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Effectiveness of spinal mobilization and postural correction exercises in the management of cervicogenic headache: a randomized controlled trial
Rani M, Kaur J
Physiotherapy Theory and Practice 2023;39(7):1391-1405
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The study aims to assess the effect of spinal mobilization and postural correction exercises in patients suffering from cervicogenic headache. METHODS: A randomized controlled trial was conducted with 72 patients. Patients were randomly allocated into three groups: spinal mobilization (n = 24), postural correction exercises (n = 24), and control group (n = 24). The primary outcome measure was Headache Impact Test-6, and secondary outcomes were headache intensity, neck pain intensity, and neck pain-related disability measured at baseline, postintervention, and follow-up period. RESULT: Comparison of baseline data (at 0 weeks) among groups showed a statistically nonsignificant difference. There was statistically significant improvement at postintervention (immediately after fourth week) in postural correction exercises group (headache disability 14.95 +/- 7.91 (p < 0.001); headache intensity 2.58 +/- 1.24 (p < 0.001); neck disability 27.66 +/- 18.71 (p < 0.001); neck pain 1.91 +/- 1.44 (p < 0.001)) and spinal mobilization group (headache disability 13.83 +/- 6.21 (p < 0.001); headache intensity 2.29 +/- 1.23 (p < 0.001); neck disability 23.39 +/- 19.51 (p < 0.001); neck pain 1.72 +/- 0.84 (p < 0.001)) as compared to the control group. The result of within-group analysis suggests that there was a statistically significant improvement in postintervention (immediately after fourth week) and follow-up (immediately after eighth week) scores as compared to baseline (at 0 weeks) scores for all outcomes in postural correction exercises (headache disability (p < 0.001), headache intensity (p < 0.001), neck disability (p < 0.001), neck pain (p < 0.001)) as well as in spinal mobilization group (headache disability (p < 0.001), headache intensity (p < 0.001), neck disability (p < 0.001), neck pain (p < 0.001 for pre versus post; p = 0.001 for pre versus follow-up)). There was a statistically nonsignificant difference between postintervention and follow-up scores of all the outcomes in the postural correction exercise and spinal mobilization group, which indicates that improvement in these groups was maintained during the follow-up period. CONCLUSION: Spinal mobilization and postural correction exercises are effective in the management of cervicogenic headache.

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