Effect of Mulligan upper cervical manual traction in the treatment of cervicogenic headache: a randomized controlled trial

Abstract

Introduction. Cervicogenic headache (CGH) is a serious condition manifested by upper cervical facet joints dysfunction. Mulligan upper cervical sustained natural apophyseal glide was noted to be effective in CGH but Mulligan upper cervical manual traction (MUCMT) has not yet been investigated. The purpose of the study was to compare the effect of MUCMT vs. traditional treatment (TT) in patients with CGH. Methods. A randomized controlled prospective parallel single-blind trial was performed. overall, 30 patients with CGH aged 30-55 years were randomly and equally allocated into the MUCMT group (A) and TT group (B) by using permuted block randomization. Group A participants were treated by TT and MUCMT while group B received hot packs, transcutaneous electrical nerve stimulation, and deep cervical flexors strengthening exercise. Patients gained 3 sessions every week for 3 weeks followed by home exercise for 3 months. Pre-treatment, post-treatment, and follow-up values for all outcome measures were recorded. The primary outcome was headache intensity. Secondary outcomes involved headache frequency, headache duration, neck disability index, and upper cervical rotation range of motion. Results. Within groups, statistical analysis revealed a significant difference in the comparison of pre-vs. post-treatment and post-treatment vs. follow-up mean values of all outcomes. Between groups, no statistical significance was observed in posttreatment and follow-up data, with 1 exception regarding upper cervical range of motion in favour of MUCMT. Conclusions. MUCMT is an effective treatment in patients with CGH, mainly with regard to upper cervical rotation range of motion.

Investigating the effectiveness of adding microcurrent therapy to a traditional treatment program in myofascial pain syndrome in terms of neck pain and function

“…This is also in agreement with a study by McMakin [44], who reported that microcurrent combined with manual therapy (chiropractic) reduced pain and increased RoM after the first 20-minute session in patients with persistent chronic MTrPs, and concluded that microcurrent therapy made chiropractic very effective in patients having persistent chronic MTrPs. The same observation was noted when hot packs, transcutaneous electrical nerve stimulation, and deep cervical flexors strengthening exercise were applied with or without Mulligan upper cervical manual traction in cervicogenic headache cases in terms of Ndi and upper cervical rotation RoM [45].…”

Aplicabilidade E Frequência De Uso Da Terapia Manual Por Fisioterapeutas Do Rio Grande Do Sul

“…Em um ensaio clínico randomizado, que buscou explorar os efeitos da tração manual superior de Mulligan® no tratamento de indivíduos com dor de cabeça cervicogênica, trouxe resultados expressivos na melhora na intensidade da cefaleia (KHALIL et al, 2019). Em concordância, Chettri et al (2014) utilizaram a tração cervical superior como terapia manual, identificaram que esta auxiliou no afastamento dos segmentos cervicais, mobilização das articulações, aumento do forame intervertebral e relaxamento dos músculos cervicais.…”

Photobiomodulation in the treatment of chronic non-specific neck pain. Randomized clinical trial

“…Physiotherapy can play an important role in the treatment of patients with chronic cervical pain, as it seeks to minimize pain, recover mobility, and strengthen the muscles, providing an improvement in quality of life [7][8][9][10][11]. For this, resources such as photobiomodulation are applied, with the use of low level laser therapy (LLLT), which is characterized by monochromaticity, collimation, spatial and temporal coherence, producing a non-invasive treatment, painless and capable of providing biomodulatory effects on living organisms [12], with anti-inflammatory, pro-repair and analgesic actions [13,14].…”