A Randomized Controlled Trial of Exercise and Manipulative Therapy for Cervicogenic Headache

Jull, Gwendolen; Trott, Patricia; Potter, Helen; Zito, Guy; Niere, Ken; Shirley, Debra; Emberson, Jonathan; Marschner, Ian C.; Richardson, Carolyn A.

doi:10.1097/00007632-200209010-00004

Cited by 643 publications

(551 citation statements)

References 35 publications

Supporting

Mentioning

485

Contrasting

Unclassified

Order By: Relevance

“…10,21,24,27,36 The majority have investigated a combination of manual therapy with exercise, as cervicogenic headache is a disorder of cervical muscular impairment as much as cervical joint dysfunction. 11,13,38 For the present investigation we chose not to incorporate exercise for re-education of muscular impairment so that we could evaluate the sole effect of the C1-C2 self-SNAG. We recognize the multidimensional nature of cervicogenic headache and that manual therapy for this con- Headache severity index baseline, mean 6 SD (SEM)* 52 6 10 (2) 51 6 9 (2)…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of a C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) in the Management of Cervicogenic Headache

Hall¹,

Chan²,

Christensen³

et al. 2007

J Orthop Sports Phys Ther

130

110

View full text Add to dashboard Cite

Headache is a common condition frequently encountered by physiotherapists in clinical practice. 18 Cervicogenic headache has been classified by the International Headache Society (IHS) 1 and accounts for 15% to 20% of all chronic and recurrent headaches. 20 Individuals with chronic cervicogenic headache experience considerable restriction of daily function, limitation of social participation, and emotional distress. 5 In addition, these t sTudy design: Randomized, double-blind, placebo controlled trial.t objeCTives: To determine the effect of a C1-C2 self-sustained natural apophyseal glide (SNAG) on cervicogenic headache. t baCkground: Cervicogenic headache is a common condition causing significant disability. Recent studies have shown a high incidence of C1-C2 dysfunction, evaluated by the flexion-rotation test (FRT), in subjects with cervicogenic headache. To manage this dysfunction, Mulligan has described a C1-C2 self-SNAG, though no studies have investigated the efficacy of this intervention approach.t meTHods: A sample of 32 subjects (mean 6 SD age, 36 6 3 years) with cervicogenic headache and FRT limitation were randomized into a C1-C2 self-SNAG or placebo group. After an initial instruction and practice visit in the clinic, interventions consisted of exercises applied independently by the subject twice daily at home on a continual basis. FRT range was measured twice, before and immediately after the instruction and practice visit. Headache symptoms were determined by a headache index over time, assessed by questionnaire preintervention, at 4 weeks postintervention, and at 12 months postintervention.t resulTs: No differences were found in baseline measures between groups. Immediately after the initial instruction and practice visit performed with the supervision of the therapist, FRT range increased by 15° (SD, 9) for the C1-C2 self-SNAG group (P,.001), which was significantly more than 5° (SD, 5) for the placebo intervention (P,.001). There was also a significant interaction for the variable headache index between group and time (P,.001), indicating that group difference was dependent on time. There was no difference in headache index scores at baseline between groups. Headache index scores were substantially less in the C1-C2 self-SNAG group (mean 6 SD points at 4 weeks, 31 6 9; mean 6 SD points at 12 months, 24 6 9) compared to the placebo group (mean 6 SD points at 4 weeks, 51 6 15; mean 6 SD points at 12 months, 44 6 13) at 4 weeks (P,.001) and 12 months (P,.001), with an overall (6SD) reduction of 54% (617%) for the individuals in the C1-C2 self-SNAG group.t ConClusions: These results provide evidence for the efficacy of the C1-C2 self-SNAG technique in the management of individuals with cervicogenic headache.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Manual therapy is often advocated for managing cervicogenic headache, 13 although few randomized controlled trials have evaluated its efficacy in isolation. 5 One trial with strong methodological quality and a large sample size found that manual therapy was beneficial in reducing cervicogenic headache.…”

mentioning

confidence: 99%

Efficacy of a C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) in the Management of Cervicogenic Headache

Hall¹,

Chan²,

Christensen³

et al. 2007

J Orthop Sports Phys Ther

130

110

View full text Add to dashboard Cite

show abstract

“…However, these and other physical factors (such as posture, cervical range of motion and neck muscle endurance) have not been prospectively investigated in office workers without neck pain. Physical risk factors are useful to investigate as they potentially can be modified with interventions, for instance exercise [18], whereas individual characteristics, such as age or gender cannot be modified. It has been argued that both physical and psychosocial contributors to work-related neck pain need to be assessed together in longitudinal designs [37], to evaluate their relative contribution to the onset of workrelated musculoskeletal pain.…”

Section: Introductionmentioning

confidence: 99%

Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study

et al. 2009

View full text Add to dashboard Cite

Neck pain is more prevalent in office workers than in the general community. To date, findings from prospective studies that investigated causal relationships between putative risk factors and the onset of neck pain in this population have been limited by high loss to follow-up. The aim of this research was to prospectively evaluate a range of risk factors for neck pain in office workers, using validated and reliable objective measures as well as attain an estimate of 1-year incidence. We assembled a cohort of 53 office workers without neck pain and measured individual, physical, workplace and psychological factors at baseline. We followed participants for 1 year to measure the incidence of neck pain. We achieved 100% participant follow-up. Cox regression analysis was applied to examine the relationship between the putative risk factors and the cumulative incidence of neck pain. The 1-year incidence proportion of neck pain in Australian office workers was estimated in this study to be 0.49 (95% CI 0.36-0.62). Predictors of neck pain with moderate to large effect sizes were female gender (HR: 3.07; 95% CI: 1.18-7.99) and high psychological stress (HR: 1.64; 95% CI: 0.66-4.07). Protective factors included increased mobility of the cervical spine (HR: 0.44; 95% CI: 0.19-1.05) and frequent exercise (HR: 0.64; 95% CI: 0.27-1.51). These results reveal that neck pain is common in Australian office workers and that there are risk factors that are potentially modifiable.

show abstract

“…[1][2][3][4][5] Criteria have also been identified as predictors of favorable responses for the use of manual therapy. [6][7][8] To target where to apply these techniques has not been clarified.…”

Section: Introductionmentioning

confidence: 99%

A simulated passive intervertebral motion task: observations of performance in a cross-sectional study

Hazle

Nitz

2012

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

Introduction: Passive motion palpation is an integral component in examination, diagnosis or classification, and treatment of persons with mechanical disorders of the cervical spine. If the magnitude of force application during passive movement assessment is associated with greater palpatory accuracy has not been established. Methods: This investigation used a novel mechanical model as a basis for assessing the palpatory force of students and clinicians. The model included multiple palpable resistance and displacement levels similar to that observed in humans. The ability of the subjects to discriminate the various levels of resistance and displacement offered by the model was concurrently measured. Results: Large variability occurred in the amount of force applied by the subjects in completing the palpatory examination. The data indicated no major differences in palpatory accuracy across the student and clinician groups with different training and experience levels beyond basic competency. Those subjects applying less force in the palpatory exam demonstrated greater accuracy of palpatory assessment with one measure. Discussion: The data indicate training and experience had minimal relationship to palpatory interpretation precision beyond the basic level and individual natural discriminatory ability may be a factor in accuracy of palpatory skill. The results demonstrate remarkable inconsistency in palpatory force among examiners and suggest that palpatory accuracy may be related to less force application.

show abstract

A Randomized Controlled Trial of Exercise and Manipulative Therapy for Cervicogenic Headache

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

Cited by 643 publications

References 35 publications

Efficacy of a C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) in the Management of Cervicogenic Headache

Efficacy of a C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) in the Management of Cervicogenic Headache

Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study

A simulated passive intervertebral motion task: observations of performance in a cross-sectional study

Contact Info

Product

Resources

About