Thoracic spine thrust manipulation for individuals with cervicogenic headache: a crossover randomized clinical trial. (4th March 2022)

• Record Type: Journal Article
• Authors: McDevitt, Amy W.; Cleland, Joshua A.; Rhon, Daniel I.; Altic, Rebecca A.K.; Courtney, Drew J.; Glynn, Paul E.; Mintken, Paul E.
• Is Part Of: Journal of manual & manipulative therapy. Volume 30:Number 2(2022)
• Page Start: 78
• Page End: 95
• Publication Date: 2022-03-04
• Subjects: Headache -- cervicogenic -- thoracic manipulation; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; 615.82
• DOI: 10.1080/10669817.2021.1947663
• Languages: English
• ISSNs: 1066-9817

Abstract

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.