A randomized controlled trial (RCT) with a pre-test and post-test design will be conducted to compare the therapeutic effectiveness of Dry Needling (DN), Acupressure Therapy (AT), and their combination (DN + AT) against a control group receiving Hot Pack Therapy in patients diagnosed with Cervicogenic Headache (CH). This study follows the CONSORT (Consolidated Standards of Reporting Trials) guidelines to ensure methodological transparency and rigor. The trial design includes: * Randomization: Participants will be randomly assigned into four study groups. * Blinding: A single-blind approach will be used, where participants are unaware of their group allocation, while the researchers administering the intervention will be aware. * Follow-up Period: Pre-assessment at baseline, post-intervention assessment, and 2-week follow-up. * Data Analysis: Standardized assessment tools will be used to evaluate the effectiveness of each intervention.
Study Duration Total Duration: 1 year Intervention Period: 2 weeks Follow-Up: Pre-test, post-test, and 2-week follow-up Intervention Procedures 1. Group A (Dry Needling Therapy - DN) * 06 sessions over 2 weeks * Needling sites: Myofascial trigger points in cervical muscles * Session duration: 20-30 minutes * Post-treatment: Cryotherapy (5 minutes) 2. Group B (Acupressure Therapy - AT) * 06 sessions over 2 weeks * Pressure applied to cervical acupressure points * Post-treatment: Cryotherapy (10 minutes) 3. Group C (Combined Therapy - DN + AT) * 06 sessions over 2 weeks * Both DN and AT applied in sequence * Post-treatment: Cryotherapy (10-15 minutes) 4. Group D (Control - Hot Pack Therapy) * 06 sessions over 2 weeks * 15-minute heat therapy per session * No active intervention
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
80
Myofacial trigger point dry needling used to treat taught bands superficial or deep inside of muscles .
Acupressure therapy based on traditional Chinese principles
combination of dry needling and acupressure therapy on cervical trigger points
Hot fermentation will be applied on cervical pain area
NHC(Doctors plaza physical therapy and Rehabilitation Centre)
Karachi, Sindh, Pakistan
Pain intensity (Numeric Pain Rating Scale, NPRS)
Pain intensity (Numeric Pain Rating Scale, NPRS) that is comprises over no's from 0 to 10 . 0 consider as no pain while 10 considered as worst pain.
Time frame: 04 weeks
secondary out come measures
Cervical range of motion
Time frame: A pre-test/post-test design with assessments at baseline and after two weeks of intervention. after 02 weeks intervention Week 3, and Week 4 for follow up total 02 weeks intervention and 02 weeks for followup
functional status
functional status by (Patient-Specific Functional Scale, PSFS).
Time frame: A pre-test/post-test design with assessments at baseline and after two weeks of intervention. after 02 weeks intervention Week 3, and Week 4 for follow up total 02 weeks intervention and 02 weeks for followup
Quality of life of patients with cervicogenic headache
impact on human Quality of life of patients with cervicogenic headache will be measured by using Headache Impact Test
Time frame: A pre-test/post-test design with assessments at baseline and after two weeks of intervention. after 02 weeks intervention Week 3, and Week 4 for follow up total 02 weeks intervention and 02 weeks for followup
Psycho-social characteristics
Psycho-social characteristics by (Depression, Anxiety, and Stress Scale-21, DASS-21
Time frame: A pre-test/post-test design with assessments at baseline and after two weeks of intervention. after 02 weeks intervention Week 3, and Week 4 for follow up total 02 weeks intervention and 02 weeks for followup
Sleep quality
Sleep quality by Pittsburgh Sleep Quality Index (PSQI
Time frame: A pre-test/post-test design with assessments at baseline and after two weeks of intervention. after 02 weeks intervention Week 3, and Week 4 for follow up total 02 weeks intervention and 02 weeks for followup
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