Cervicogenic HeadacheCGHNCT07373912
Impact of Adding Instrument-assisted Soft Tissue Mobilization to Mulligan Therapy in Patients With Cervicogenic Headache
A study testing instrumeted assissted soft tissue mobilization and mulligan therapy, mulligan therapy and postural correction exercises in people with Cervicogenic Headache, run by Cairo University.
Trial summary
this study will be conducted to investigate the impact of adding Instrument assisted soft tissue mobilization technique to mulligan therapy in patients with cervicogenic headache Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Cervicogenic Headache
- What is being tested?
- instrumeted assissted soft tissue mobilization and mulligan therapy, mulligan therapy and postural correction exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- No sites listed yet
- Study dates
- 1 Feb 2026to 1 Jul 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- -Unilateral CGH presentation
- Age group above 18 years' old
- History of chronic CGH (>3 months)
- CGH owing to cervical spine (neck) dysfunction
- Reduced cervical motion
- Neck stiffness and movement restriction
Who cannot join
- Participants with other types of headache (migraine headache)
- Headache owing to other causes (sinus, tumor, neural, and tempero-mandibular joint issues)
- Any contraindications to manual and manipulative therapy (fracture, instability, osteoporosis and neural symptoms)
- Taking analgesics or corticosteroids and migraine-specific medications, such as triptans
- Metastasis
- Cardiac conditions (stroke and syncope)
- Neurological conditions (radiculopathy, myelopathy)
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
this study will be conducted to investigate the impact of adding Instrument assisted soft tissue mobilization technique to mulligan therapy in patients with cervicogenic headache
Read the detailed description
Cervicogenic headache (CGH) has seen a notable rise in prevalence in recent years, substantially impairing patients' daily functioning and occupational productivity. Despite its considerable burden, CGH remains frequently underdiagnosed and inadequately managed, often progressing to a chronic state that heightens the risk of work absenteeism and long-term disability and as the most common type of pain disorders, affecting 66% of the global population, represent a major public health concern due to their detrimental impact on quality of life and economic productivity . Epidemiological data indicate that CGH affects 4.1% of the general population, with prevalence escalating to 17.5% among individuals with severe headaches.Instrument Assisted Soft Tissue Mobilization using Graston (GT®) tool is regarded as one the most advanced and promising methods ,utilizing a specially designed instrument to adress a variety of soft tissue pathologies such as myofascial adhesions , scar tissue restriction , tissue thickenings, ridges, fibrotic nodules, crystalline deposits . this technique works by generating a mobilizing effect ,which contributes to pain reduction ,enhanced range of motion and improved overall function.The Mulligan manual technique is considered one of the most effective forms of manipulations. In contrast to conventional mobilization, which depends entirely on the therapist, Mulligan proposed that applying pressure to the spinous processes while the patient is in a weight-bearing position would cause the facet joints to glide in a coordinated ,parallel direction . simultaneously ,this approach involve the patient's active participation during movemwnt in order to achieve the perfect therapeutic outcomes
- Conditions
- Cervicogenic Headache
- Being tested
- instrumeted assissted soft tissue mobilization and mulligan therapy, mulligan therapy, postural correction exercises
- Keywords
- Instrument Assisted Soft Tissue Mobilization, mulligan therapy
- Medical subject headings
- Post-Traumatic Headache
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
instrumeted assissted soft tissue mobilization and mulligan therapyOther
the patients will receive IASTM tools over the length of targeted muscles (descending fiber of trapezius, suboccipitalis muscles ) for 5 minutes. also, SNAG technique; Each patient will be asked to sit comfortably, and the treating therapist will stand beside the patient. The patient's head will be free and cradled between the therapist's right forearm and body, and the therapist stand at the patient's right side. The therapist then will place his right index, middle, and ring fingers at the base of the occiput and kept his right little finger over the spinous process of C2. Next, with the lateral border of his left thenar eminence, gentle pressure will be applied in a ventral and upward direction(45 degrees) over the right little finger. finally postural correction execises
mulligan therapyOther
SNAG technique; Each patient will be asked to sit comfortably, and the treating therapist will stand beside the patient. The patient's head will be free and cradled between the therapist's right forearm and body, and the therapist stand at the patient's right side. The therapist then will place his right index, middle, and ring fingers at the base of the occiput and kept his right little finger over the spinous process of C2. Next, with the lateral border of his left thenar eminence, gentle pressure will be applied in a ventral and upward direction(45 degrees) over the right little finger. Finally, postural correction exercises will be addedd
postural correction exercisesOther
the exercises will incluse, Stretching exercises for the sternocleidomastoids,the Scalenes,upper fibers of trapezius and strengthening exercises for cervical muscles
| Study group | Role | What they receive |
|---|---|---|
| instrumeted assissted soft tissue mobilization and mulligan therapy | Experimental | twenty patients will receive IASTM, mulligan therapy and postural correction exercises three times per week for 6 weeks. Receives: Other: instrumeted assissted soft tissue mobilization and mulligan therapy; Other: mulligan therapy; Other: postural correction exercises |
| mulligan therapy | Experimental | Twenty patients will receive Mulligan therapy and postural correction exercises three times per week for 6 weeks. Receives: Other: mulligan therapy; Other: postural correction exercises |
| postural correction exercises | Active comparator | Twenty patients will receive postural correction exercises three times per week for 6 weeks. Receives: Other: postural correction exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
neck disability
Assessment of neck function was performed by Arabic neck disability index. It is a valid and reliable tool in the assessment of neck function. It contains ten category/classes. Each category contains six choices (zero-five).Score from zero to four no disability, from five to 15 this is mild, From 15 to 24 this is moderate, from 25 to 34 this is severe, more than 34 this is a complete disability
Measured: up to 6 weeks
Secondary outcomes (6)
pain intensity
The scale will be used is the VAS, which consists of a line, usually 10 cm long, ranging from no pain or discomfort (zero) , to the worst pain that could possibly feel (10)
Measured: up to 6 weeks
cervical range of motion
The CROM device will be used to assess cervical range of motion. it is headmounted equipment consists of a plastic frame placed on the head over the nose and the ears, secured by a Velcro strap. Two independent inclinometers, 1 in the sagittal plane and 1 in the frontal plane, are attached to the frame and indicate the position of the head with respect to the line of gravity. A third inclinometer is positioned in the horizontal plane and indicates the position of the head in rotation, with respect to a reference position
Measured: up to six weeks
muscle stiffness
The MyotonPRO (Myoton AS, Tallinn, Estonia) is a recently introduced device that can objectively measure the mechanical properties of muscles including analyzing muccsle stiffness (N/m).
The measurement procedure involved pressing the device against the skin, with a force of 0.18 N and instantly applying an impulse of 0.4 N for duration of 15 ms. The skin surface oscillation induced by the\ MyotonPRO was measured
Measured: up to six weeks
headache frequency
the number of days the subjects experienced headaches (frequency)
Measured: up to six weeks
headache duration
the total number of hours they experienced headaches (duration)
Measured: up to six weeks
medication intake
The frequency with which they used painkillers (medication intake) for their headaches were also noted
Measured: up to 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jan 2026
- Study start1 Feb 2026 (estimated)
- Primary completion1 Jul 2026 (estimated)
- Study completion1 Jul 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Cervicogenic HeadacheStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- instrument-assisted soft tissue mobilization, Mulligan therapy, and postural correction exercises
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Doaa Youssef Ahmed Mahmoud, Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07373912
- Sponsor's protocol ID
- P.T.REC/012/006193
- Acronym
- CGH
- Status last verified
- Jan 2026
- First submitted
- 21 Jan 2026
- Last updated
- 28 Jan 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Adding Instrument-assisted Soft Tissue Mobilization to Mulligan Therapy in Patients With Cervicogenic Headache
- ClinicalTrials.gov ID
- NCT07373912
- Acronym / sponsor ID
- CGH / P.T.REC/012/006193
- Conditions
- Cervicogenic Headache
- Keywords
- Instrument Assisted Soft Tissue Mobilization, mulligan therapy
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Feb 2026 (estimated)
- Primary completion
- 1 Jul 2026 (estimated)
- Study completion
- 1 Jul 2026 (estimated)
- First posted
- 28 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
this study will be conducted to investigate the impact of adding Instrument assisted soft tissue mobilization technique to mulligan therapy in patients with cervicogenic headache
Detailed description
Cervicogenic headache (CGH) has seen a notable rise in prevalence in recent years, substantially impairing patients' daily functioning and occupational productivity. Despite its considerable burden, CGH remains frequently underdiagnosed and inadequately managed, often progressing to a chronic state that heightens the risk of work absenteeism and long-term disability and as the most common type of pain disorders, affecting 66% of the global population, represent a major public health concern due to their detrimental impact on quality of life and economic productivity . Epidemiological data indicate that CGH affects 4.1% of the general population, with prevalence escalating to 17.5% among individuals with severe headaches.Instrument Assisted Soft Tissue Mobilization using Graston (GT®) tool is regarded as one the most advanced and promising methods ,utilizing a specially designed instrument to adress a variety of soft tissue pathologies such as myofascial adhesions , scar tissue restriction , tissue thickenings, ridges, fibrotic nodules, crystalline deposits . this technique works by generating a mobilizing effect ,which contributes to pain reduction ,enhanced range of motion and improved overall function.The Mulligan manual technique is considered one of the most effective forms of manipulations. In contrast to conventional mobilization, which depends entirely on the therapist, Mulligan proposed that applying pressure to the spinous processes while the patient is in a weight-bearing position would cause the facet joints to glide in a coordinated ,parallel direction . simultaneously ,this approach involve the patient's active participation during movemwnt in order to achieve the perfect therapeutic outcomes
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- instrument-assisted soft tissue mobilization, Mulligan therapy, and postural correction exercises
| Arm | Type | Receives |
|---|---|---|
| instrumeted assissted soft tissue mobilization and mulligan therapy | Experimental | Other: instrumeted assissted soft tissue mobilization and mulligan therapy, Other: mulligan therapy, Other: postural correction exercisestwenty patients will receive IASTM, mulligan therapy and postural correction exercises three times per week for 6 weeks. |
| mulligan therapy | Experimental | Other: mulligan therapy, Other: postural correction exercisesTwenty patients will receive Mulligan therapy and postural correction exercises three times per week for 6 weeks. |
| postural correction exercises | Active comparator | Other: postural correction exercisesTwenty patients will receive postural correction exercises three times per week for 6 weeks. |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- -Unilateral CGH presentation
- Age group above 18 years' old
- History of chronic CGH (>3 months)
- CGH owing to cervical spine (neck) dysfunction
- Reduced cervical motion
Key exclusion criteria (7 listed)
- Participants with other types of headache (migraine headache)
- Headache owing to other causes (sinus, tumor, neural, and tempero-mandibular joint issues)
- Any contraindications to manual and manipulative therapy (fracture, instability, osteoporosis and neural symptoms)
- Taking analgesics or corticosteroids and migraine-specific medications, such as triptans
- Metastasis
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| instrumeted assissted soft tissue mobilization and mulligan therapythe patients will receive IASTM tools over the length of targeted muscles (descending fiber of trapezius, suboccipitalis muscles ) for 5 minutes. also, SNAG technique; Each patient will be asked to sit comfortably, and the treating therapist will stand beside the patient. The patient's head will be free and cradled between the therapist's right forearm and body, and the therapist stand at the patient's right side. The therapist then will place his right index, middle, and ring fingers at the base of the occiput and kept his right little finger over the spinous process of C2. Next, with the lateral border of his left thenar eminence, gentle pressure will be applied in a ventral and upward direction(45 degrees) over the right little finger. finally postural correction execises | Other | instrumeted assissted soft tissue mobilization and mulligan therapy |
| mulligan therapySNAG technique; Each patient will be asked to sit comfortably, and the treating therapist will stand beside the patient. The patient's head will be free and cradled between the therapist's right forearm and body, and the therapist stand at the patient's right side. The therapist then will place his right index, middle, and ring fingers at the base of the occiput and kept his right little finger over the spinous process of C2. Next, with the lateral border of his left thenar eminence, gentle pressure will be applied in a ventral and upward direction(45 degrees) over the right little finger. Finally, postural correction exercises will be addedd | Other | instrumeted assissted soft tissue mobilization and mulligan therapy, mulligan therapy |
| postural correction exercisesthe exercises will incluse, Stretching exercises for the sternocleidomastoids,the Scalenes,upper fibers of trapezius and strengthening exercises for cervical muscles | Other | instrumeted assissted soft tissue mobilization and mulligan therapy, mulligan therapy, postural correction exercises |
Primary outcome
neck disability
Time frame: up to 6 weeks
Assessment of neck function was performed by Arabic neck disability index. It is a valid and reliable tool in the assessment of neck function. It contains ten category/classes. Each category contains six choices (zero-five).Score from zero to four no disability, from five to 15 this is mild, From 15 to 24 this is moderate, from 25 to 34 this is severe, more than 34 this is a complete disability
6 secondary outcomes
pain intensity
Time frame: up to 6 weeks
cervical range of motion
Time frame: up to six weeks
muscle stiffness
Time frame: up to six weeks
headache frequency
Time frame: up to six weeks
headache duration
Time frame: up to six weeks
medication intake
Time frame: up to 6 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Jan 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A study testing instrumeted assissted soft tissue mobilization and mulligan therapy, mulligan therapy and postural correction exercises in people with Cervicogenic Headache, run by Cairo University.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 28 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact doaa youssef, master (01113279369, Doaa10997youssef@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
neck disability (time frame: up to 6 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jan 2026.