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Published online 2016 Mar 21. doi:  10.3389/fneur.2016.00040

Table 1

Return to:   Mobilization and Manipulation of the Cervical Spine in Patients with Cervicogenic Headache:
Any Scientific Evidence?


Description of included studies.

SubjectsExperimental interventionControl or comparison interventionTime of follow-upOutcome measures
Borusiak et al. (29)N = 52; n = 26 spinal manipulative therapy (SMT), n = 26 placeboHVLA treatment session after 2-month baseline documentationLight touch of cervical spine after 2-month baseline documentation2 monthsPercentage of days with headache, duration of headache, school absence due to headache, analgesic consumption, and headache intensity

Dunning et al. (19)N = 110; n = 58 manipulation, n = 52 mobilization6–8 SMT sessions for 4 weeksMobilization (6–8 sessions) and exercise for 4 weeks1 week, 4 weeks, and 3 monthsNumeric pain rating scale, headache frequency, duration, and disability using NDI

Haas et al. (20)N = 23 completed1, 3, and 4 visits for 3 weeks – HVLAHeat and soft tissue therapy. Modification of ADL and rehab exercises12 weeksDisability scales and HA scale

Haas et al. (21)N = 80; n = 40 experimental, n = 40 controlSMT – HVLA spinal manipulation of the CS and TS; 8 or 16 treatments5 min of moist heat, 5 min of light massage; 8 or 16 treatments4, 8, 16, and 20 weeks by phone; 12 and 24 weeks via mailNeck pain and disability using the 100-point modified Von Korpf scale. Number of CEH and other HA, medications

Hall et al. (25)N = 32; n = 16 SNAG, n = 16 placeboSubjects taught C1-C2 self-SNAG mobilization using cervical strap; 2 repetitions 2× daily for 12 monthsSham mobilization with self-SNAG cervical strap; 2 repetitions 2× daily for 12 months4 weeks and 12 monthsROM (flexion rotation test), long-term self-reported headache symptoms (VAS and questionnaire)

Jull et al. (17)N = 200; n = 49, 51, and 52 experimental; n = 48 controlMT – low velocity cervical joint mobilization and high velocity manipulation techniques to the cervical spine; MT and Thera Ex combined; Thera ExThera Ex – low load endurance exercise to train muscle control of the cervicoscapular region3, 6, and 12 monthsNorthwick Park neck pain questionnaire, changes in HA frequency, intensity (VAS), and duration (average number of hours that HA lasted in the past week)
Control group – received no PT intervention

Khan et al. (23)N = 60; n = 30 SNAG, n = 30 posterior anterior vertebral mobilization (PAVM)SNAG treatment and ice on cervical spine for 6 sessions over 6 weeksPAVM treatment and ice on cervical spine for 6 sessions over 6 weeksPosttest at 6 weeksPain (VAS) and disability using NDI

Nilsson et al. (24)N = 53; n = 28 experimental, n = 25 controlLow-amplitude cervical manipulation 2×/week for 3 weeksLow-level laser in the upper cervical region and deep friction massage5 weeksChange in analgesic use per day from week 1 to week 5, HA intensity per episode, and number in HA hours/day

Shin and Lee (22)N = 40; n = 20 SNAG, n = 20 controlMulligan SNAG treatment, 20 min 3×/week for 4 weeksPlacebo (contact only); 12× in 4 weeksPre- and post-assessment; no long-term follow-upVAS for pain, NDI, and headache duration

Youssef and Shanb (26)N = 35; n = 18 mobilization, n = massageHVLA cervical spine manipulation; AROM, strengthening, endurance exercisesMassage; active range of motion (AROM), strengthening, and endurance exercisesPre- and post-assessment; no long-term follow-upHA pain, intensity, duration, NDI, and AROM
ADL, activities of daily living
AROM, active range of motion
HVLA, high velocity, low amplitude
NDI, neck disability index
SNAG, sustained natural apophyseal glide
VAS, visual analog scale
.