An Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled Trial

Abstract Introduction There is a multitude of evidence supporting the use of manual and manipulative therapy techniques for patients with cervicogenic headache (CGH). However, evidence in finding and comparing the efficacy of instrument assisted soft tissue mobilization with manual therapy in unilat...

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Main Authors: Gopal Nambi, Mshari Alghadier, Humaira Khanam, Shahul Hameed Pakkir Mohamed, Osama R. Aldhafian, Naif A. Alshahrani, Paramasivan Mani, Mohamed Faisal Chevidikunnan, Fayaz Khan, Alaa Jameel A. Albarakati
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Language:English
Published: Adis, Springer Healthcare 2024-10-01
Series:Pain and Therapy
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Online Access:https://doi.org/10.1007/s40122-024-00671-w
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author Gopal Nambi
Mshari Alghadier
Humaira Khanam
Shahul Hameed Pakkir Mohamed
Osama R. Aldhafian
Naif A. Alshahrani
Paramasivan Mani
Mohamed Faisal Chevidikunnan
Fayaz Khan
Alaa Jameel A. Albarakati
author_facet Gopal Nambi
Mshari Alghadier
Humaira Khanam
Shahul Hameed Pakkir Mohamed
Osama R. Aldhafian
Naif A. Alshahrani
Paramasivan Mani
Mohamed Faisal Chevidikunnan
Fayaz Khan
Alaa Jameel A. Albarakati
author_sort Gopal Nambi
collection DOAJ
description Abstract Introduction There is a multitude of evidence supporting the use of manual and manipulative therapy techniques for patients with cervicogenic headache (CGH). However, evidence in finding and comparing the efficacy of instrument assisted soft tissue mobilization with manual therapy in unilateral cervicogenic headache is lacking. Therefore, the objective of the study is to find and compare the long term effects of instrument assisted soft tissue mobilization along with spinal manipulation therapy in patients with cervicogenic headache. Methods It is a randomized, single-blinded controlled study conducted at University hospital. Overall, 64 participants with CGH were divided into spinal manipulation therapy group (SMT; n = 32) and spinal manipulation therapy with instrument assisted soft tissue mobilization (ISM) group (SMT + ISM; n = 32) and they received the respective treatment for 4 weeks. In addition, both groups received 10 min of heat therapy and neck isometric exercises three times a day. The primary (CGH frequency) and secondary (CGH pain intensity, CGH disability neck pain frequency, pain intensity, pain threshold, neck disability index and quality of life) scores were measured at baseline, after 4 weeks, and at 6 months. Results The reports of the SMT and SMT + ISM group were compared. Following 4 weeks of training, and at 6 months follow up the SMT + ISM group showed more significant changes in the primary outcome (CGH frequency) with a −4.3 [(95% confidence interval (CI) −4.80 to −3.79] and −1.7 (95% CI −1.92 to −1.47), when compared with the SMT group alone (p = 0.001). The secondary outcomes (CGH pain intensity, CGH disability, neck pain frequency, neck pain intensity, neck disability index, and quality of life) also shows more significant changes in the SMT + ISM group than the SMT group (p = 0.001). The same gradual improvement can be seen in the above variables at 6 months follow up. At the same time, neck pain threshold level does not show any improvement at 4 weeks (p ≥ 0.05) but shows a statistical difference at 6 months follow up. No such adverse effects or consequences were noted during or after the intervention. Conclusions The study concluded that spinal manipulation therapy with instrument assisted soft tissue mobilization provided better long-term outcomes in patients with cervicogenic headache. This study provided a piece of sound physical therapy evidence for a widespread and costly clinical condition, such as cervicogenic headache. Clinical Trial Registration The trial was registered prospectively in the Indian clinical trial registry with CTRI/2020/06/026243 on 30/06/2020.
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spelling doaj-art-a69aa07fb5a241ff914c0643409db8f12025-08-20T02:49:56ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2024-10-011361679169310.1007/s40122-024-00671-wAn Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled TrialGopal Nambi0Mshari Alghadier1Humaira Khanam2Shahul Hameed Pakkir Mohamed3Osama R. Aldhafian4Naif A. Alshahrani5Paramasivan Mani6Mohamed Faisal Chevidikunnan7Fayaz Khan8Alaa Jameel A. Albarakati9Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz UniversityDepartment of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz UniversityDepartment of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz UniversityDepartment of Physical Therapy, Faculty of Applied Medical Sciences, University of TabukDepartment of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz UniversityOrthopedic Surgery Department, King Fahad Medical City, Ministry of HealthDepartment of Rehabilitation Sciences, King Saud bin Abdulaziz, University of Health SciencesDepartment of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz UniversityDepartment of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz UniversityDepartment of Surgery, College of Medicine, Umm Al-Qura UniversityAbstract Introduction There is a multitude of evidence supporting the use of manual and manipulative therapy techniques for patients with cervicogenic headache (CGH). However, evidence in finding and comparing the efficacy of instrument assisted soft tissue mobilization with manual therapy in unilateral cervicogenic headache is lacking. Therefore, the objective of the study is to find and compare the long term effects of instrument assisted soft tissue mobilization along with spinal manipulation therapy in patients with cervicogenic headache. Methods It is a randomized, single-blinded controlled study conducted at University hospital. Overall, 64 participants with CGH were divided into spinal manipulation therapy group (SMT; n = 32) and spinal manipulation therapy with instrument assisted soft tissue mobilization (ISM) group (SMT + ISM; n = 32) and they received the respective treatment for 4 weeks. In addition, both groups received 10 min of heat therapy and neck isometric exercises three times a day. The primary (CGH frequency) and secondary (CGH pain intensity, CGH disability neck pain frequency, pain intensity, pain threshold, neck disability index and quality of life) scores were measured at baseline, after 4 weeks, and at 6 months. Results The reports of the SMT and SMT + ISM group were compared. Following 4 weeks of training, and at 6 months follow up the SMT + ISM group showed more significant changes in the primary outcome (CGH frequency) with a −4.3 [(95% confidence interval (CI) −4.80 to −3.79] and −1.7 (95% CI −1.92 to −1.47), when compared with the SMT group alone (p = 0.001). The secondary outcomes (CGH pain intensity, CGH disability, neck pain frequency, neck pain intensity, neck disability index, and quality of life) also shows more significant changes in the SMT + ISM group than the SMT group (p = 0.001). The same gradual improvement can be seen in the above variables at 6 months follow up. At the same time, neck pain threshold level does not show any improvement at 4 weeks (p ≥ 0.05) but shows a statistical difference at 6 months follow up. No such adverse effects or consequences were noted during or after the intervention. Conclusions The study concluded that spinal manipulation therapy with instrument assisted soft tissue mobilization provided better long-term outcomes in patients with cervicogenic headache. This study provided a piece of sound physical therapy evidence for a widespread and costly clinical condition, such as cervicogenic headache. Clinical Trial Registration The trial was registered prospectively in the Indian clinical trial registry with CTRI/2020/06/026243 on 30/06/2020.https://doi.org/10.1007/s40122-024-00671-wCervicogenic headacheSpinal manipulationInstrument assisted soft tissue mobilization
spellingShingle Gopal Nambi
Mshari Alghadier
Humaira Khanam
Shahul Hameed Pakkir Mohamed
Osama R. Aldhafian
Naif A. Alshahrani
Paramasivan Mani
Mohamed Faisal Chevidikunnan
Fayaz Khan
Alaa Jameel A. Albarakati
An Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled Trial
Pain and Therapy
Cervicogenic headache
Spinal manipulation
Instrument assisted soft tissue mobilization
title An Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled Trial
title_full An Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled Trial
title_fullStr An Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled Trial
title_full_unstemmed An Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled Trial
title_short An Additive Effect of Instrument-Assisted Soft Tissue Mobilization with Spinal Manipulation in Cervicogenic Headache: a Randomized Controlled Trial
title_sort additive effect of instrument assisted soft tissue mobilization with spinal manipulation in cervicogenic headache a randomized controlled trial
topic Cervicogenic headache
Spinal manipulation
Instrument assisted soft tissue mobilization
url https://doi.org/10.1007/s40122-024-00671-w
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