A randomised control trial of exercise and manipulative therapy for cervicogenic headache

Jull, Gwendolen, Trott, Patricia, Potter, Helen, Zito, Guy, Niere, Ken, Shirley, Debra, Emberson, Jonathan, Marschner, Ian and Richardson, Carolyn (2002) A randomised control trial of exercise and manipulative therapy for cervicogenic headache. Spine, 27 17: 1835-1843.


Author Jull, Gwendolen
Trott, Patricia
Potter, Helen
Zito, Guy
Niere, Ken
Shirley, Debra
Emberson, Jonathan
Marschner, Ian
Richardson, Carolyn
Title A randomised control trial of exercise and manipulative therapy for cervicogenic headache
Journal name Spine   Check publisher's open access policy
Publication date 2002-09-15
Sub-type Article
DOI 10.1097/00007632-200209010-00004
Volume number 27
Issue number 17
ISSN 0362-2436
Start page 1835
End page 1843
Total pages 9
Editor James N. Weinstein
Place of publication London, England
Publisher Lippincott Williams & Wilkins
Language eng
Subject 321024 Rehabilitation and Therapy - Occupational and Physical
321028 Rheumatology and Arthritis
321017 Orthopaedics
Abstract Study Design. A multicenter, randomized controlled trial with unblinded treatment and blinded outcome assessment was conducted. The treatment period was 6 weeks with follow-up assessment after treatment, then at 3, 6, and 12 months. Objectives. To determine the effectiveness of manipulative therapy and a low-load exercise program for cervicogenic headache when used alone and in combination, as compared with a control group. Summary of Background Data. Headaches arising from cervical musculoskeletal disorders are common. Conservative therapies are recommended as the first treatment of choice. Evidence for the effectiveness of manipulative therapy is inconclusive and available only for the short term. There is no evidence for exercise, and no study has investigated the effect of combined therapies for cervicogenic headache. Methods. In this study, 200 participants who met the diagnostic criteria for cervicogenic headache were randomized into four groups: manipulative therapy group, exercise therapy group, combined therapy group, and a control group. The primary outcome was a change in headache frequency. Other outcomes included changes in headache intensity and duration, the Northwick Park Neck Pain Index, medication intake, and patient satisfaction. Physical outcomes included pain on neck movement, upper cervical joint tenderness, a craniocervical flexion muscle test, and a photographic measure of posture. Results. There were no differences in headache-related and demographic characteristics between the groups at baseline. The loss to follow-up evaluation was 3.5%. At the 12-month follow-up assessment, both manipulative therapy and specific exercise had significantly reduced headache frequency and intensity, and the neck pain and effects were maintained (P < 0.05 for all). The combined therapies was not significantly superior to either therapy alone, but 10% more patients gained relief with the combination. Effect sizes were at least moderate and clinically relevant. Conclusion. Manipulative therapy and exercise can reduce the symptoms of cervicogenic headache, and the effects are maintained.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

 
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