and morphological change is a known phenomenon that can impact significantly on strength and functional performance in patients with acute or chronic presentations conditions. Real‐time ultrasound (RTUS) imaging is a noninvasive valid and reliable method of quantifying quadriceps muscle anatomy and architecture. To date, there is a paucity of normative data on the architectural properties of superficial and deep components of the quadriceps muscle group to inform assessment and evaluation of intervention programs. The aims of this study were to (1) quantify the anatomical architectural properties of the quadriceps muscle group (rectus femoris, vastus intermedius, and vastus lateralis) using RTUS in healthy older adults and (2) to determine the relationship between RTUS muscle parameters and measures of quadriceps muscle strength. Thirty middle aged to older males and females (age range 55–79 years; mean age =59.9 ± 7.08 years) were recruited. Quadriceps muscle thickness, cross‐sectional area, pennation angle, and echogenicity were measured using RTUS. Quadriceps strength was measured using hand‐held dynamometry. For the RTUS‐derived quadriceps morphological data, rectus femoris mean results; circumference 9.3 cm; CSA 4.6 cm2; thickness 1.5 cm; echogenicity 100.2 pixels. Vastus intermedius mean results; thickness 1.8 cm; echogenicity 99.1 pixels. Vastus lateralis thickness 1.9 cm; pennation angle 17.3°; fascicle length 7.0 cm. Quadriceps force was significantly correlated only with rectus femoris circumference (r = 0.48, p = 0.007), RF echogenicity (r = 0.38, p = 0.037), VI echogenicity (r = 0.43, p = 0.018), and VL fascicle length (r = 0.43, p = 0.019). Quadriceps force was best predicted by a three‐variable model (adjusted R2 = 0.46, p < 0.001) which included rectus femoris echogenicity (B = 0.43, p = 0.005), vastus lateralis fascicle length (B = 0.33, p = 0.025) and rectus femoris circumference (B = 0.31, p = 0.041). Thus respectively, rectus femoris echogenicity explains 43%, vastus lateralis fascicle length explains 33% and rectus femoris circumference explains 31% of the variance of quadriceps force. The study findings suggest that RTUS measures were reliable and further research is warranted to establish whether these could be used as surrogate measures for quadriceps strength in adults to inform exercise and rehabilitation programs.