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Completed

NCT Number: NCT07025187

the Effect of Integrated Neuomuscular Inhibition Technique on Adult Females With Cervicogenic Headache

The purpose of the current study is investigating the effect of integrated neuromuscular inhibition technique on adult females with cervicogenic headache.

Methods: Forty females with cervicogenic headache will be recruited. Patients will be randomly assigned into two groups, group A and group B . Patients in both groups will receive a traditional medical treatment, but group (B) will receive additional integrated neuromuscular inhibition technique.

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Key information

Conditions

Cervicogenic Headache Brain Diseases Central Nervous System Diseases Headache Disorders Headache Disorders, Secondary Nervous System Diseases Post-Traumatic Headache

Age range

18 year–60 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Khalid enb elwaleed polyclinic

Tanta, Algharbia, 6620010, Egypt

About this study

Measurements will be taken for all participants before the start of treatment program then after the end of 4 weeks treatment program, then after another 4 weeks of follow up.all patients will be evaluated for headache pain intensity, cervicogenic headache frequency, cervicogenic headache duration, cervical range of motion in all directions, the isometric endurance capacity of sternocledomastoid and anterior scalene, kinesiophobia, neck disability, and headache impact test-6.

All patients will receive a traditional medical program by an experienced neurologist in the form of Muscle relaxants tizanidine ,4 mg to 32 mg, Three times a day.

Patients in experimental group (B) will receive the same program as control group (A) plus the INIT for upper trapezius and suboccipital muscles. The INIT program will be administrated three times a week for one month.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

1 - A diagnosis of CGH will be made by an experienced neurologist as per the International Classification of Headache Disorders 3rd edition (ICHD-3) , but not including occipital nerve blockage 2-Additional inclusion criteria will include female patients aged> 18 years and<60 years.

3-headache intensity ≥ 3 on eleven-point numerical rating scale at enrolment. 4-at least three-month history of headache with a mean frequency of > 1/week. 5-hypomobility of the upper cervical spine (C0 to C3) on manual examination; and reproduction of the headache on palpation of the upper cervical spine (C0 to C3).

6-In addition, patients should exhibit active trigger points within the suboccipital, and upper trapezius muscles, ipsilaterally over the symptomatic side reproducing their headache symptoms .

Exclusion criteria

  • Patients will be excluded if they have any of the following:
  • cervical radiculopathy,
  • history of neck, shoulder trauma or surgery,
  • history of intervention for head or neck pain within the previous 3 months,
  • A diagnosis of other types of headaches using the criteria of ICHD-3.

Treatment and study plan

Muscle relaxants tizanidine

Drug

All patients will receive a traditional medical program by an experienced neurologist in the form of Muscle relaxants tizanidine ,4 mg to 32 mg, Three times a day for one month .

Integrated Neuromuscular Inhibition technique

Other

Patients in experimental group (B) will receive the same program as control group (A) plus the INIT for upper trapezius and suboccipital muscles. The INIT program will be administrated three times a week for one month .

Other names: INIT

Primary outcomes

  1. headache pain intensity

    Time frame: Baseline, 4 weeks and 8 weeks .

    headache pain intensity measured by 11-Numerical rating scale. Primary outcome updated to headache intensity to better reflect the study objective.

Secondary outcomes

  1. kinesiophobia

    Time frame: Baseline, 4 weeks and 8 weeks .

    kinesiophobia will be measured by Arabic Tampa scale

  2. Isometric endurance capacity of sternocledomastoid and anterior scalene

    Time frame: Baseline, 4 weeks and 8 weeks .

    The isometric endurance capacity of the sternocleidomastoid and anterior scalene will be assessed using an isometric test.

  3. the impact of headaches on patients' lives

    Time frame: Baseline, 4 weeks and 8 weeks .

    the impact of headaches on patients' lives measured by Arabic headache impact test-6.

  4. neck disability

    Time frame: Baseline, 4 weeks and 8 weeks .

    the neck disability will be measured by Arabic neck disability index

  5. headache frequency

    Time frame: Baseline, 4 weeks and 8 weeks

    Cervicogenic headache frequency, which is a self-administered outcome variable, will be identified by asking patients to enter their CGH pain experience in a medical logbook every evening to find the number of painful days in the last week, ranging from 0 to 7 days.

  6. headache duration

    Time frame: Baseline, 4 weeks and 8 weeks .

    Headache duration will be measured as the total hours of headache in the last week.

  7. cervical ROM in all directions

    Time frame: Baseline, 4 weeks and 8 weeks .

    Cervical right and left lateral flexion, extension, and flexion ROM will be measured using the iPhone clinometer application, whereas cervical right and left rotation ROM will be measured using the iPhone compass application.

Sponsors and collaborators

Lead sponsor

Kafrelsheikh University

Other

Registry information

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jun 17, 2025
Registry last updated
Nov 18, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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