Comparative Effects Of Eye-Cervical Re-Education Exercises And Pressure Biofeedback Training Of Deep Cervical Flexors In Cervicogenic Headache

Recruiting now · Not applicable

Conditions studied: Cervicogenic Headache

In brief

Cervicogenic headache (CGH) is a secondary headache that originates from dysfunction in the upper cervical spine, particularly the atlanto-occipital and C1-C3 segments, and is perceived in one or more regions of the head and/or face. The underlying mechanism involves convergence of cervical and trigeminal afferents in the trigeminocervical nucleus. Structures innervated by the C1, C2, and C3 spinal nerves are capable of producing referred pain to the head. CGH is relatively common, accounting for approximately 15-20% of all chronic headaches. It typically worsens with neck movement and is often associated with limited cervical range of motion. One of the key impairments in individuals with CGH is disrupted cervical sensorimotor control, particularly affecting proprioception and deep cervical muscle coordination. Physical therapy is widely recognized as the first-line treatment for CGH, with emerging evidence supporting interventions aimed at improving cervical proprioception and neuromuscular control. This study aims to compare the effectiveness of two sensorimotor-based physical therapy approaches-eye-cervical re-education and pressure biofeedback training of deep cervical flexors (DCF)-in patients with CGH. The primary outcomes include pain intensity, functional disability, cervical range of motion (ROM), and cervical joint position sense (proprioception). Participants will be recruited using purposive sampling from Fauji Foundation Hospital and Foundation University College of Physical Therapy (FUCP), Islamabad. After providing written informed consent, eligible participants will be randomized into two groups. Group 1 will receive conventional physical therapy along with eye-cervical re-education exercises, while Group 2 will receive conventional therapy combined with pressure biofeedback DCF training. Data will be collected at baseline and after the 10th treatment session to assess within- and between-group changes in the outcome measures. This study aims to inform evidence-based physical therapy practice in the management of cervicogenic headache.

Key facts

Study ID

NCT07526025

Run by

Foundation University Islamabad

People needed

34

Starts

2026-05-19

Expected to finish

2026-06-15

Last updated by the study team

2026-05-20

Who can join

Age: 18 and older, up to 45. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age 18 to 45 years
• Both genders
• Unilateral neck pain and referred headache
• Headache is precipitated by neck movements or sustained positions.
• Positive cervical flexion rotation test
• Headache reproduced with provocation of the involved upper cervical segments.
• Restricted upper cervical segmental mobility.

You may not qualify if…

• • Cervical radiculopathy
• Known or suspected vestibular disorders such as BBPV (Benign Paroxysmal Positional Vertigo), vestibular neuritis, meniere's disease, labyrinthitis
• Visual problems such as occipital neuralgia
• History of traumatic neck injury/surgery or cervical instability
• Rheumatoid arthritis
• Osteoporosis
• Metabolic disorders
• Spinal infection or tumors
• Vertebrobasilar insufficiency
• Other headache types such as tension headache, migraine etc

Where it is running

• Foundation University College of Physical Therapy — Islamabad, Punjab Province, Pakistan (enrolling)

Full record on ClinicalTrials.gov

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