The purpose of the current study is investigating the effect of integrated neuromuscular inhibition technique on adult females with cervicogenic headache. Methods: Forty females with cervicogenic headache will be recruited. Patients will be randomly assigned into two groups, group A and group B . Patients in both groups will receive a traditional medical treatment, but group (B) will receive additional integrated neuromuscular inhibition technique.
Measurements will be taken for all participants before the start of treatment program then after the end of 4 weeks treatment program, then after another 4 weeks of follow up.all patients will be evaluated for headache pain intensity, cervicogenic headache frequency, cervicogenic headache duration, cervical range of motion in all directions, the isometric endurance capacity of sternocledomastoid and anterior scalene, kinesiophobia, neck disability, and headache impact test-6. All patients will receive a traditional medical program by an experienced neurologist in the form of Muscle relaxants tizanidine ,4 mg to 32 mg, Three times a day. Patients in experimental group (B) will receive the same program as control group (A) plus the INIT for upper trapezius and suboccipital muscles. The INIT program will be administrated three times a week for one month.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
40
All patients will receive a traditional medical program by an experienced neurologist in the form of Muscle relaxants tizanidine ,4 mg to 32 mg, Three times a day for one month .
Patients in experimental group (B) will receive the same program as control group (A) plus the INIT for upper trapezius and suboccipital muscles. The INIT program will be administrated three times a week for one month .
Khalid enb elwaleed polyclinic
Tanta, Algharbia, Egypt
headache pain intensity
headache pain intensity measured by 11-Numerical rating scale. Primary outcome updated to headache intensity to better reflect the study objective.
Time frame: Baseline, 4 weeks and 8 weeks .
kinesiophobia
kinesiophobia will be measured by Arabic Tampa scale
Time frame: Baseline, 4 weeks and 8 weeks .
Isometric endurance capacity of sternocledomastoid and anterior scalene
The isometric endurance capacity of the sternocleidomastoid and anterior scalene will be assessed using an isometric test.
Time frame: Baseline, 4 weeks and 8 weeks .
the impact of headaches on patients' lives
the impact of headaches on patients' lives measured by Arabic headache impact test-6.
Time frame: Baseline, 4 weeks and 8 weeks .
neck disability
the neck disability will be measured by Arabic neck disability index
Time frame: Baseline, 4 weeks and 8 weeks .
headache frequency
Cervicogenic headache frequency, which is a self-administered outcome variable, will be identified by asking patients to enter their CGH pain experience in a medical logbook every evening to find the number of painful days in the last week, ranging from 0 to 7 days.
Time frame: Baseline, 4 weeks and 8 weeks
headache duration
Headache duration will be measured as the total hours of headache in the last week.
Time frame: Baseline, 4 weeks and 8 weeks .
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cervical ROM in all directions
Cervical right and left lateral flexion, extension, and flexion ROM will be measured using the iPhone clinometer application, whereas cervical right and left rotation ROM will be measured using the iPhone compass application.
Time frame: Baseline, 4 weeks and 8 weeks .