Amy W McDevitt1, Joshua A Cleland2, Daniel I Rhon3, Rebecca A K Altic4, Drew J Courtney5, Paul E Glynn6, Paul E Mintken1. 1. Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 2. Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA. 3. Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas, USA. 4. CU Sports Physical Therapy and Rehabilitation, University of Colorado Health, Denver, Colorado, USA. 5. DBS Fitness San Diego Physical Therapy, San Diego, California, USA. 6. Glynn Physical Therapy, Lexington, Massachusetts, USA.
Abstract
OBJECTIVE: To determine if thoracic spine manipulation (TSM) improves pain and disability in individuals with cervicogenic headache (CeH). METHODS: A randomized controlled crossover trial was conducted on 48 participants (mean age: 34.4 years) with CeH symptoms. Participants were randomized to 6 sessions of TSM or no treatment (Hold) and after 4-weeks, groups crossed over. Outcomes were collected at 4, 8 and 12 weeks and included: headache disability inventory (HDI), neck disability index (NDI), and the global rating of change (GRC). Outcomes were analyzed using a linear mixed-effects model with Bonferroni correction. Odds of achieving the minimal clinically important difference (MCID) on the GRC of +4 or greater were also calculated. Scores at 4 weeks represent the only timepoint where 1 group is fully treated and other group has not received any treatment. RESULTS: Comparing hold to active treatment, HDI were not significantly different between groups (mean difference = 7.39, 95 CI: -4.39 to 19.18; P = 0.214) at any timepoint; the NDI was significant (mean difference = 6.90, 95 CI: 0.05 to 13.75; P = 0.048) at 4 weeks. Odds of achieving the +4 MCID on the GRC (OR = 38.0, 95 CI: 6.6 to 220.0; p < 0.001) favored TSM at 4 weeks. CONCLUSION: TSM had no effect on headache-related disability but resulted in significant improvements in neck-related disability and participant reported perceived improvement. Future studies are needed to examine the long-term impact of TSM in this population.
OBJECTIVE: To determine if thoracic spine manipulation (TSM) improves pain and disability in individuals with cervicogenic headache (CeH). METHODS: A randomized controlled crossover trial was conducted on 48 participants (mean age: 34.4 years) with CeH symptoms. Participants were randomized to 6 sessions of TSM or no treatment (Hold) and after 4-weeks, groups crossed over. Outcomes were collected at 4, 8 and 12 weeks and included: headache disability inventory (HDI), neck disability index (NDI), and the global rating of change (GRC). Outcomes were analyzed using a linear mixed-effects model with Bonferroni correction. Odds of achieving the minimal clinically important difference (MCID) on the GRC of +4 or greater were also calculated. Scores at 4 weeks represent the only timepoint where 1 group is fully treated and other group has not received any treatment. RESULTS: Comparing hold to active treatment, HDI were not significantly different between groups (mean difference = 7.39, 95 CI: -4.39 to 19.18; P = 0.214) at any timepoint; the NDI was significant (mean difference = 6.90, 95 CI: 0.05 to 13.75; P = 0.048) at 4 weeks. Odds of achieving the +4 MCID on the GRC (OR = 38.0, 95 CI: 6.6 to 220.0; p < 0.001) favored TSM at 4 weeks. CONCLUSION: TSM had no effect on headache-related disability but resulted in significant improvements in neck-related disability and participant reported perceived improvement. Future studies are needed to examine the long-term impact of TSM in this population.
Authors: Joshua A Cleland; Paul E Mintken; Kristin Carpenter; Julie M Fritz; Paul Glynn; Julie Whitman; John D Childs Journal: Phys Ther Date: 2010-07-15
Authors: Matthew Jordan Deal; Bradley P Richey; Cyrus Anthony Pumilia; Ibrahim Mamdouh Zeini; Charles Wolf; Todd Furman; Daryl Christopher Osbahr Journal: Am J Sports Med Date: 2020-04-16 Impact factor: 6.202