Efficacy of lumbar motor control training in treatment of patients with cervicogenic headache

Abstract

BackgroundCervicogenic headache (CGH), is a secondary headache arising from cervical disorders. Training core muscles have a corrective effect on the whole spine. Moreover, increased deep neck flexors (DNFs) activation is closely linked with balanced core stabilization of the global cervical-thoracic-lumbopelvic chains. This study aimed to investigate the effect of lumbar motor control training combined with cervical stabilization exercises compared to cervical stabilization exercises alone in CGH patients.MethodsFifty-two subjects of both genders with CGH and chronic mechanical neck pain (CMNP) participated in this study. They were recruited from the outpatient Physical Therapy Clinic at Mubarak Central Hospital, Giza, Egypt; their mean age was 28.1 ± 5.8 years and their BMI was 22.8 ± 1.6 kg/m2. They received treatment for three sessions per week for 4 weeks. Subjects were assigned randomly into two equal groups; the control group: received cervical stabilization exercises (axial elongation, cranio-cervical flexion, cervical extension, rowing, and Y-exercise). Study group: received cervical stabilization exercise in addition to lumbar motor control training (abdominal draw-in maneuver, side plank, and quadruped position), each exercise had a 4-week progression. Headache frequency, duration, intensity by visual analog scale (VAS), and neck functional disability by Neck Disability Index (NDI) were measured before the first session and after the last session of the 4 weeks of treatment.ResultsThere was a high statistically significant difference in post-treatment mean values of headache frequency, headache duration, headache intensity, and neck functional disability between the two groups in favor of the study group.ConclusionAdding lumbar motor control training to cervical stabilization exercise is more effective than cervical stabilization alone in decreasing headache frequency, duration, intensity, and neck functional disability in CGH patients with CMNP.Trial registrationNCT05952115. Registered 11 July 2023-retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/LoginUser?ts=1&cx=-jg9qo4.