Clinical Research Directory

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 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.

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.