Effect of Mulligan manual therapy and exercise on headache frequency, intensity, disability, and upper cervical joint hypomobility in people with episodic tension-type headache: a randomized clinical trial.
Background: The effectiveness of Mulligan manual therapy has been investigated in cervicogenic headache but not in tension-type headache (TTH). Objective: To compare the effectiveness of exercise + Mulligan manual therapy over exercise or exercise + sham in episodic TTH. Methods: Using a randomized...
| Publicado en: | Physiotherapy Theory & Practice Vol. 41; no. 11; pp. 2271 - 2288 |
|---|---|
| Autores principales: | , , |
| Formato: | pictorial research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Taylor & Francis Ltd
Nov2025
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188855880&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188855880 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09593985 BCJ jtl: Physiotherapy Theory & Practice issn: 09593985 maglogo: Y pubinfo: dt: Nov2025 vid: 41 iid: 11 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 188855880 185856764 188855880 188855880 10.1080/09593985.2025.2516765 188855880 ppf: 2271 ppct: 17 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Effect of Mulligan manual therapy and exercise on headache frequency, intensity, disability, and upper cervical joint hypomobility in people with episodic tension-type headache: a randomized clinical trial. aug: au: Satpute, Kiran Bedekar, Nilima Hall, Toby affil: Department of Musculoskeletal Physiotherapy, Smt. Kashibai Navale College of Physiotherapy, Pune, India sug: subj: Manual Therapy Evaluation Therapeutic Exercise Evaluation Tension Headache Therapy Pain Measurement Disability Evaluation Physical Therapy Methods Cervical Vertebrae Physiopathology Treatment Outcomes Human Male Female Adolescence Adult Middle Age Randomized Controlled Trials Random Assignment Prospective Studies Range of Motion Patient Satisfaction Pain Threshold Clinical Reasoning India Hospitals Ambulatory Care Facilities Outpatients Visual Analog Scaling Questionnaires Descriptive Statistics Comparative Studies Intraclass Correlation Coefficient Intrarater Reliability Data Analysis Software Post Hoc Analysis Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Background: The effectiveness of Mulligan manual therapy has been investigated in cervicogenic headache but not in tension-type headache (TTH). Objective: To compare the effectiveness of exercise + Mulligan manual therapy over exercise or exercise + sham in episodic TTH. Methods: Using a randomized clinical trial design, 99 subjects with episodic TTH received six sessions of allocated intervention over 4 weeks. Headache frequency, intensity, duration, medication intake, disability, upper cervical rotation, pressure-pain thresholds, and patient satisfaction were assessed at baseline, 4 weeks, 3, and 6 months. Results: Headache frequency reduced significantly in group exercise + Mulligan manual therapy compared to group exercise post-intervention (MD −1.0 day, 95% CI −2.0 to −0.0) (p =.002), and at 3-month follow-up (MD −1 days, 95% CI −2.0 to 0.0) (p =.002), but only at post-intervention compared to group exercise + sham (MD 1.0 day, 95% CI 0.0 to 2.0) (p =.008). The clinical relevance is unclear as between-group differences did not reach a clinical threshold. No difference was observed at 6 months (p >.17). A similar trend was observed for other outcomes. There was no difference between groups exercise and exercise + sham for any outcome (p >.17). Conclusion: In episodic TTH, exercise + Mulligan manual therapy provided short-term clinically uncertain improvements in headache parameters. These results differ to studies of cervicogenic headache. Unsuitability of Mulligan manual therapy for underlying pathophysiological mechanisms in episodic TTH may explain these results. Practitioners should consider Mulligan manual therapy for selected patients and only as part of evidence-based multimodal management of episodic TTH. TRIAL registration: CTRI/2019/06/019506. pubtype: Academic Journal doctype: pictorial research tables/charts randomized controlled trial Journal Article ougenre: Unknown language: English refInfo: holdings: @attributes: islocal: N |
|---|