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this study will be conducted to investigate the impact of adding integrated neuromuscular inhibition technique to postural correction exercises in patients with cervicogenic headache
Cervicogenic headache (CeH) is a secondary headache attributed to dysfunctions of the cervical spine. CGH is a non-throbbing, unilateral, side locked headache that originates in the cervical spine and gradually spreads to the occipital, temporal and orbital areas. It is associated with neck pain or stiffness and is often aggravated by sustained neck postures, repeated neck movements or physical activity. INIT is effective as it causes sustained or intermittent compression which causes ischemia reduces local circulation until pressure is released, after which a flushing of fresh oxygenated blood occurs. Mechanoreceptors impulses interface with slower pain messages reducing amount of pain messges reaching the brain, releasing pain relieving hormones, decreasing myofascial pain. Stretches the taut bands of muscles fibers. INIT along with strengthening excercises proved to be beneficial in decreasing disability improving Range of motion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Integrated Neuromuscular Inhibition Technique | Experimental | Forty-five patients will receive integrated neuromuscular inhibition technique plus postural correction exercises three times a week for six weeks |
|
| Postural Correction Exercise | Active Comparator | Forty-five patients will receive postural correction exercises three times a week for six weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Integrated Neuromuscular Inhibition Technique | Other | Patients will receive integrated neuromuscular inhibition technique in the form of intermittent ischemic compression, strain counterstrain, and muscle energy technique plus postural correction exercises |
| Measure | Description | Time Frame |
|---|---|---|
| pain intensity | visual analogue scale will be used to asses pain intensity which patient will be instructed to put point on line from no pain to tolerable pain. The scale consists of a line, usually 100 mm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel . | up to six weeks |
| headache disability | The Headache spesific Disability Questionnaire was used to assess headcahe disability. it is a self-administered scale with 9 items that assesses pain intensity, work or school disruptions, and the effect on recreational activities in individuals with headache complaints. Higher scores reflect greater impairment. | up to 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| pressure pain threshold | pressure pain threshold pressure pain threshold will be assessed by commander algometer | up to 6 weeks |
| cervical range of motion | range of motion will be measured by inclinometer CROM. The CROM (deluxe version - Performance Attainment Associates, Roseville, MN, USA) measures the cervical range of motion5- for fexion, extension, lateral fexion, and rotation using separate inclinometers. These inclinometers are attached to a frame similar to that for eyeglasses one in the sagittal plane for fexion - extension, second in the frontal plane for lateral fexion and a third in the horizontal plane for rotation. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| alshaymaa abd elazeim, phd | Contact | 01033771553 | alshaymaa.shaaban@pt.cu.edu.eg |
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integrated neuromuscular inhibition technique and postural correction exercises
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| Postural Correction Exercise | Other | The exercise program will be in the form of stretching exercises for the sternocleidomastoids (SCM), the scalenes, and upper fibers of trapezius; strengthening isometric exercises for the neck flexors, extensors, lateral flexors, and neck rotators; and postural correction exercises. |
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| up to 6 weeks |
| headache frequency | the number of days the subjects feel headache (headache frequency). | up to six weeks |
| medication intake | from the patients' diary in the last week , medications intake will be recorded as follow: 1) not at all; 2) once a week; 3) once every couple of days; 4) once or twice a day; or 5) three or more times a day | up to six weeks |
| headache duration | the total hours of headache (headache duration). | up to six weeks |
| ID | Term |
|---|---|
| D051298 | Post-Traumatic Headache |
| ID | Term |
|---|---|
| D051271 | Headache Disorders, Secondary |
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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