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Mulligan Technique Versus Proprioceptive Training in Cervicogenic Headache

ConditionCervicogenic Headache
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-45
SponsorCairo University

About this trial

This study will be conducted to compare the effectiveness of mulligan versus proprioceptive training on pain severity, headache disability, flexion rotation test, pain threshold, cervical joint position error in patients with cervicogenic headache.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

CGH pain intensity between 3 and 8 on 10-point pain scale.

CGH due to cervical spine dysfunction.

Reduced cervical motion.

Neck pain followed by headache.

Disqualifiers

Participants with other types of headache (migraine).

Headache due to other causes (sinus, tumor, neural, or temporomandibular joint issues), and any type of physical therapy treatment in the past three months.

Any contraindications to manual and manipulative therapy (fracture, instability, osteoporosis, arthropathy, or neural symptoms).

Using analgesics or corticosteroids.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Mulligan Technique

    Other intervention

    Mulligan Mobilization Technique will include Headache SNAG, Reverse Headache SNAG, and C1-C2 SNAG rotation. All techniques will be performed with the participant sitting in an erect posture. Headache SNAG and Reverse Headache SNAG will be applied at C2 for 10-30 seconds, with a maximum of 10 repetitions. C1-C2 SNAG rotation will be performed toward the restricted side for 10 repetitions with end-range overpressure and 30 seconds of rest between repetitions. The intervention will be administered in addition to the conventional physical therapy program for 12 sessions, 3 sessions per week for 4 weeks.

  • Proprioceptive Training

    Other intervention

    Proprioceptive training will include head relocation practice, cervical joint position retraining, and oculomotor exercises. Joint position sense will be trained using a head-mounted laser pointer with head movements and relocation to the neutral position, progressing from eyes open to eyes closed. Cervical joint position retraining will include tracing patterns with the laser. Oculomotor training will include eye-follow, saccades, gaze stability, and eye-head coordination exercises, with progression by increasing movement speed and range and modifying visual targets. The intervention will be administered in addition to the conventional physical therapy program for 12 sessions, 3 sessions per week for 4 weeks.

  • Conventional physical therapy program

    Other intervention

    The conventional physical therapy program will include hot pack application for 10 minutes, therapeutic ultrasound for 5 minutes on each side at an intensity of 1-1.5 W/cm² over the trapezius, upper cervical, and occipitovertebral regions, and low-load endurance exercises for the craniocervical and cervicoscapular muscles. The exercise program will include craniocervical flexion training using pressure biofeedback and scapular muscle endurance exercises. The conventional program will be administered to participants in both study arms.

Treatment groups

48 Participants
are divided into 2 treatment groups
Group A: Mulligan Technique + Conventional physical therapy programExperimental treatment 2 interventions
Group B: Proprioceptive Training + Conventional physical therapy programExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Pain Intensity

Pain intensity will be assessed using the Visual Analogue Scale (VAS). Participants will rate their pain intensity on a 10-cm scale, where 0 indicates no pain and 10 indicates maximum intolerable pain.

Time frame
4 weeks
2

Headache Impact

Headache impact will be assessed using the Arabic version of the Headache Impact Test-6 (HIT-6). The total score ranges from 36 to 78, with higher scores indicating a greater impact of headache on daily functioning.

Time frame
4 weeks
3

Right Cervical Flexion-Rotation Range of Motion

Right cervical flexion-rotation range of motion will be assessed using the Cervical Range of Motion (CROM) instrument during the Flexion-Rotation Test (FRT). Rotation will be measured in degrees for the right side.

Time frame
4 weeks
4

Left Cervical Flexion-Rotation Range of Motion

Left cervical flexion-rotation range of motion will be assessed using the Cervical Range of Motion (CROM) instrument during the Flexion-Rotation Test (FRT). Rotation will be measured in degrees for the left side.

Time frame
4 weeks

Secondary outcomes

1

Cervical Joint Position Error

Cervical proprioception will be assessed using the Cervical Joint Position Error Test (CJPET) with a head-mounted laser pointer. Participants will attempt to relocate the head to the neutral starting position without visual cues. Joint position error will be measured and converted to degrees using the formula: angle = tan-¹ \[error distance/90 cm\].

Time frame
4 weeks

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Cairo University

Lead sponsor

Source ClinicalTrials.gov

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