PMID- 34269160 OWN - NLM STAT- MEDLINE DCOM- 20220405 LR - 20220717 IS - 2042-6186 (Electronic) IS - 1066-9817 (Print) IS - 1066-9817 (Linking) VI - 30 IP - 2 DP - 2022 Apr TI - Thoracic spine thrust manipulation for individuals with cervicogenic headache: a crossover randomized clinical trial. PG - 78-95 LID - 10.1080/10669817.2021.1947663 [doi] AB - OBJECTIVE: To determine if thoracic spine manipulation (TSM) improves pain and disability in individuals with cervicogenic headache (CeH). METHODS: A randomized controlled crossover trial was conducted on 48 participants (mean age: 34.4 years) with CeH symptoms. Participants were randomized to 6 sessions of TSM or no treatment (Hold) and after 4-weeks, groups crossed over. Outcomes were collected at 4, 8 and 12 weeks and included: headache disability inventory (HDI), neck disability index (NDI), and the global rating of change (GRC). Outcomes were analyzed using a linear mixed-effects model with Bonferroni correction. Odds of achieving the minimal clinically important difference (MCID) on the GRC of +4 or greater were also calculated. Scores at 4 weeks represent the only timepoint where 1 group is fully treated and other group has not received any treatment. RESULTS: Comparing hold to active treatment, HDI were not significantly different between groups (mean difference = 7.39, 95 CI: -4.39 to 19.18; P = 0.214) at any timepoint; the NDI was significant (mean difference = 6.90, 95 CI: 0.05 to 13.75; P = 0.048) at 4 weeks. Odds of achieving the +4 MCID on the GRC (OR = 38.0, 95 CI: 6.6 to 220.0; p < 0.001) favored TSM at 4 weeks. CONCLUSION: TSM had no effect on headache-related disability but resulted in significant improvements in neck-related disability and participant reported perceived improvement. Future studies are needed to examine the long-term impact of TSM in this population. FAU - McDevitt, Amy W AU - McDevitt AW AD - Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. FAU - Cleland, Joshua A AU - Cleland JA AUID- ORCID: 0000-0002-1930-6208 AD - Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA. FAU - Rhon, Daniel I AU - Rhon DI AUID- ORCID: 0000-0002-4320-990X AD - Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio, Texas, USA. FAU - Altic, Rebecca A K AU - Altic RAK AD - CU Sports Physical Therapy and Rehabilitation, University of Colorado Health, Denver, Colorado, USA. FAU - Courtney, Drew J AU - Courtney DJ AD - DBS Fitness San Diego Physical Therapy, San Diego, California, USA. FAU - Glynn, Paul E AU - Glynn PE AD - Glynn Physical Therapy, Lexington, Massachusetts, USA. FAU - Mintken, Paul E AU - Mintken PE AUID- ORCID: 0000-0002-1427-2424 AD - Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20210716 PL - England TA - J Man Manip Ther JT - The Journal of manual & manipulative therapy JID - 9433812 SB - IM MH - Adult MH - Cross-Over Studies MH - Humans MH - *Manipulation, Spinal/methods MH - Neck Pain/therapy MH - *Post-Traumatic Headache/diagnosis/therapy MH - Spine PMC - PMC8967200 OTO - NOTNLM OT - Headache OT - cervicogenic OT - thoracic manipulation COIS- Drs. Cleland, Mintken and Glynn receive honorariums for teaching continuing education courses which include techniques used in this study. All other author(s) do not have conflicts of interest to report. EDAT- 2021/07/17 06:00 MHDA- 2022/04/05 06:00 PMCR- 2022/07/16 CRDT- 2021/07/16 08:46 PHST- 2021/07/17 06:00 [pubmed] PHST- 2022/04/05 06:00 [medline] PHST- 2021/07/16 08:46 [entrez] PHST- 2022/07/16 00:00 [pmc-release] AID - 1947663 [pii] AID - 10.1080/10669817.2021.1947663 [doi] PST - ppublish SO - J Man Manip Ther. 2022 Apr;30(2):78-95. doi: 10.1080/10669817.2021.1947663. Epub 2021 Jul 16.