A study to analyse the effect of Mckenzie’s method of exercise to treat upper cross syndrome associated with cervicogenic headache

Introduction: Upper cross syndrome (UCS) occurs when the muscle in the neck, shoulders, and chest become deformed usually as a result of poor posture. The aim of the study is to analyse the effect of McKenzie’s method of exercise to treat upper cross syndrome associated with cervicogenic headache. Materials and Methods: This experimental study was conducted in outpatient department physiotherapy A.C.S. Medical College and Hospital. Fifty subjects were selected for the study of the age group between 20 to 50 years of both male and female sex. Duration of this study was about 3 months. Each patient was trained about three session per week, 30 minutes per session. The session included McKenzie’s method of exercise to improve the shoulder and neck movements and postural corrections of the subjects. The outcome measure done using visual analogue scale (VAS) for cervicogenic headache and upper cross syndrome questionnaire (UCS). Results: The results on comparing upper cross syndrome questionnaire score and Visual Analog Scale score showed that between the pre-test (4.93) and post-test (3.43) mean values with group McKenzie’s exercise showed highly significant difference. Thus, it is appropriate that McKenzie’s method of exercise to treat upper cross syndrome associated with cervicogenic headache is effective.

Effects of different methods of physiotherapy in individuals with cervicogenic headaches

Objective. To assess the effects of different physiotherapy methods in individuals with cervicogenic headache. Methods. 20 subjects with cervicogenic headaches have been studied. Subjects were randomized to two groups of 10 subjects. The first group of subjects underwent physiotherapy with post – isometric relaxation, the second group – physiotherapy in combination with vibration. Before and after the interventions, pain intensity, neck disability index, active cervical range of motion and neck muscle strength were evaluated in all subjects. Results. Physiotherapy reduces the intensity of pain (from strong and very strong to moderate intensity), improves neck function (from severe to moderate disability), increases active cervical range of motion by four to six degrees and increases neck muscle strength (p < 0,05). When comparing results between groups, no statistically significant difference in results were observed (p > 0,05). Conclusion: Complex physiotherapy in combination with post – isometric relaxation or vibration helps to improve the function of individual neck, increase active cervical range of motion and strength of muscle strength.

Ultrasonography Method of Deep Cervical Muscles and Thickness Measurement Reliability in Cervicogenic Headache and Healthy Subjects:APilot Study

Introduction: In Cervicogenic Headache (CGH), motor control of muscles is impaired and deep upper neck muscles (extensor and flexor muscles) become atrophied. In this research, thickness measurement of Longus Capitis (LCap), Rectus Capitis Posterior Major (RCPM), and Obliquus Capitis Superior (OCS) muscles were conducted and intra-rater reliability of the thickness measurement of these muscles was assessed in CGH and healthy subjects. Materials and Methods: Twenty subjects, including 10 healthy subjects (19-32 years old) and 10 CGH patients (20-35 years old) participated in this study. LCap thickness was measured at the level of C3-C4 in the supine position and posterior muscles (RCPM and OCS) thickness at the C1-C2 level in the sitting position. All ultrasound images were captured by a linear probe with a 50-mm footprint in B mode option and frequency range of 9-12 Hz. Intraclass Correlation Coefficients (ICC), Standard Error Of Measurement (SEM), and the Smallest Detectable Difference (SDD) were calculated for data analysis. Results: The ICC for thickness measurement of LCap was from 0.70 to 0.91 (good to excellent), for RCPM thickness was from 0.69 to 0.94 and for OCS muscle thickness was from 0.87 to 0.98. SEM values for LCap were between 0.08 and 0.25 and the SDD values between 0.22 and 0.71. SEM values for RCPM were between 0.22 and 0.43 and these values were reported for OCS muscle between 0.19 and 0.45. Conclusion: The results indicated that the presented position and the level of ultrasonography in this study are appropriate and ultrasound is a reliable tool to measure the deep upper neck muscle thickness in CGH and healthy subjects.

A comparative shape analysis of the cervical spine between individuals with cervicogenic headaches and asymptomatic controls

As some researchers theorized that cervicogenic headache (CEH) might be related to bony and discal features of the cervical spine, this retrospective study examined the shapes of the cervical vertebrae and intervertebral discs (IVDs) of individuals with CEH and compared them to asymptomatic controls. Scans of 40 subjects in their late 20’s–mid 30’s affected with CEH and 40 asymptomatic controls were obtained (overall = 19,040 measurements, age-sex matched, 20 males and 20 females in each group). The following cervical spine variables were measured: Supine lordosis, vertebral body-heights, A-P lengths, mediolateral widths and sagittal-wedging; IVDs heights and sagittal-wedging; pedicle heights, widths and transverse angles; laminar widths and transverse angles; articular facet angles, spinal canal, and transverse foramen lengths, widths, and areas. Both groups had similar shape variation along the cervical in all the measured parameters. There were no significant left–right differences in all measured parameters and no significant differences between the CEH and control groups concerning sex and age. Cervical IVDs were lordotic in shape, whereas their adjacent vertebral bodies were kyphotic in shape except for C2. In conclusion, the shape of the cervical spine and IVDs in subjects in their late 20’s–mid 30’s affected with CEH is identical to asymptomatic controls.

Effectiveness of sustained natural apophyseal glides in females with cervicogenic headache: A randomized controlled trial

BACKGROUND: Cervicogenic headache (CGH) is a common condition that results in significant disability. To treat this dysfunction, Mulligan described sustained natural apophyseal gliders (SNAGs) as a manual therapy approach. However, only inconclusive short-term evidence exists for treating CGH with SNAGs. OBJECTIVE: The present study aims to investigate the effect of SNAGs in the treatment of CGH. METHODS: Fourty female patients ranging from 20 to 40 years with CGH were randomly assigned to two groups: 20 in a treatment group and 20 in a control group. SNAGs were applied to the treatment group while the control group received placebo treatment. Both groups received their respective treatment for 20 minutes, alternately three times per week, for a total of 12 times in four weeks. The outcome measures were the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). Participants were assessed at baseline and at the end of each week. The data was analyzed using SPSS version 20. Independent t-testing was used to reveal changes between groups. One-way ANOVA was used to determine changes within groups. The level of significance was P< 0.05. RESULTS: Twenty participants (100%) in the treatment group and 17 (85%) in the control group had a history of headache aggravation with active movements or passive head positioning. There was no significant difference at baseline (p> 0.05), indicating that both groups were homogeneous at the time of recruitment. The p value (p< 0.05) showed a significant difference in pain and level of disability at three and four weeks (p< 0.05) in patients treated with SNAGs. However, the cervical range of motion (ROM) showed a statistically significant improvement in flexion and extension in the treatment group (p< 0.05) while there was no significant improvement in side flexion and rotation ROM in both groups (p> 0.05). CONCLUSION: This study found that SNAGs were effective in reducing pain and neck disability and improved ROM in females with CGH.