MigraineNCT07403175
Synergistic Impact of Postural Correction Interventions and Sustained Natural Apophyseal Glides in Migraine
A study testing Sustained Natural Apophyseal Glides, Postural Correction Exercises and Conventional Physical Therapy in people with Migraine, run by Riphah International University at 1 site in Pakistan.
Trial summary
This study was conducted to evaluate the synergistic impact of postural correction interventions and sustained natural apophyseal glides on severity, quality of life and disability in patients with migraine. Read more about this study
- Who is it for?
- Ages 22 to 45 yearsHealthy volunteers can take part
- Conditions the study is for
- Migraine
- What is being tested?
- Sustained Natural Apophyseal Glides, Postural Correction Exercises and Conventional Physical Therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 sitePakistan
- Study dates
- 10 Jan 2025to 31 Oct 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 22 to 45 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- A diagnosis of episodic migraine made by the primary investigator according to ICHD-2.
- Symptoms must include at least two of the following: Unilateral pain, Pulsating/throbbing pain, Nausea, Vomiting, Photophobia/phonophobia.
- Participants should be full time employees or Desktop users.
- Participants have a history of at least migraine >4 days per month.
- Participants having history of migraine lasting from 4-72 hours
- Age group between 22 and 45 years.
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- Both gender male and female.
- Participants who agree to cut-off any pharmacological treatment during study.
- Participants should have an average score between 3-6 on pain intensity scale.
Who cannot join
- Participants having active migraine and other headache types e.g. Cluster headache.
- Previous neck/head trauma from >2 years.
- Any neck/head surgery >2 years
- Spinal infections/diseases e.g. Tumor, TB spine
- Any history of neurological disorders e.g. stroke, abcess, haemorrhage, haematoma
- Severe Osteoporosis
Show all 10Show fewer
- Pregnancy
- Upper motor neuron disease, cervical stenosis, and metabolic diseases in bone and joint.
- Ongoing radiotherapy, chemotherapy, steroid therapy, or anticoagulants.
- Psychiatric diseases such as phobia/obsession and depression.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Synergistic Impact of Postural Correction Interventions and Sustained Natural Apophyseal Glides on Severity, Disability and Quality of Life in Patients With Migraine
This study was conducted to evaluate the synergistic impact of postural correction interventions and sustained natural apophyseal glides on severity, quality of life and disability in patients with migraine.
- Conditions
- Migraine
- Being tested
- Sustained Natural Apophyseal Glides, Postural Correction Exercises, Conventional Physical Therapy
- Keywords
- Disability, Headache, Migraine, Sustained Natural Apophyseal Glide, Neck Disability
- Medical subject headings
- Migraine Disorders, Headache
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Sustained Natural Apophyseal GlidesOther
Also called SNAGs
Headache SNAG: A posteroanterior mobilization of the second cervical vertebrae is maintained for 10-30 seconds having the patient comfortably seated on a chair or couch. A maximum of six repetitions were administered. The patient is administered SNAG mobilization by placing the medial border of the thumb's distal phalanx on the spine of one vertebra above while standing behind the patient. The thumb tips were positioned at a 45° angle, and another thumb is used to provide the glides. Glides are performed in 3 sets and 6 times during the session.
Reverse Headache SNAG: Anterio-posterior mobilization of the second cervical vertebrae is maintained for 10-30 seconds having the patient comfortably seated on a chair or couch. A maximum of 6 repetitions were administered.
Postural Correction ExercisesOther
The main exercises used in this group are stretching, strengthening, and endurance exercise to maintain a healthy posture and correct the faulty posture due to weakened and tightened muscles Each subject will receive 6 treatment sessions spread over 4 consecutive weeks and each treatment session will not extend beyond 30 min.
- Stretching exercises
- Levator scapulae stretching
- Upper trapezius stretching
- Scalenes muscle stretching
- Pectoralis major stretch
- Pectoralis minor stretch
- Sternocleidomastoid stretch
- Strengthening Exercises
- Lower trapezius strengthening
- Rhomboids strengthening
- Deep cervical flexors strengthening
- Endurance Training
Conventional Physical TherapyOther
- Hot pack for 20 minutes on the neck region (upper trapezius) in sitting position.
- Soft tissue mobilization includes deep tissue massage locally to the cervical region by applying pressure with fingers and palms.
- Isometrics of neck in which the patient is seated on a chair or standing, or in a comfortable position having spine in a neutral position. Placing hands on patient's forehead by asking the patient to gently push head forward while simultaneously resisting the movement therapist's hands. Hold the contraction for 5-10 seconds, then relax. this movement was repeated in all directions.
| Study group | Role | What they receive |
|---|---|---|
| Sustained Natural Apophyseal Glides & Postural Correction Exercises | Experimental | Not described Receives: Other: Sustained Natural Apophyseal Glides; Other: Postural Correction Exercises; Other: Conventional Physical Therapy |
| Sustained Natural Apophyseal Glides | Active comparator | Not described Receives: Other: Sustained Natural Apophyseal Glides; Other: Conventional Physical Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale (NPRS)
The NRS is used to gauge the patient's degree of pain. On a 0-10 scale, where 0 represents no pain, 1-3 represents mild pain, 4-6 represents moderate pain, and 7-10 represents severe pain, this tool is frequently used to gauge the intensity of pain. Patients rate how much pain they are currently experiencing as well as how much pain they have experienced in the past 24 hours. The patient's level of pain might be represented by the average of three evaluations or by any single value
Measured: From enrollment to the end of treatment at 4 weeks.
Migraine Specific Quality of Life Questionnaire (MSQ Version 2.1)
This questionnaire is used to evaluate migraine patient's quality of life. The 14-item MSQ version 2.1 measures QOL impacts in three domains: Role function-restrictive (RFR), which measures the functional impact of migraine through limitations on daily social and work activities; Role function-preventive (RFP), which measures the impact of migraine through prevention of daily work and social activities; and Emotional function (EF), which measures the emotional impact of migraine through three items. The raw total score was the sum of all item scores, which were rescaled from 0 to 100, with a higher score denoting better quality of life. Raw scores in each domain were calculated as the sum of all item scores.
Measured: From enrollment to the end of treatment at 4 weeks.
Migraine Disability Assessment Scale (MDA)
The Migraine Disability Assessment Scale (MIDAS) is intended to assist individuals and medical professionals in comprehending how migraines affect day-to-day living. MIDAS gives a more accurate view of the overall impact of migraines by evaluating how frequently they occur and how they interfere with social activities, employment, and domestic duties. It is simpler to customize therapy to meet each patient's needs when the information is used to determine treatment choices and monitor progress overtime. In the end, it's a tool that facilitates improved communication and assistance in migraine management by allowing patients to share their experiences and difficulties.
Measured: From enrollment to the end of treatment at 4 weeks.
Secondary outcomes (6)
ROM Cervical Spine (Flexion)
Changes in cervical spine flexion ROM at baseline and 4th week of intervention was measured using goniometer.
Measured: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Extension)
Changes in cervical spine extension ROM at baseline and 4th week of intervention was measured using goniometer.
Measured: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Lateral Flexion) Left Side
Changes in cervical spine lateral flexion on left side ROM at baseline and 4th week of intervention was measured using goniometer.
Measured: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Lateral Flexion) Right Side
Changes in cervical spine lateral flexion on right side ROM at baseline and 4th week of intervention was measured using goniometer.
Measured: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Rotation) Left Side
Changes in cervical spine rotation on left side ROM at baseline and 4th week of intervention was measured using goniometer.
Measured: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Rotation) Right Side
Changes in cervical spine rotation on right side ROM at baseline and 4th week of intervention was measured using goniometer.
Measured: From enrollment to the end of treatment at 4 weeks.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Feb 2026
- Study start10 Jan 2025
- Primary completion31 Oct 2025
- Study completion31 Oct 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for MigraineStudies of the same condition, open and under way.
- More trials run by Riphah International 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
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 44 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Rafia Mannan, MS-SPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07403175
- Sponsor's protocol ID
- REC/RCR & AHS/24/01104
- Status last verified
- Feb 2026
- First submitted
- 4 Feb 2026
- Last updated
- 11 Feb 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 11 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Synergistic Impact of Postural Correction Interventions and Sustained Natural Apophyseal Glides on Severity, Disability and Quality of Life in Patients With Migraine
- ClinicalTrials.gov ID
- NCT07403175
- Acronym / sponsor ID
- REC/RCR & AHS/24/01104
- Conditions
- Migraine
- Keywords
- Disability, Headache, Migraine, Sustained Natural Apophyseal Glide, Neck Disability
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 44 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 10 Jan 2025 (actual)
- Primary completion
- 31 Oct 2025 (actual)
- Study completion
- 31 Oct 2025 (actual)
- First posted
- 11 Feb 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 was conducted to evaluate the synergistic impact of postural correction interventions and sustained natural apophyseal glides on severity, quality of life and disability in patients with migraine.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Sustained Natural Apophyseal Glides & Postural Correction Exercises | Experimental | Other: Sustained Natural Apophyseal Glides, Other: Postural Correction Exercises, Other: Conventional Physical Therapy |
| Sustained Natural Apophyseal Glides | Active comparator | Other: Sustained Natural Apophyseal Glides, Other: Conventional Physical Therapy |
Who may qualify
- Ages
- 22 to 45 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (9 listed)
- A diagnosis of episodic migraine made by the primary investigator according to ICHD-2.
- Symptoms must include at least two of the following: Unilateral pain, Pulsating/throbbing pain, Nausea, Vomiting, Photophobia/phonophobia.
- Participants should be full time employees or Desktop users.
- Participants have a history of at least migraine >4 days per month.
- Participants having history of migraine lasting from 4-72 hours
Key exclusion criteria (10 listed)
- Participants having active migraine and other headache types e.g. Cluster headache.
- Previous neck/head trauma from >2 years.
- Any neck/head surgery >2 years
- Spinal infections/diseases e.g. Tumor, TB spine
- Any history of neurological disorders e.g. stroke, abcess, haemorrhage, haematoma
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 |
|---|---|---|
| Sustained Natural Apophyseal GlidesAlso: SNAGsHeadache SNAG: A posteroanterior mobilization of the second cervical vertebrae is maintained for 10-30 seconds having the patient comfortably seated on a chair or couch. A maximum of six repetitions were administered. The patient is administered SNAG mobilization by placing the medial border of the thumb's distal phalanx on the spine of one vertebra above while standing behind the patient. The thumb tips were positioned at a 45° angle, and another thumb is used to provide the glides. Glides are performed in 3 sets and 6 times during the session. Reverse Headache SNAG: Anterio-posterior mobilization of the second cervical vertebrae is maintained for 10-30 seconds having the patient comfortably seated on a chair or couch. A maximum of 6 repetitions were administered. | Other | Sustained Natural Apophyseal Glides, Sustained Natural Apophyseal Glides & Postural Correction Exercises |
| Postural Correction ExercisesThe main exercises used in this group are stretching, strengthening, and endurance exercise to maintain a healthy posture and correct the faulty posture due to weakened and tightened muscles Each subject will receive 6 treatment sessions spread over 4 consecutive weeks and each treatment session will not extend beyond 30 min. * Stretching exercises * Levator scapulae stretching * Upper trapezius stretching * Scalenes muscle stretching * Pectoralis major stretch * Pectoralis minor stretch * Sternocleidomastoid stretch * Strengthening Exercises * Lower trapezius strengthening * Rhomboids strengthening * Deep cervical flexors strengthening * Endurance Training | Other | Sustained Natural Apophyseal Glides & Postural Correction Exercises |
| Conventional Physical Therapy* Hot pack for 20 minutes on the neck region (upper trapezius) in sitting position. * Soft tissue mobilization includes deep tissue massage locally to the cervical region by applying pressure with fingers and palms. * Isometrics of neck in which the patient is seated on a chair or standing, or in a comfortable position having spine in a neutral position. Placing hands on patient's forehead by asking the patient to gently push head forward while simultaneously resisting the movement therapist's hands. Hold the contraction for 5-10 seconds, then relax. this movement was repeated in all directions. | Other | Sustained Natural Apophyseal Glides, Sustained Natural Apophyseal Glides & Postural Correction Exercises |
Primary outcome
Numeric Pain Rating Scale (NPRS)
Time frame: From enrollment to the end of treatment at 4 weeks.
The NRS is used to gauge the patient's degree of pain. On a 0-10 scale, where 0 represents no pain, 1-3 represents mild pain, 4-6 represents moderate pain, and 7-10 represents severe pain, this tool is frequently used to gauge the intensity of pain. Patients rate how much pain they are currently experiencing as well as how much pain they have experienced in the past 24 hours. The patient's level of pain might be represented by the average of three evaluations or by any single value
Migraine Specific Quality of Life Questionnaire (MSQ Version 2.1)
Time frame: From enrollment to the end of treatment at 4 weeks.
This questionnaire is used to evaluate migraine patient's quality of life. The 14-item MSQ version 2.1 measures QOL impacts in three domains: Role function-restrictive (RFR), which measures the functional impact of migraine through limitations on daily social and work activities; Role function-preventive (RFP), which measures the impact of migraine through prevention of daily work and social activities; and Emotional function (EF), which measures the emotional impact of migraine through three items. The raw total score was the sum of all item scores, which were rescaled from 0 to 100, with a higher score denoting better quality of life. Raw scores in each domain were calculated as the sum of all item scores.
Migraine Disability Assessment Scale (MDA)
Time frame: From enrollment to the end of treatment at 4 weeks.
The Migraine Disability Assessment Scale (MIDAS) is intended to assist individuals and medical professionals in comprehending how migraines affect day-to-day living. MIDAS gives a more accurate view of the overall impact of migraines by evaluating how frequently they occur and how they interfere with social activities, employment, and domestic duties. It is simpler to customize therapy to meet each patient's needs when the information is used to determine treatment choices and monitor progress overtime. In the end, it's a tool that facilitates improved communication and assistance in migraine management by allowing patients to share their experiences and difficulties.
6 secondary outcomes
ROM Cervical Spine (Flexion)
Time frame: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Extension)
Time frame: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Lateral Flexion) Left Side
Time frame: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Lateral Flexion) Right Side
Time frame: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Rotation) Left Side
Time frame: From enrollment to the end of treatment at 4 weeks.
ROM Cervical Spine (Rotation) Right Side
Time frame: From enrollment to the end of treatment at 4 weeks.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Feb 2026.
- Individual participant dataSharing planned: No
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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. This study is not recruiting at the moment.
Rafia Mannan, MS-SPT principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Sustained Natural Apophyseal Glides, Postural Correction Exercises and Conventional Physical Therapy in people with Migraine, run by Riphah International University at 1 site in Pakistan.
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 9 inclusion and 10 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: finished, as of the sponsor's last update on 11 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale (NPRS) (time frame: From enrollment to the end of treatment at 4 weeks.). The study lists 3 primary outcomes in all. 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 11 Feb 2026.