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Murtza S, Noor R, Bashir MS, Ikram M. Effects of sustained natural apophyseal glides versus rocabado 6 × 6 program in subjects with cervicogenic headache. BMC Musculoskelet Disord 2024; 25:169. [PMID: 38389050 PMCID: PMC10882877 DOI: 10.1186/s12891-024-07290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/18/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Cervicogenic headache is designated as the most common type of secondary headache that results from conditions affecting the neck's bony components, muscles, and intervertebral discs rather than the head itself. OBJECTIVE The purpose was to determine the effects of Sustained Natural Apophyseal Glides (SNAGs) versus the Rocabado 6 × 6 program in subjects with cervicogenic headaches. METHODS This study was a randomized clinical trial. The sample size was 38, and participants aged 20-60 years (mean age 40.22 ± 9.66) suffering from cervicogenic headaches were randomly allocated using the lottery method into two groups with 19 participants in each group. Assessment of subjects was done before starting treatment and by the end of the 8th week for all the variables. Outcome measures were the Neck Disability Index (NDI), 6-item Headache Impact Test (HIT-6), Flexion-Rotation test (FRT) to assess the rotation range of motion at the level of C1-C2 (goniometer) and the Numeric Pain Rating Scale (NPRS) for the intensity of pain. Data analysis was done by SPSS (IBM) 25. To check the normality of the data the Shapiro-Wilk test was used. RESULTS In the Shapiro-Wilk test p-value of all the testing variables i.e. NDI, HIT-6 score, FRT and NPRS was > 0.05, data was normally distributed and parametric tests were used. Group A showed a considerable improvement (p < 0.05) in all variables compared to Group B, while within-group analysis of both groups shows that all outcome measures show significant results (p < 0.05). CONCLUSION It was concluded that both SNAGs and Rocabado's 6 × 6 exercises were effective for the treatment of cervicogenic headache but the effects of headache SNAG were superior and produced more improvement in intensity of headache, disability, frequency of headache, duration of headache as compared to Rocabado 6 × 6 exercises. TRIAL REGISTRATION NUMBER This study was registered at ClinicalTrials.gov ID: NCT05865808 on date 19/05/2023.
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Affiliation(s)
- Sadia Murtza
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Lahore, Pakistan
| | - Rabiya Noor
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Lahore, Pakistan
| | | | - Mehwish Ikram
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Lahore, Pakistan.
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Ernst MJ, Sax N, Meichtry A, Aegerter AM, Luomajoki H, Lüdtke K, Gallina A, Falla D. Cervical musculoskeletal impairments and pressure pain sensitivity in office workers with headache. Musculoskelet Sci Pract 2023; 66:102816. [PMID: 37394322 DOI: 10.1016/j.msksp.2023.102816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Office workers are specifically vulnerable to headache conditions. Neck pain is reported by almost 80% of patients with headaches. Associations between currently recommended tests to examine cervical musculoskeletal impairments, pressure pain sensitivity and self-reported variables in headache, are unknown. The aim of this study is to evaluate whether cervical musculoskeletal impairments and pressure pain sensitivity are associated with self-reported headache variables in office workers. METHODS This study reports a cross-sectional analysis using baseline data of a randomized controlled trial. Office workers with headache were included in this analysis. Multivariate associations, controlled for age, sex and neck pain, between cervical musculoskeletal variables (strength, endurance, range of motion, movement control) and pressure pain threshold (PPT) over the neck and self-reported headache variables, such as frequency, intensity, and the Headache-Impact-Test-6, were examined. RESULTS Eighty-eight office workers with a 4-week headache frequency of 4.8 (±5.1) days, a moderate average headache intensity (4.5 ± 2.1 on the NRS), and "some impact" (mean score: 53.7 ± 7.9) on the headache-impact-test-6, were included. Range of motion and PPT tested over the upper cervical spine were found to be most consistently associated with any headache variable. An adjusted R2 of 0.26 was found to explain headache intensity and the score on the Headache-Impact-Test-6 by several cervical musculoskeletal and PPT variables. DISCUSSION Cervical musculoskeletal impairments can explain, irrespective of coexisting neck pain, only little variability of the presence of headache in office workers. Neck pain is likely a symptom of the headache condition, and not a separate entity.
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Affiliation(s)
- Markus J Ernst
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK; Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.
| | - Nadine Sax
- Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - André Meichtry
- Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Andrea Martina Aegerter
- Institute of Public Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Hannu Luomajoki
- Institute of Physiotherapy, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Kerstin Lüdtke
- Institute of Health Sciences, Department of Physiotherapy, Universität zu Lübeck, Germany
| | - Alessio Gallina
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Anarte-Lazo E, Rodriguez-Blanco C, Bernal-Utrera C, Falla D. Headache production during physical examination in patients with and without headache attributed to a whiplash injury: A case-control study. Musculoskelet Sci Pract 2023; 66:102779. [PMID: 37271677 DOI: 10.1016/j.msksp.2023.102779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Provocation of headache on physical examination of the neck may reflect a role of cervical structures in the presence of acute whiplash-associated headache (WAH). OBJECTIVE To determine differences in headache provocation during physical tests in people with and without WAH after a whiplash injury. DESIGN Case-control study. METHODS Forty-seven people with acute whiplash-associated disorders participated, 28 with WAH. Passive accessory intervertebral movement over the tubercle of C1, the spinous processes of C2-C3 and facet joints of C0-C4, the flexion-rotation test (FRT), manual palpation of cranio-cervical muscles and the upper limb neurodynamic test + cranio-cervical flexion were assessed bilaterally twice by a blinded examiner; headache provocation was determined. Cohen's kappa and Chi-squared were determined to evaluate the intra-rater reliability of test results and differences between groups, respectively. A logistic regression model was also performed. RESULTS Intra-rater reliability of headache provocation was good or excellent for most tests. Significant differences between groups were found with higher positive tests in WAH for the assessment of C2 (68%), the most painful side of C0-C1 (57%), C1-C2 (75%) and C2-C3 (53%), most (79%) and least (25%) restricted sides of the FRT, and manual palpation of the most painful side for the trapezius (53%), masseter (50%) and temporalis (46%) muscles. Provocation of headache during the assessment of C2 and C1-C2 on the most painful side demonstrated the highest association with WAH. CONCLUSION Mechanical provocation of headache is more frequent in people with WAH than in those without headache soon after a whiplash injury.
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Affiliation(s)
- E Anarte-Lazo
- Doctoral Program in Health Sciences, University of Seville, Seville, Spain; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - C Rodriguez-Blanco
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - C Bernal-Utrera
- Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.
| | - D Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Cioeta M, Pournajaf S, Goffredo M, Giovannico G, Franceschini M. Improving Adherence to a Home Rehabilitation Plan for Chronic Neck Pain through Immersive Virtual Reality: A Case Report. J Clin Med 2023; 12:jcm12051926. [PMID: 36902713 PMCID: PMC10003452 DOI: 10.3390/jcm12051926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Idiopathic chronic neck pain is a highly disabling musculoskeletal condition. Immersive virtual reality shows a promising efficacy in the treatment of chronic cervical pain through the mechanism of distraction from the pain. This case report describes the management of C.F., a fifty-seven-year-old woman, who suffered from neck pain for fifteen months. She had already undergone a cycle of physiotherapy treatments including education, manual therapy, and exercises, following international guidelines. The patient's poor compliance did not allow adherence to the exercise's prescription. Home exercise training through virtual reality was therefore proposed to the patient to improve her adherence to the treatment plan. The personalization of the treatment allowed the patient to resolve in a short time period her problem and return to live with her family peacefully.
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Affiliation(s)
- Matteo Cioeta
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 000163 Rome, Italy
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Sanaz Pournajaf
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 000163 Rome, Italy
- Correspondence: (S.P.); (M.G.)
| | - Michela Goffredo
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 000163 Rome, Italy
- Correspondence: (S.P.); (M.G.)
| | - Giuseppe Giovannico
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Marco Franceschini
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 000163 Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00166 Rome, Italy
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Greenbaum T, Emodi-Perlman A. Headache and orofacial pain: A traffic-light prognosis-based management approach for the musculoskeletal practice. Front Neurol 2023; 14:1146427. [PMID: 36895899 PMCID: PMC9990418 DOI: 10.3389/fneur.2023.1146427] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/26/2023] [Indexed: 02/22/2023] Open
Abstract
Introduction Headache (HA) is one of the most prevalent disabling conditions worldwide and is classified as either primary or secondary. Orofacial pain (OFP) is a frequent pain perceived in the face and/or the oral cavity and is generally distinct from a headache, according to anatomical definitions. Based on the up-to-date classification of the International Headache Society, out of more than 300 specific types of HA only two are directly attributed to the musculoskeletal system: The cervicogenic HA and HA attributed to temporomandibular disorders. Because patients with HA and/or OFP frequently seek help in the musculoskeletal practice, a clear and tailored prognosis-based classification system is required to achieve better clinical outcomes. Purpose The aim of perspective article is to suggest a practical traffic-light prognosis-based classification system to improve the management of patients with HA and/or OFP in the musculoskeletal practice. This classification system is based on the best available scientific knowledge based on the unique set-up and clinical reasoning process of musculoskeletal practitioners. Implications Implementation of this traffic-light classification system will improve clinical outcomes by helping practitioners invest their time in treating patients with significant involvement of the musculoskeletal system in their clinical presentation and avoid treating patients that are not likely to respond to a musculoskeletal based intervention. Furthermore, this framework incorporates medical screening for dangerous medical conditions, and profiling the psychosocial aspects of each patient; thus follows the biopsychosocial rehabilitation paradigm.
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Affiliation(s)
- Tzvika Greenbaum
- Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Zárate-Tejero C, Hidalgo-García C, Lucha-López O, Hernández-Secorún M, Krauss J, Rodríguez-Rubio P. Association between age, sex and cervical and upper cervical rotation tests. Descriptive and correlational study in healthy volunteers. Ther Adv Chronic Dis 2023; 14:20406223231170158. [PMID: 37152351 PMCID: PMC10155033 DOI: 10.1177/20406223231170158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Background Active cervical spine rotation (ACROM Rot) shows cervical rotation and flexion rotation test (FRT); side-bending rotation test (SBRT) and upper cervical axial rotation test (C0-C2ART) are described to measure upper cervical rotation. The objectives of this study are (1) to describe the normal range of motion (ROM) of ACROM Rot, and the ROM in FRT, SBRT and C0-C2ART tests; (2) to explore the correlation among the four tests and (3) to investigate the influence of age and sex in their ROM. Methods A cross-sectional study was carried out with healthy volunteers from 18 to 75 years of age. Tests were measured using a CROM device and a bubble inclinometer. Descriptive analysis was performed to establish normative data for the ROM tests. Correlation analysis was conducted to understand the relation between upper and global cervical rotation ROM and among the three upper cervical rotation tests. Linear regression models were developed to understand the influence of age and sex in the ROM of all tests. Results Normative values were obtained from 122 healthy volunteers (50% male), by sex and age strata. The degree of correlation ranged between 0.582 (p < 0.01) for FRT and ACROM Rot left and 0.217 (p < 0.05) for SBRT and C0-C2ART left. Linear regression models showed the influence of sex for ACROM Rot right (men -4.64° less than women), SBRT (men -4.1° less than women) left and C0-C2ART right and left (men -2.24° and -1.78° less than women). The age influenced rotation ROM with a decrease for every 10 years of -2.11° and -1.96° for ACROM Rot right and left, of -1.72° and -1.26° for FRT right and left and -0.58° and -0.41° for C0-C2ART right and left in the linear regression models. No association was found between age and SBRT (p = 0.63 for right SBRT and p = 0.49 for left SBRT). Conclusion Weak-to-moderate correlation was found between the upper cervical spine rotation tests and with the ACROM. Women had a larger ROM in ACROM Rot right, SBRT left and C0-C2ART. Decreases in ROM related with age were observed for ACROM Rot, FRT and C0-C2ART but not for SBRT.
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Affiliation(s)
- Carlos Zárate-Tejero
- Physiotherapy Department, Faculty of Medicine
and Health Sciences, Universitat Internacional de Catalunya, Barcelona,
Spain
| | | | | | - Mar Hernández-Secorún
- Unidad de Investigación en Fisioterapia,
Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza,
Spain
| | - John Krauss
- School of Health Sciences, Oakland University,
Rochester, MI, USA
| | - Pere Rodríguez-Rubio
- Physiotherapy Department, Faculty of Medicine
and Health Sciences, Universitat Internacional de Catalunya, Barcelona,
Spain
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Elizagaray-García I, Perez-Garcia L, Párraga-Delgado R, Javier-Valverde F, Luedtke K, Gil-Martínez A. Flexion-rotation test and C0-C2 axial rotation test. Are they equally reliable for novice clinicians? Musculoskelet Sci Pract 2022; 62:102625. [PMID: 35961064 DOI: 10.1016/j.msksp.2022.102625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To analyse the inter- and intra-examiner reliability for the neck flexion-rotation test and the C0-C2 axial rotation test when applied in asymptomatic subjects by two novice physiotherapists. DESIGN Repeated measures reliability study design. The study was approved by the Research Ethics Committee of [X], in compliance with the Declaration of Helsinki (CSEULS-PI: 004/2020). METHODS 32 asymptomatic adults were included, recruited by convenience sampling. Two sessions were scheduled for each subject, with an intersession break of 30 min. Two inexperienced raters blinded to their own previous and peer results performed three movements to both sides using the flexion-rotation test and the C0-C2 axial rotation test in randomised order of rater, test and direction. A third researcher collected the data measured by inertial sensors and displayed to the Pro Motion Capture software. RESULTS Both raters showed good-excellent intra-examiner reliability (ICC(2,3) ranging from 0.88 to 0.94) and moderate to good inter-examiner reliability (ICC(2,3) ranging from 0.58 to 0.86) to measure the rotation ROM with the FRT. The C0-C2 axial rotation test resulted in poor to moderate intra-examiner reliability (ICC(2,3) ranging from 0.33 to 0.74) and poor inter-examiner reliability using (ICC(2,3) ranging from 0.16 to 0.37). CONCLUSION Although performed by novice raters, the FRT showed good to excellent intra and inter-examiner reliability. Results for the C0-C2 axial rotation test were less reliable. We suggest that novice physiotherapists use the FRT instead of the C0-C2 axial rotation test in order to determine C1-C2 dysfunction.
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Affiliation(s)
- Ignacio Elizagaray-García
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain; CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, 28023, Madrid, Spain; Motion in Brains Research Group, Centro Superior de Estudios Universitarios La Salle, 28023, Madrid, Spain; Instituto de Rehabilitación Funcional y Ciencias Aplicadas al Deporte (IRF-La Salle). Centro Superior Estudios Universitarios La Salle, Madrid, Spain.
| | - Laura Perez-Garcia
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain.
| | - Ricardo Párraga-Delgado
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain.
| | - Fernando Javier-Valverde
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain.
| | - Kerstin Luedtke
- Institute of Health Sciences, Department Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Luebeck, Germany.
| | - Alfonso Gil-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain; CranioSPain Research Group, Centro Superior de Estudios Universitarios La Salle, 28023, Madrid, Spain; Instituto de Rehabilitación Funcional y Ciencias Aplicadas al Deporte (IRF-La Salle). Centro Superior Estudios Universitarios La Salle, Madrid, Spain; Instituto de investigación biosanitaria del Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; Unidad de fisioterapia, Hospital Universitario La Paz, Madrid, Spain.
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Liu B, Gao Y, Ye K, Yang Z, Hou G, Zhang Z, Ji H, Zhou F, Tian Y. Cervical Spine Fracture Prediction by Simple Plain X-Ray in Ankylosing Spondylitis Patients after Low-Energy Trauma. Orthop Surg 2022; 14:2939-2946. [PMID: 36178011 PMCID: PMC9627076 DOI: 10.1111/os.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Timely diagnosis is essential in the management of cervical spine fracture (CSF) in ankylosing spondylitis (AS) patients. However, the value of simple plain X‐ray in the early management of ASCSF has not been well‐studied. This study aimed to explore the prediction ability of simple plain X‐ray for CSF in AS patients who suffer from low‐energy trauma (LET). Methods From January 2010 to December 2020, AS patients who experienced LET were retrospectively reviewed. Clinical data including gender, age, body mass index, time interval between AS diagnosis and trauma, smoking or not, and a presence of continuous bony bridge between anterior margin of C1 and C2 body or not were collected. Morphological features including atlanto‐occipital gap, Pavlov ratio of C2–7, Angle A–D, Borden's index, and Harrison's value were measured by the lateral cervical X‐ray. All data was compared between patients who had CSF and those who did not. Binary logistic regression analysis and receiver operator characteristic (ROC) curves were applied to discriminate and assess the predictive parameters. Results A total of 129 AS patients were divided into Fracture group (41 cases) and Non‐fracture group (88 cases) based on whether CSF existed. Twelve parameters showed significant differences between two groups (p < 0.05). According to the binary logistic regression model, four of the 12 parameters showed a further correlation with the occurrence of CSF, namely, mean Pavlov ratio (p < 0.001, OR = 0.067, 95% CI: 0.023 to 0.194), Angle D (p = 0.031, OR = 1.057, 95% CI: 1.005 to 1.112), Borden's index (p = 0.042, OR = 1.131, 95% CI: 0.994 to 1.287), the time interval between the AS diagnosis and the trauma (p < 0.020, OR = 0.935, 95% CI: 0.883 to 0.990). The ROC curve further revealed the mean Pavlov ratio had the largest AUC (0.793) with the cut‐off of 0.72. While the optimal cut‐off value was 45.65° for Angle D (sensitivity = 61.0%, specificity = 78.4%), 9.79 for Borden's index (sensitivity = 87.8%, specificity = 37.5%), 15.50 years for the time interval between AS diagnosis and trauma (sensitivity = 70.7%, specificity = 56.8%). Conclusions The time interval between the AS diagnosis and the trauma, mean Pavlov ratio, Angle D, and Borden's index showed predictive ability for the occurrence of CSF in AS patients who encounter LET. Surgeons should consider measuring these parameters in the management of AS patient.
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Affiliation(s)
- Bingchuan Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Yitian Gao
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Kaifeng Ye
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Zhongwei Yang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Guojin Hou
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Zhishan Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Hongquan Ji
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Fang Zhou
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
| | - Yun Tian
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Disease Research, Peking University Third Hospital, Beijing, China
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Elgueta-Cancino E, Rice K, Abichandani D, Falla D. Measurement properties of smartphone applications for the measurement of neck range of motion: a systematic review and meta analyses. BMC Musculoskelet Disord 2022; 23:138. [PMID: 35144583 PMCID: PMC8832814 DOI: 10.1186/s12891-022-05066-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background Smartphone applications offer an accessible and practical option to measure neck range of motion (ROM) and are becoming more commonly used in clinical practice. We assessed the validity, reliability, and responsiveness of smartphone applications (apps) to measure neck ROM in people with and without neck pain. Methods A comprehensive electronic search strategy of the main electronic databases was conducted from inception until June 2021. The identified studies investigated apps which measured neck ROM, and evaluated their validity, reliability, or responsiveness, in adult participants with neck pain or asymptomatic individuals. Two independent reviewers determined eligibility and risk of bias following COSMIN guidelines. The quality of evidence was assessed according to the GRADE approach. Results Eleven studies, with a total of 376 participants were included. Three types of apps were identified: clinometer apps, compass apps, and other apps of ‘adequate’ to ‘doubtful’ risk of bias. A meta-analysis revealed ‘good’ to ‘excellent’ intra-rater and inter-rater reliability across the three types of apps. The overall validity was rated from ‘moderate’ to ‘very high’ across all apps. The level of evidence was rated as ‘low’ to ‘very low’. Conclusion Smartphone applications showed sufficient intra-rater reliability, inter-rater reliability, and validity to measure neck ROM in people with and without neck pain. However, the quality of evidence and the confidence in the findings are low. High-quality research with large sample sizes is needed to further provide evidence to support the measurement properties of smartphone applications for the assessment of neck ROM. Study registration Following indications of Prisma-P guidelines, this protocol was registered in PROSPERO on 1/05/2021 with the number CRD42021239501. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05066-6.
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Affiliation(s)
- E Elgueta-Cancino
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - K Rice
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - D Abichandani
- Division of Physiotherapy, Institute of Health and Social Care, London South Bank University, London, UK
| | - D Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
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Singh P, Verma S, Agrawal M, Sawarkar D, Borkar S, Kumar A, Garg K, Agrawal D, Gupta D, Satyarthee G, Chandra S, Kale S. Use of Intraoperative Imaging to Preserve C1-C2 Mobility in Complex Atlas-Hangman Fractures. Neurol India 2022; 70:209-214. [DOI: 10.4103/0028-3886.336335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sensorimotor performance in acute-subacute non-specific neck pain: a non-randomized prospective clinical trial with intervention. BMC Musculoskelet Disord 2021; 22:1017. [PMID: 34863120 PMCID: PMC8645120 DOI: 10.1186/s12891-021-04876-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 11/15/2021] [Indexed: 01/01/2023] Open
Abstract
Background The assessment of cervical spine kinematic axial rotation performance is of great importance in the context of the study of neck sensorimotor control. However, studies addressing the influence of the level of provocation of spinal pain and the potential benefit of passive manual therapy mobilizations in patients with acute-subacute non-specific neck pain are lacking. Methods A non-randomized prospective clinical trial with an intervention design was conducted. We investigated: (1) the test-retest reliability of kinematic variables during a fast axial head rotation task standardized with the DidRen laser test device in 42 Healthy pain-free Control Participants (HCP) (24.3 years ±6.8); (2) the differences in kinematic variables between HCP and 38 patients with Acute-subacute Non-Specific neck Pain (ANSP) assigned to two different groups according to whether their pain was localized in the upper or lower spine (46.2 years ±16.3); and (3) the effect of passive manual therapy mobilizations on kinematic variables of the neck during fast axial head rotation. Results (1) Intra-class correlation coefficients ranged from moderate (0.57 (0.06-0.80)) to excellent (0.96 (0.91-0.98)). (2) Kinematic performance during fast axial rotations of the head was significantly altered in ANSP compared to HCP (age-adjusted) for one variable: the time between peaks of acceleration and deceleration (p<0.019). No significant difference was observed between ANSP with upper vs lower spinal pain localization. (3) After the intervention, there was a significant effect on several kinematic variables, e.g., ANSP improved peak speed (p<0.007) and performance of the DidRen laser test (p<0.001), with effect sizes ranging from small to medium. Conclusion (1) The DidRen laser test is reliable. (2) A significant reduction in time between acceleration and deceleration peaks was observed in ANSP compared to HCP, but with no significant effect of spinal pain location on kinematic variables was found. (3) We found that neck pain decreased after passive manual therapy mobilizations with improvements of several kinematic variables. Trial registration Registration Number: NCT 04407637 Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04876-4.
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Gugliotti M, Tau J, Gallo K, Sagliocca N, Horan M, Sussman N, Wisnewski R. Between-week reliability of the cervical range of motion (CROM) device for upper cervical rotation. J Man Manip Ther 2021; 29:176-180. [PMID: 32808588 PMCID: PMC8183562 DOI: 10.1080/10669817.2020.1805691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: The Cervical Range of Motion (CROM) device is a valid and reliable clinical tool used to measure full cervical rotation, however, its reliability for measuring upper cervical rotation is unknown.Objectives: Assess between-week test-retest reliability of the CROM device in measuring upper cervical rotationMethod: Thirty students participated in this test-retest reliability study. The CROM device was used to measure left and right cervical rotation in both a seated neutral and fully flexed head-neck position. Interclass correlation coefficient (ICC) was calculated for all motions. Measurement error was determined using standard error of measurement (SEM) and minimal detectable change (MDC).Results: The CROM device demonstrated moderate to good reliability (ICCs 0.65-0.9) of full and upper cervical rotation. The SEMs and MDCs of this study are small and suggest that the chance of repeated measurement error was relatively minimal for the between-week trials.Conclusions: The CROM device is a reliable outcome tool for measuring upper cervical rotation. The clinical implications of these findings suggest that therapists can utilize the CROM device to more completely examine all planes of upper and full cervical mobility. It may also assist in identifying upper cervical ROM limitations associated with underlying cervical pathology or motion dysfunction.
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Affiliation(s)
- Mark Gugliotti
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
| | - Jessica Tau
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
| | - Kelly Gallo
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
| | - Natalina Sagliocca
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
| | - Michael Horan
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
| | - Nicole Sussman
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
| | - Robert Wisnewski
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
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The association between specific temporomandibular disorders and cervicogenic headache. Musculoskelet Sci Pract 2021; 52:102321. [PMID: 33482538 DOI: 10.1016/j.msksp.2021.102321] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 12/19/2020] [Accepted: 01/08/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Upper neck signs, symptoms and hypomobility have been shown to present with a higher prevalence in patients with temporomandibular disorders (TMDs). However, there is currently no evidence of an association between specific TMDs and cervicogenic headache (CGH). Therefore, the aim of this study was to evaluate the odds ratio and the relative risk of CGH in patients with specific TMDs. METHOD 116 participants, including 74 patients with TMD (pain-related/intraarticular/mixed TMD) and 42 healthy controls took part in this study. The TMD diagnosis was made by senior faculty members of the Dental School according to the Diagnostic Criteria for TMD, while the cervical diagnosis was made by a qualified senior physical therapist. The analysis comprised the evaluation of the odds ratio of CGH among patients with TMD and the relative risk (RR) for CGH during 14-24 months of follow-up. RESULTS Significantly higher odds ratios of cervicogenic headache were found among pain-related and mixed TMD (12.17 and 10.76, respectively) versus healthy controls. During the 14-24 months of follow-up, there was no significant difference of relative risk for CGH among patients with TMD versus healthy controls. SUMMARY AND CONCLUSIONS The results support a clear clinical association between painful TMD (pain-related and mixed TMD) and cervicogenic headache.
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Satpute KH, Parekh K, Hall TM. The C0-C2 axial rotation test - Reliability and correlation with the flexion rotation test in people with cervicogenic headache and migraine. Musculoskelet Sci Pract 2021; 51:102286. [PMID: 33187891 DOI: 10.1016/j.msksp.2020.102286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/28/2020] [Accepted: 11/01/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The C0-C2 axial rotation test is a measure of upper cervical range of motion (UCROM), reported to be reliable in a headache free population. The objective was to determine the intra- and inter-rater reliability of the C0-C2 axial rotation test in people with a diagnosis of cervicogenic headache (CGH) or episodic migraine. METHODS Two therapists independently evaluated UCROM during the C0-C2 axial rotation test and flexion-rotation test (FRT) with an iPhone in 70 subjects (mean age 37.7 SD 11.6 years) with a diagnosis of CGH (35 subjects) or episodic migraine (35 subjects) on two occasions. Measurement procedures were standardized; and the order of testing randomized. RESULTS Reliability of the C0-C2 axial rotation test was moderate to high (ICC > 0.70). The standard error of measurement and minimum detectable change for this test were at most 2°. In subjects with CGH mean UCROM to the most restricted side was 9.3° (1.9) and 8.8° (2.1) for rater 1 and 2 respectively. While in patients with episodic migraine mean UCROM to the restricted side was 13.7° (1.6) and 13.6° (2.0) for rater 1 and 2 respectively. DISCUSSION The C0-C2 axial rotation test has at least moderate levels of reliability and correlates well with mobility determined by the FRT.
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Affiliation(s)
- Kiran H Satpute
- Department of Musculoskeletal Physiotherapy, Smt. Kashibai Navale College of Physiotherapy, Pune, Maharashatra, India.
| | - Krisha Parekh
- Department of Musculoskeletal Physiotherapy, Smt. Kashibai Navale College of Physiotherapy, Pune, Maharashatra, India.
| | - Toby M Hall
- School of Physiotherapy and Exercise Science, Curtin University, P.O. Box U1987, Perth, WA, 6845, Australia.
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Rodríguez-Sanz J, Malo-Urriés M, Lucha-López MO, Pérez-Bellmunt A, Carrasco-Uribarren A, Fanlo-Mazas P, Corral-de-Toro J, Hidalgo-García C. Effects of the Manual Therapy Approach of Segments C0-1 and C2-3 in the Flexion-Rotation Test in Patients with Chronic Neck Pain: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020753. [PMID: 33477316 PMCID: PMC7829773 DOI: 10.3390/ijerph18020753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/13/2021] [Accepted: 01/15/2021] [Indexed: 12/13/2022]
Abstract
Background: Flexion-rotation test predominantly measures rotation in C1-2 segment. Restriction in flexion-rotation may be due to direct limitation in C1-2, but also to a premature tightening of the alar ligament as a result of lack of movement in C0-1 or C2-3. The aim of this study was to compare the effect of a 20-min single cervical exercise session, with or without manual therapy of C0-1 and C2-3 segment in flexion-rotation test, in patients with chronic neck pain and positive flexion-rotation test. Methods: Randomized controlled clinical trial in 48 subjects (24 manual therapy+exercise/24 exercise). Range of motion and pain during flexion-rotation test, neck pain intensity and active cervical range of motion were measured before and after the intervention. Results: Significant differences were found in favour of the manual therapy group in the flexion-rotation test: right (p < 0.001) and left rotation (p < 0.001); pain during the flexion-rotation test: right (p < 0.001) and left rotation (p < 0.001); neck pain intensity: (p < 0.001); cervical flexion (p < 0.038), extension (p < 0.010), right side-bending (p < 0.035), left side-bending (p < 0.002), right rotation (p < 0.001), and left rotation (p < 0.006). Conclusions: Addition of one C0-C1 and C2-C3 manual therapy session to cervical exercise can immediately improve flexion-rotation test and cervical range of motion and reduce pain intensity.
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Affiliation(s)
- Jacobo Rodríguez-Sanz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, C/Josep Trueta s/n, Sant Cugat del Vallés, 08195 Barcelona, Spain; (A.P.-B.); (A.C.-U.)
- Correspondence: ; Tel.: +34-636-13-67-89
| | - Miguel Malo-Urriés
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain; (M.M.-U.); (M.O.L.-L.); (P.F.-M.); (J.C.-d.-T.); (C.H.-G.)
| | - María Orosia Lucha-López
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain; (M.M.-U.); (M.O.L.-L.); (P.F.-M.); (J.C.-d.-T.); (C.H.-G.)
| | - Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, C/Josep Trueta s/n, Sant Cugat del Vallés, 08195 Barcelona, Spain; (A.P.-B.); (A.C.-U.)
| | - Andoni Carrasco-Uribarren
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, C/Josep Trueta s/n, Sant Cugat del Vallés, 08195 Barcelona, Spain; (A.P.-B.); (A.C.-U.)
| | - Pablo Fanlo-Mazas
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain; (M.M.-U.); (M.O.L.-L.); (P.F.-M.); (J.C.-d.-T.); (C.H.-G.)
| | - Jaime Corral-de-Toro
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain; (M.M.-U.); (M.O.L.-L.); (P.F.-M.); (J.C.-d.-T.); (C.H.-G.)
| | - César Hidalgo-García
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain; (M.M.-U.); (M.O.L.-L.); (P.F.-M.); (J.C.-d.-T.); (C.H.-G.)
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On-site multi-component intervention to improve productivity and reduce the economic and personal burden of neck pain in Swiss office-workers (NEXpro): protocol for a cluster-randomized controlled trial. BMC Musculoskelet Disord 2020; 21:391. [PMID: 32560714 PMCID: PMC7305619 DOI: 10.1186/s12891-020-03388-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 06/01/2020] [Indexed: 12/24/2022] Open
Abstract
Background Non-specific neck pain and headache are major economic and individual burden in office-workers. The aim of this study is to investigate the effect of a multi-component intervention combining workstation ergonomics, health promotion information group workshops, neck exercises, and an app to enhance intervention adherence to assess possible reductions in the economic and individual burden of prevalent and incident neck pain and headache in office workers. Methods/design This study is a stepped wedge cluster-randomized controlled trial. Eligible participants will be any office-worker aged 18–65 years from two Swiss organisations in the Cantons of Zurich and Aargau, working more than 25 h a week in predominantly sedentary office work and without serious health conditions of the neck. One hundred twenty voluntary participants will be assigned to 15 clusters which, at randomly selected time steps, switch from the control to the intervention group. The intervention will last 12 weeks and comprises workstation ergonomics, health promotion information group workshops, neck exercises and an adherence app. The primary outcome will be health-related productivity losses (presenteeism, absenteeism) using the Work Productivity and Activity Impairment Questionnaire. Secondary outcomes are neck disability and pain (measured by the Neck Disability Index, and muscle strength and endurance measures), headache (measured by the short-form headache impact test), psychosocial outcomes (e.g. job-stress index, Fear-Avoidance Beliefs Questionnaire), workplace outcomes (e.g. workstation ergonomics), adherence to intervention, and additional measures (e.g. care-seeking). Measurements will take place at baseline, 4 months, 8 months, and 12 months after commencement. Data will be analysed on an intention to treat basis and per protocol. Primary and secondary outcomes will be examined using linear mixed-effects models. Discussion To the authors’ knowledge, this study is the first that investigates the impact of a multi-component intervention combining current evidence of effective interventions with an adherence app to assess the potential benefits on productivity, prevalent and incident neck pain, and headache. The outcomes will impact the individual, their workplace, as well as private and public policy by offering evidence for treatment and prevention of neck pain and headache in office-workers. Trial registration ClinicalTrials.gov, NCT04169646. Registered 15 November 2019 - Retrospectively registered.
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Satpute K, Bedekar N, Hall T. Headache symptom modification: the relevance of appropriate manual therapy assessment and management of a patient with features of migraine and cervicogenic headache - a case report. J Man Manip Ther 2019; 28:181-188. [PMID: 31537198 DOI: 10.1080/10669817.2019.1662637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES People who suffer from headache frequently present with multiple headache forms and the precise diagnosis of the dominant headache form can be challenging. This case report describes a headache symptom modification approach in the diagnosis and management of a patient presenting with combined features of chronic migraine and cervicogenic headache (CGH). METHODS A 28-year-old female presented with combined features of chronic migraine and CGH diagnosed according to guidelines published by the International Headache Society. Her main complaints were frequent and severe headache along with frequent neck pain and disability. Symptom modification based on the Mulligan Concept was utilized for assessment of musculoskeletal dysfunction associated with headache which identified upper cervical articular impairment. Impairments were also identified in craniocervical muscle control and endurance. Interventions comprised six sessions of Mulligan manual therapy to address cervical spine impairments, exercise for craniocervical control and endurance, as well as patient education. RESULTS Headache frequency at 6 months follow up was reduced from 16 to 3 days per month and intensity from 72 to 23 on Visual Analogue Scale. Clinically relevant improvements were also found in headache duration, pressure pain thresholds, medication intake and Headache Activities of Daily Living Index post-treatment and continued up to 6 months follow-up without adverse events. DISCUSSION This case report illustrates the use of a manual therapy symptom modification approach in the management of headache. Improvement in headache symptoms and disability suggests that the musculoskeletal impairments and headache symptoms were more a feature of CGH rather than migraine. The mechanisms underlying these changes in symptoms and impairments are discussed.
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Affiliation(s)
- Kiran Satpute
- Department of Kinesiotherapy and Physical Diagnosis, Department of Musculoskeletal Physiotherapy, Smt. Kashibai Navale College of Physiotherapy , Pune, India
| | - Nilima Bedekar
- Department of Musculoskeletal Physiotherapy, Sancheti Institute College of Physiotherapy , Pune, India
| | - Toby Hall
- School of Physiotherapy and Exercise Science, Curtin University , Perth, Australia
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