Evidence map›Paper›PMID 26852024›Full record

Trial reportBMC musculoskeletal disorders2016

Upper cervical and upper thoracic manipulation versus mobilization and exercise in patients with cervicogenic headache: a multi-center randomized clinical trial.

James R Dunning, Raymond Butts, Firas Mourad, Ian Young, Cesar Fernandez-de-Las Peñas, Marshall Hagins, Thomas Stanislawski, Jonathan Donley, Dustin Buck, Todd R Hooks and 1 more

11 registry-linked trialsOpen access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC musculoskeletal disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 11 registered trials, which are not on this map. Cited by 40 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 3 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01580280 nacompletednot on this map

Effect of Upper Cervical and Upper Thoracic Thrust Manipulation Versus Mobilization and Exercise in Patients With Cervicogenic Headache

TypeinterventionalSponsorAlabama Physical Therapy & AcupunctureRan2012 to 2014Enrolled112ConditionsCervicogenic HeadacheArmsThrust Manipulation, Non-thrust Mobilization and Exercise
NCT03385889 nacompletednot on this mapstarted 2018, after this paper: background citation

Effects of Cervical Spine Manual Therapy on Range of Motion, Joint Position Sense, and Balance in Participants With Cervicogenic Headache

TypeinterventionalSponsorShenandoah UniversityRan2018 to 2019Enrolled35ConditionsUnilateral Headache, Musculoskeletal Neck PainArmsCervical Spine Mobilization, Cervical Spine Manipulation
NCT04054869 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Bio-mechanical Reasoning and Lateral Specificity of Upper Cervical Joint Mobilization to Improve Cervical Rotation, Improve Function and Reduce Pain.... Does it Matter?

TypeinterventionalSponsorAndrews UniversityRan2019 to 2020Enrolled15ConditionsNeck PainArmsBio-mechanically correct manual therapy at the cervical atlanto-axial joints, Bio-mechanically in-correct manual therapy at the cervical atlanto-axial joints
NCT04156308 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Effectiveness of the Osteopathic Treatment in Patients With Nonspecific Cervical Pain: Randomized Controlled Pragmatic Clinical Trial

TypeinterventionalSponsorEscola D'osteopatia De BarcelonaRan2019 to 2020Enrolled132ConditionsManual Therapies, Neck PainArmsOsteopathic Manipulative Treatment (OMT) - Temp1, Combined Exercises
NCT04242290 completednot on this mapstarted 2019, after this paper: background citation

Is it Possible to Distinguish Cervicogenic Headache From Neck Pain With Cervicospinal Posture?: A Single-blind, Prospective Cross-sectional Trial

Typeobservational_patient_registrySponsorHitit UniversityRan2019 to 2019Enrolled90ConditionsCervicogenic Headache, Neck PainArmsLateral radiography
NCT04777890 nacompletednot on this mapstarted 2021, after this paper: background citation

Effects of Instrumental, Manipulative and Soft Tissue Approaches for the Suboccipital Region in Subjects With Chronic Mechanical Neck Pain. A Randomized Controlled Trial

TypeinterventionalSponsorJuan José Arjona RetamalRan2021 to 2021Enrolled100ConditionsChronic Mechanical Neck PainArmssuboccipital inhibition, INYBI, INYBI + upper cervical manipulation
NCT04993950 nacompletednot on this mapstarted 2022, after this paper: background citation

Effects of Sustained Natural Apophyseal Glides Along With Thoracic Postural Correction Techniques in Patients With Chronic Cervicogenic Headache

TypeinterventionalSponsorRiphah International UniversityRan2022 to 2022Enrolled38ConditionsCervicogenic HeadacheArmssustained natural apophyseal glides, SNAGS with thoracic postural correction techniques
NCT05582616 nacompletednot on this mapstarted 2022, after this paper: background citation

The Safety and Feasibility of Transcranial Direct Current Stimulation Combined With Conservative Treatment for Cervicogenic Headaches

TypeinterventionalSponsorUniversity of CalgaryRan2022 to 2024Enrolled32ConditionsCervicogenic HeadacheArmsTranscranial Direct Current Stimulation, Sham Transcranial Direct Current Stimulation
NCT05849545 nacompletednot on this mapstarted 2021, after this paper: background citation

Comparing the Effects of the Graston Tool and Neuromuscular Reeducation in Reducing Cervical Headache.

TypeinterventionalSponsorHealth Education Research Foundation (HERF)Ran2021 to 2021Enrolled30ConditionsCervicogenic HeadacheArmsGarston tool, Neuromuscular Re-education
NCT06452628 naunknown statusnot on this mapstarted 2024, after this paper: background citation

Effects of Mulligan Mobilizations Versus Active Release Technique on Pain, Range of Motion and Disability in Patients With Tension-Type Headache.

TypeinterventionalSponsorRiphah International UniversityRan2024 to 2024Enrolled33ConditionsTension-Type HeadacheArmsMulligan mobilizations, Active Release Technique, Mulligan mobilizations with active release technique
NCT07617051 nacompletednot on this mapstarted 2022, after this paper: background citation

The Effectiveness of Passive Physiological Intervertebral Movements in Patients With Cervicogenic Headache: A Randomized Clinical Trial

TypeinterventionalSponsorJordan University of Science and TechnologyRan2022 to 2025Enrolled64ConditionsCervicogenic HeadacheArmsPassive Physiological Intervertebral Movements, Therapeutic Exercise
3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 3 syntheses or guidelines pooled it, 128 citations in OpenAlex.

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  20. Headache Characteristics in Chronic Neck Pain Patients with Loss of Cervical Lordosis: A Cross-Sectional Study Considering Cervicogenic Headache.Medical science monitor : international medical journal of experimental and clinical research · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 2 countries.

James R DunningAlabama Physical Therapy & Acupuncture, Montgomery, AL, USA. jamesdunning@hotmail.com.
Raymond ButtsResearch Physical Therapy Specialists, Columbia, SC, USA. buttsraymond@yahoo.com.
Firas MouradUniversidad Rey Juan Carlos, Alcorcón, Spain. firas.mourad@me.com.
Ian YoungSpine and Sport, Savannah, GA, USA. youngian@spinesport.org.
Cesar Fernandez-de-Las PeñasDepartment of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain. cesarfdlp@yahoo.es.
Marshall HaginsDepartment of Physical Therapy, Long Island University, Brooklyn, NY, USA. marshall.hagins@liu.edu.
Thomas StanislawskiBack to Health, Brooklyn, NY, USA. thomas.stanislawski@gmail.com.
Jonathan DonleyResearch Physical Therapy Specialists, Columbia, SC, USA. jonathan.donley@palmettohealth.org.
Dustin BuckCutting Edge Orthopedics, Gilbert, AZ, USA. dustinbuck@hotmail.com.
Todd R HooksChampion Sports Medicine, Birmingham, AL, USA. trhooks@hotmail.com.
Joshua A ClelandDepartment of Physical Therapy, Franklin Pierce University, Manchester, NH, USA. joshcleland@comcast.net.
American Physical Therapy Association · USUniversidad Rey Juan Carlos · ESAmerican Sports Medicine Institute · USCenter for Brooklyn History · USFranklin Pierce University · USLong Island University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough commonly utilized interventions, no studies have directly compared the effectiveness of cervical and thoracic manipulation to mobilization and exercise in individuals with cervicogenic headache (CH). The purpose of this study was to compare the effects of manipulation to mobilization and exercise in individuals with CH.

methodsOne hundred and ten participants (n = 110) with CH were randomized to receive both cervical and thoracic manipulation (n = 58) or mobilization and exercise (n = 52). The primary outcome was headache intensity as measured by the Numeric Pain Rating Scale (NPRS). Secondary outcomes included headache frequency, headache duration, disability as measured by the Neck Disability Index (NDI), medication intake, and the Global Rating of Change (GRC). The treatment period was 4 weeks with follow-up assessment at 1 week, 4 weeks, and 3 months after initial treatment session. The primary aim was examined with a 2-way mixed-model analysis of variance (ANOVA), with treatment group (manipulation versus mobilization and exercise) as the between subjects variable and time (baseline, 1 week, 4 weeks and 3 months) as the within subjects variable.

resultsThe 2X4 ANOVA demonstrated that individuals with CH who received both cervical and thoracic manipulation experienced significantly greater reductions in headache intensity (p < 0.001) and disability (p < 0.001) than those who received mobilization and exercise at a 3-month follow-up. Individuals in the upper cervical and upper thoracic manipulation group also experienced less frequent headaches and shorter duration of headaches at each follow-up period (p < 0.001 for all). Additionally, patient perceived improvement was significantly greater at 1 and 4-week follow-up periods in favor of the manipulation group (p < 0.001).

conclusionsSix to eight sessions of upper cervical and upper thoracic manipulation were shown to be more effective than mobilization and exercise in patients with CH, and the effects were maintained at 3 months.

trial registrationNCT01580280 April 16, 2012.

Indexed as

Cervical VertebraeThoracic VertebraeAdultExercise TherapyFemaleFollow-Up StudiesHumansMaleManipulation, SpinalMiddle AgedNeck PainPost-Traumatic HeadacheTreatment Outcome

Identifiers

PMID26852024
PMCPMC4744384
OpenAlexW2279667347

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

and 5 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.