Abstract
M.Tech.
Objective. Previous studies have provided evidence of cervical manipulation as an effective treatment in the management of cervicogenic headache reduction, however there is no record of studies ascertaining the effectiveness of biomechanical pelvic blocking in such treatment. This controlled clinical trial aimed at establishing biomechanical pelvic blocking as an alternative treatment for cervicogenic headaches yielding similar results.
Methods. In this study 30 participants between the ages of 18 and 60, symptomatic of cervicogenic headaches were included in the clinical trial. These 30 participants divided in to three groups of equal size by means of random selection. Group A received cervical spine manipulation only, group B received biomechanical pelvic blocking and group C was treated by means of both cervical spine manipulation and biomechanical pelvic blocking. The design of this pilot study was such that the spinal manipulative therapy was the control between the groups, therefore allowing us to identify whether biomechanical pelvic blocking was effective in the treatment of cervicogenic headaches. The patients were treated 6 times, twice weekly over a period of three weeks.
Objective data collected on the first, third and sixth visits by means of the Saunders digital inclinometer. Cervical Range of Motion digital inclinometry measurements taken were that of forward flexion, extension and both right and lateral flexion. Subjective data collected by means of The Numerical Pain Rating Scale and Mc Gill Pain Questionnaire as well as the Neck Disability Index. The Numerical Pain Rating Scale and the Mc Gill Pain Questionnaire measured the headache pain intensity and the Neck Disability Index ascertained the degree of cervical disability as well as neck pain intensity experienced by the patients. These questionnaires were completed by the patient on the first, third and sixth consultation.
Results. In terms of the digital inclinometry assessment, statistically significant results existed although not consistently for the same group per ROM. Extension showed Group C demonstrating the greatest increase in terms of cervical extension range of motion. Statistically significant difference existed between the groups for extension ROM. Forward flexion calculated as the most improved for group C however, no statistically significant difference existed. Group A proved most effective in increasing both cervical left and right lateral flexion range of motion. The reliability of digital inclinometer in obtaining accurate measurements is questionable.
The subjective data although overall no statistically significant difference was noted between the groups for the period of the treatments, a definite clinical significance was established, group A did show the greatest overall improvement in pain intensity. Group C followed group A, the difference between these groups indicating the small relevance of the pelvic blocking. The Neck Disability Index demonstrated the greatest improvement within group C followed by group A and then group B. This marked improvement in group C in comparison to group’s A and B is suggestive of the immediate effects of cervical manipulative therapy as well as the spinal compensation due to treatment of the pelvis by the means of blocking. As this questionnaire, serves to establish the patients’ perception in terms of cervical pain and disability it indicated the biomechanical pelvic blocking to be questionably effective in the improvement in neck disability and pain.