Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt -
Department of Physical Therapy for Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Eur J Phys Rehabil Med. 2021 Oct;57(5):758-766. doi: 10.23736/S1973-9087.21.06595-3. Epub 2021 May 5.
Physical therapists may use the Graston technique to relieve soft-tissue restrictions and pain in the upper cervical region. However, no studies have tested the efficacy of the Graston technique in patients with cervicogenic headache.
The aim of the study was to investigate the effect of adding the Graston technique to an exercise program on pain intensity, neck disability, cervical range of motion, headache frequency and duration, and medication intake in subjects with cervicogenic headache.
The design of this study was a single-blinded (assessor), randomized controlled trial.
The setting was outpatient rehabilitation clinic.
Sixty patients, from 35 to 50 years old, with cervicogenic headache have participated in the study. Patients were recruited from the outpatient clinics of Tala general hospital in Menoufia governorate.
Patients were assigned randomly into two groups. Patients in the study group received the Graston technique in addition to an exercise program, while patients in the control group received the exercise program only. All patients received 3 sessions a week for 4 weeks. The primary outcome measure was the Visual Analogue Scale (VAS), while the secondary outcome measures were Neck Disability Index (NDI), Cervical Range of Motion (CROM), headache frequency and duration, and medication intake. All outcomes were measured at baseline, after 2 weeks as well as after 4 weeks of intervention.
After 2 weeks of the treatment, statistically significant differences were found in all the measured outcomes (P<0.05) in favor of the Graston group except for neck extension (P=0.08). After 4 weeks of the intervention, statistically significant differences were found in all the measured outcomes (P<0.05) in favor of the Graston group.
Short-term effect of using the Graston technique in combination with an exercise program can reduce pain, decrease headache frequency and duration, and medication intake more than the exercise program alone in the medium-term.
Although the study results for NDI and neck ROM were statistically significant, it is neither clinically relevant change nor clearly outside the range of measurement error.
物理治疗师可能会使用格拉斯顿技术来缓解上颈椎区域的软组织受限和疼痛。然而，目前还没有研究测试格拉斯顿技术在颈源性头痛患者中的疗效。
本研究旨在探讨在运动方案中加入格拉斯顿技术对颈源性头痛患者的疼痛强度、颈部活动障碍、颈椎活动范围、头痛频率和持续时间以及药物摄入的影响。
这是一项单盲（评估者）、随机对照试验。
门诊康复诊所。
共有 60 名年龄在 35 岁至 50 岁之间的颈源性头痛患者参与了这项研究。这些患者是从 Menoufia 省 Tala 综合医院的门诊招募而来。
患者被随机分为两组。研究组患者除了接受运动方案外，还接受格拉斯顿技术治疗，而对照组患者仅接受运动方案。所有患者每周接受 3 次治疗，持续 4 周。主要观察指标为视觉模拟评分（VAS），次要观察指标为颈部活动障碍指数（NDI）、颈椎活动范围（CROM）、头痛频率和持续时间以及药物摄入。所有结果均在基线时、治疗 2 周后以及治疗 4 周后进行测量。
治疗 2 周后，除了颈部伸展（P=0.08）外，格拉斯顿组在所有测量结果上均表现出统计学上的显著差异（P<0.05）。治疗 4 周后，格拉斯顿组在所有测量结果上均表现出统计学上的显著差异（P<0.05）。
在中期，与单独使用运动方案相比，格拉斯顿技术联合运动方案的短期应用可以更有效地减轻疼痛、减少头痛频率和持续时间以及药物摄入。
尽管 NDI 和颈部 ROM 的研究结果具有统计学意义，但既没有临床相关的变化，也没有明显超出测量误差范围。
