Clinical Research Directory

Baseline Cervical Joint Position Error and Headache Intensity

Cervicogenic headache is a type of headache associated with problems or dysfunction in the neck. People with cervicogenic headache may experience headache pain along with neck pain, reduced neck movement, and difficulties with normal neck function. Cervical joint position error (JPE) is a measure of how accurately a person can return their head to its starting position after moving the neck. A greater JPE may indicate reduced accuracy of neck position sense. The purpose of this retrospective study is to determine whether the amount of cervical JPE measured before physiotherapy is associated with headache intensity at the completion of physiotherapy in adults clinically classified with cervicogenic headache. The study will also examine whether baseline cervical JPE is associated with achieving a meaningful reduction in headache intensity. The study will use existing clinical records of adults aged 18 to 65 years who were clinically classified with cervicogenic headache and received routine physiotherapy at a university teaching hospital. Records from January 2023 to December 2025 will be reviewed. Participants must have had cervical JPE and headache intensity recorded before physiotherapy and must have completed at least four physiotherapy sessions with a treatment-completion assessment. Cervical JPE will be assessed from the recorded baseline measurements obtained using a CROM (Cervical Range of Motion) device. Headache intensity will be assessed using the Numeric Pain Rating Scale (NPRS), where 0 represents no pain and 10 represents the worst imaginable pain. The primary outcome will be headache intensity recorded at the treatment-completion assessment. The study will compare baseline cervical JPE with treatment-completion headache intensity while taking into account other relevant factors, including baseline headache intensity, neck disability, age, and sex. The study will also examine whether participants achieved a reduction of at least 2 points on the NPRS during the observed treatment period. As this is a retrospective observational study, the researchers will not assign or change participants' treatment. The study will use information already available in clinical records and will not require participants to receive additional treatment or undergo additional assessments. The study is intended to determine whether baseline cervical JPE may be associated with subsequent headache outcomes and whether it may be useful as a potential prognostic factor. It will not determine whether cervical JPE causes headache or whether JPE should be used to select a particular physiotherapy treatment. The findings may help guide future research on factors that are associated with treatment outcomes in people with cervicogenic headache. Further prospective studies may be needed to determine whether cervical JPE has useful prognostic value at the individual patient level.

Comparison of Myofascial Release and Mulligan Concept Techniques in Patients With Cervicogenic Headache

The International Headache Society classifies cervicogenic headache as a secondary headache caused by a disorder of the cervical spine and its components. Mulligan Concept (SNAG) is a gentle manual therapy that can be applied to the neck area. The myofascial release technique is also a massage-type manual therapy technique that is widely used in physiotherapy to relieve pain and tension in the relevant muscle group. This clinical trial aims to investigate the effectiveness of the Mulligan Concept and myofascial release technique in patients with cervicogenic headaches. The main questions it aims to answer are: 1. Does the Mulligan Concept improve hand grip strength, pressure pain threshold, range of motion, pain frequency, pain intensity, pain duration, number of medications used, daily living activities, and disability in patients with cervicogenic headache? 2. Does myofascial release technique improve hand grip strength, pressure pain threshold, range of motion, pain frequency, pain intensity, pain duration, number of medications used, daily living activities, and disability in patients with cervicogenic headache? Researchers will compare the Mulligan Concept to a myofascial release technique to see which physiotherapy method has more significant results in treating cervicogenic headaches. Participants will: * Undergo the evaluations mentioned above before and after interventions * Undergo Mulligan Concept applications or the myofascial release technique 3 times a week for 4 weeks * Keep a diary of their symptoms and the number of times they use a drug