This study aims to investigate the effect of specific exercise programs on individuals suffering from cervicogenic headaches, a type of headache originating from neck problems. While traditional physiotherapy is the standard approach, this research examines whether the addition of specific "fascia-focused" exercises or "breathing exercises" provides improved relief. Fascia is a thin, protective membrane layer surrounding every muscle and organ in the body. In this study, participants will be divided into three groups. All participants will receive standard neck exercises and posture training. One group will perform dynamic exercises targeting the body's connective tissue (fascia) to improve flexibility and coordination. Another group will practice specific breathing techniques to help reduce muscle tension and stress-related triggers. The exercises will be administered to participants for 8 weeks. It is expected that fascia exercises and breathing exercises will have positive effects on headaches as a result of the applied treatments.
This study is designed as a prospective, three-arm, randomized controlled trial to evaluate the effectiveness of different exercise-based interventions in individuals with Cervicogenic Headache (CGH). CGH is a secondary headache resulting from dysfunction of the cervical spine and related structures, typically characterized by neck pain and restricted cervical mobility. Participants diagnosed with CGH according to the International Classification of Headache Disorders (ICHD-3) criteria will be recruited from a physical medicine and rehabilitation clinical setting. Following informed consent, eligible participants will be randomly allocated to one of the three study arms. All participants will receive a standardized physiotherapy program comprising patient education and therapeutic exercises targeting cervical function. In addition to the baseline protocol, the intervention groups will receive either thoracolumbar fascia-activating exercises or specific breathing exercises. The primary outcome measure is the Headache Impact Test-6 (HIT-6). Additionally, pain intensity, functional status, quality of life, and psychological status will be assessed using validated clinical instruments.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
72
The exercise program will consist of mobility, activation, and stabilization exercises targeting the thoracolumbar fascia. The intervention is designed to improve fascial mobility, enhance force transmission, and optimize neuromuscular coordination of the trunk. Exercises will be performed under supervision, consisting of three sessions per week for eight weeks.
The breathing exercise program will consist of techniques focusing on diaphragmatic breathing and respiratory control. This intervention aims to improve breathing patterns, enhance respiratory efficiency, and reduce accessory muscle overactivity. Exercises will be performed under supervision, consisting of three sessions per week for eight weeks.
Participants in this group will receive conventional physiotherapy treatment, including postural education, cervical range of motion exercises, stretching, and strengthening exercises targeting the cervical and surrounding musculature.Exercises will be performed under supervision, consisting of three sessions per week for eight weeks.Participants will be followed for outcome assessments at baseline, post-intervention, and follow-up.
Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital
Istanbul, Istanbul, Turkey (Türkiye)
Change in Headache Impact Test (HIT-6) score from baseline to 8 weeks (post-intervention)
The Headache Impact Test (HIT-6) is a validated 6-item questionnaire used to assess the impact of headache on daily life. Scores range from 36 to 78, with higher scores indicating greater headache-related disability.
Time frame: Baseline, 8 weeks (post-intervention)
Change in headache frequency recorded by headache diary from baseline to 8 weeks (post-intervention) and 12 weeks (follow-up)
Headache frequency will be assessed using a headache diary and recorded as the number of headache days per week based on participant-reported entries.
Time frame: Baseline, 8 weeks (post-intervention), and 12 weeks (follow-up)
Change in pain intensity measured by the Visual Analog Scale (VAS) from baseline to 8 weeks (post-intervention) and 12 weeks (follow-up)
The Visual Analog Scale (VAS) is a validated tool used to assess pain intensity. It consists of a 10 cm scale ranging from "no pain" to "worst imaginable pain," with higher scores indicating greater pain intensity.
Time frame: Baseline, 8 weeks (post-intervention), and 12 weeks (follow-up)
Change in neck-related disability measured by the Neck Disability Index (NDI) from baseline to 8 weeks (post-intervention) and 12 weeks (follow-up)
The Neck Disability Index (NDI) is a validated 10-item questionnaire used to assess neck-related disability and functional limitations. Higher scores indicate greater disability.
Time frame: Baseline, 8 weeks (post-intervention), and 12 weeks (follow-up)
Change in quality of life measured by the WHOQOL-BREF from baseline to 8 weeks (post-intervention) and 12 weeks (follow-up)
The WHOQOL-BREF is a validated questionnaire developed by the World Health Organization to assess quality of life across four domains: physical health, psychological health, social relationships, and environment. It consists of 26 items, with higher scores indicating better quality of life.
Time frame: Baseline, 8 weeks (post-intervention), and 12 weeks (follow-up)
Change in Headache Impact Test (HIT-6) score from baseline to 12 weeks (follow-up)
The Headache Impact Test (HIT-6) is a validated 6-item questionnaire used to assess the impact of headache on daily life. Scores range from 36 to 78, with higher scores indicating greater headache-related disability.
Time frame: Baseline, 12 weeks (follow-up)
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