Effects of Shi Style Cervical Mobilization Versus SNAGS in Patients With Cervicogenic Headache

Riphah International University

Status: Completed

Conditions: Cervicogenic Headache

Treatments: Other: shi style mobilization; Other: SNAGS

Study type: Interventional

Funder types: Other

Identifiers

NCT06459726

REC/RCR&AHS/23/0182

Details and patient eligibility

About

Cervicogenic headache (CGH) manifests as unilateral neck pain referred from the neck's soft tissues or bony structures. The aim of this study will be to compare the effectiveness of Shi style cervical mobilization versus Sustained Natural Apophyseal Glides on pain, strength and functional disability in patients with Cervicogenic Headache.

Full description

A Randomized Clinical Trial will be conducted at Jinnah hospital Lahore through consecutive sampling technique on 40 patients which will be allocated using simple random sampling through sealed opaque enveloped into Group A and Group B. Group A will be treated with shi style mobilizations with 6 sesions over 4 weeks for 20minutes. Group B will be treated with Sustained Natural Apophyseal Glides with Number of repetitions are increased gradually from 6 to 10 and end physiological movement is maintained for 10seconds. Outcome measures will be conducted through NPRS for pain , Deep Neck flexors strength by pressure Biofeedback, Dizziness Handicap Inventory for pain and change in dizziness, NDI for functional impairments and SF 36 for quality of life.Data will be analyzed through SPSS software version 25 .

Enrollment: 40 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age:18 to 65 years.
• Both male and females.
• Unilateral dominant headache.
• Positive International Headache Society Diagnostic Criteria (IHS) for cervicogenic headache.
• Decrease strength deep neck flexors by pressure biofeedback.
• Tenderness of the upper 3 cervical spine joints.

Exclusion criteria

• • Patients who received any treatment for CGH within the previous 3 months that would interfere with this study.

  • Pregnant females.
  • Inflammatory conditions in which manual therapy is contraindicated(29).
  • Cancer or brain diseases.
  • Recent fracture or injuries.
  • Congenital conditions of the cervical spine.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups

shi style mobilisation

Active Comparator group

Description:

In this group patient will receive Shi style cervical mobilization SCM including three crucial steps soothing tendon step, mobilization step and dredging collateral step 6 sessions over 2 weeks for 20 minutes.

Treatment:

Other: shi style mobilization

SNAGS

Active Comparator group

Description:

Patient will receive sustained natural apophyseal glides as described by brian mulligan. Patient position will be upright sitting when therapist will apply a sustained passive assesory glide while patient moves actively through available physiological range of motion in the direction in which symptoms are produced(25). the headache SNAG technique will be performed with the patient sitting on a chair in the erect posture. The therapist will handle C2 spinous process with the middle phalanx of one hand. With the other hand, he will perform ventral gliding on C2 for 10 repetitions holding for 10 seconds in each glide with a rest time of 30 seconds in between. Patient will be asked to report dizziness or any other symptom after procedure. If patient reports symptom then angle of application is changed to ensure symptom free treatment in all patients. Number of repetitions are increased gradually from 6 to 10 and end physiological movement is maintained for 10seconds

Treatment:

Other: SNAGS