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Effect of Myofascial Release Technique Alone or Combined With Exercises on Cervical Cobb Angle, Sleep Quality, and Psychological Factors in Patients With Cervicogenic Headache

Sponsor: Al-Azhar University • ClinicalTrials.gov ID: NCT07168512

Registry updated: 2026-09-18

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Description

This study will investigate whether myofascial release therapy alone or in combination with therapeutic exercises can improve cervical spine alignment, measured by cervical Cobb angle on X-ray, in patients with cervicogenic headache. The research will also examine potential effects on sleep quality and psychological factors."

Interventions

Exercises (Endurance and strengthening) (Other)
Neck Strengthening and Endurance Exercises with Hot Packs Preparation: A moist hot pack will be applied for 10-15 minutes to the cervical region before exercise to reduce stiffness and enhance tissue extensibility. Exercise program: Deep cervical flexor training: Chin tucks in supine and sitting, progressing to sustained isometric holds. Extensor and scapular stabilizer training: Prone head lifts and shoulder retraction exercises with light resistance. Endurance training: Low-load, high-repetition exercises focusing on maintaining cervical posture against gravity. Progression: Intensity and duration will gradually increase, emphasizing endurance over maximal strength to correct postural deficits. Frequency: 40 minutes per session, 3 times per week for 6 weeks Rationale: The combined use of heat and targeted exercises improves neuromuscular control, enhances cervical stability, and supports better cervical curvature correction. Myofascial Release Technique
Myofascial release technique (Other)
Myofascial Release Technique Target areas: Suboccipital muscles, upper trapezius, levator scapulae, and deep cervical fascia. Method: A physiotherapist will perform gentle, sustained manual pressure and low-load, long-duration stretching on restricted cervical and upper thoracic fascia to reduce tension and improve soft tissue mobility. Duration and frequency: Each session will include 30'to 50 minutes of myofascial release, delivered 3 times per week for the study period for 6 weeks. Rationale: This technique aims to decrease myofascial restrictions contributing to abnormal cervical alignment and pain, thereby facilitating improved posture and muscle activation.

Eligibility criteria

Inclusion Criteria: * Age 20-55 years. * Clinical diagnosis of cervicogenic headache according to International Classification of Headache Disorders (ICHD-3) criteria (headache attributed to cervical disorder). Exclusion Criteria: * History of major cervical spine pathology such as fracture, dislocation, congenital malformation, tumor, infection, or inflammatory arthritis (e.g., rheumatoid arthritis, ankylosing spondylitis). * Previous cervical spine surgery or fusion at any level. * Red flag symptoms indicating serious pathology (e.g., progressive neurological deficit, unexplained weight loss, fever, history of cancer). * Systemic or neurological disorders that may affect neck function or headache (e.g., multiple sclerosis, Parkinson's disease). * Severe osteoporosis or metabolic bone disease that contraindicates cervical X-ray imaging. * Vascular disorders such as vertebrobasilar insufficiency or carotid artery disease. * Pregnancy or breastfeeding (due to radiation exposure during cervical radiography). * Unstable psychiatric conditions (e.g., severe depression, psychosis) that may interfere with participation or adherence. * Recent physiotherapy or manual therapy targeting the cervical region within the past 6 weeks, or planned during the study outside the protocol. * Use of botulinum toxin or steroid injections to the neck or head region in the past 6 months. * Contraindications to manual therapy or exercise (e.g., acute cervical disc herniation, severe myelopathy, unstable cardiovascular disease). * Inability to understand study procedures, comply with treatment sessions, or provide informed consent. * Symptoms of migraine, tension-type headache (TTH), or any other headache apart from cervicogenic headache.

Conditions

Effect of Physiotherapy on Cobb Angle in Patients With Cervicogenic Headache

Locations

Naser Medical Complex — Gaza, Gaza Strip, Palestinian Territories
Ministry of Health — Gaza, Palestinian Territories
Naser medical Complex, Al shifa hospital — Gaza, Palestinian Territories

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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