Thoracic spine thrust manipulation for individuals with cervicogenic headache: a crossover randomized clinical trial.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • McDevitt, AW; Cleland, JA; Rhon, DI; Altic, RAK; Courtney, DJ; Glynn, PE; Mintken, PE

Published Date

  • April 2022

Published In

Volume / Issue

  • 30 / 2

Start / End Page

  • 78 - 95

PubMed ID

  • 34269160

Pubmed Central ID

  • PMC8967200

Electronic International Standard Serial Number (EISSN)

  • 2042-6186

Digital Object Identifier (DOI)

  • 10.1080/10669817.2021.1947663


  • eng

Conference Location

  • England