Cervicogenic HeadacheNCT07508410
Comparison of the Eficacy of Mulligan Mobilization and Myofascial Release in Patients With Cervicogenic Headache
A study testing Mulligan mobilization therapy, Myofascial release therapy and Exercise therapy in people with Cervicogenic Headache, run by Konya Beyhekim Training and Research Hospital at 1 site in Turkey (Türkiye).
Trial summary
Cervicogenic headache (CBH) is defined as a headache caused by a disorder in the cervical spine, bones, discs, or soft tissue elements, which is also accompanied by neck pain. Unilateral, non-reversible oculo, fronto, temporal pain, pain that increases with poor neck positioning and incorrect neck movements, and may… Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Cervicogenic Headache
- What is being tested?
- Mulligan mobilization therapy, Myofascial release therapy and Exercise therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Dec 2025to 1 Dec 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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Individuals aged 18-65
- Having experienced neck or headache for 3 months
- Meeting the diagnostic criteria for cervicogenic headache;
- Unilateral pain
- Reduced range of motion in the neck
- Ipsilateral shoulder discomfort
- Ipsilateral arm discomfort
- Pain that worsens with different neck movements and is painful on palpation
Who cannot join
- Migraine
- Cluster headache
- Cervical radiculopathy
- Entrapment neuropathy
- Myelopathy
- Rheumatoid arthritis
Show all 12Show fewer
- Undergoing cervical spinal surgery
- Pregnant women
- Those who received physical therapy within 6 months
- Those with a history of major psychiatric illness
- Those with a history of uncontrolled systemic diseases (cardiovascular, pulmonary, hepatic, renal, hematological)
- Those with a history of uncontrolled systemic endocrine diseases (dm, hyperthyroidism)
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Konya Beyhekim Eğitim ve Araştırma Hastanesi
Konya, 42060
Konya, Selçuklu, Türkiye (Türkiye), 42060 Konya Beyhekim Eğitim ve Araştırma Hastanesi
About this study
Cervicogenic headache (CBH) is defined as a headache caused by a disorder in the cervical spine, bones, discs, or soft tissue elements, which is also accompanied by neck pain.
Unilateral, non-reversible oculo, fronto, temporal pain, pain that increases with poor neck positioning and incorrect neck movements, and may be seen with restricted movement in the upper cervical and occiput regions.
The aim of this thesis is to compare the effectiveness of Mulligan mobilization technique and myofascial release methods used in the treatment of cervicogenic headache through a prospective clinical study.
Read the detailed description
This study is designed as a prospective, case-control, hospital-based study. Ninety patients aged 18-65 years who present to our hospital with cervicogenic headaches lasting at least 3 months will be included in the study.
Participants will be given full information about the procedure and will provide written informed consent.
The study will be conducted in accordance with the principles outlined in the Helsinki Declaration.
All participants will undergo a comprehensive medical history and a detailed physical examination.
Sociodemographic and clinical data, including age, gender, height, weight, education level, employment status, and income level, will be collected through standardized questionnaires.
A total of 90 patients diagnosed with cervicogenic headache will be randomly assigned to three groups.
Group 1 (n=30) will receive mulligan mobilization therapy three times a week for four weeks (12 sessions total) and a home exercise program.
Group 2 (n=30) will receive myofascial release therapy three times a week for four weeks (12 sessions total), in addition to a home exercise program.
Group 3 (n=30) will receive only a home exercise program three times a week for four weeks (12 sessions total).
All patients will be evaluated at three different time points: before treatment, immediately after treatment is completed, and one month after treatment.
The following assessments will be made during the evaluation process:
To determine the frequency of cervicogenic headaches, patients were given a headache diary.
Head and neck pain in the individuals included in the study was evaluated using the visual analog scale (VAS) before and after treatment.
Participants' functional status was assessed using the headache impact test (HIT-6).
The headache disability inventory/index (HDI) was used to measure the impact of headaches on daily life.
The short form-12 (SF-12) questionnaire was used to assess the patients' quality of life.
- Conditions
- Cervicogenic Headache
- Being tested
- Mulligan mobilization therapy, Myofascial release therapy, Exercise therapy
- Keywords
- Neck pain, Massage therapy, Musculoskeletal diseases, Musculoskeletal manipulation, Rehabilitation, Complementary therapies
- Medical subject headings
- Post-Traumatic Headache, Neck Pain, Musculoskeletal Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mulligan mobilization therapyOther
Each patient was asked to sit comfortably, and the therapist performing the treatment stood beside them. The patient's head was free and positioned between the therapist's right forearm and body, with the therapist standing to the patient's right. The therapist then placed their right index, middle, and ring fingers on the base of the occiput and held their right little finger on the spinous process of C2. Next, gentle pressure was applied ventrally and upward (45 degrees) to the lateral edge of the left thenar process and the right little finger. The gliding motion was applied rhythmically (three times per second) ten times. The therapist continuously slid the joint and actively asked the patient to move their head towards the side where the dysfunction and pain were located. He held the SNAG technique for 10 seconds. This technique was repeated 10 times over approximately 8 minutes.
Myofascial release therapyOther
The procedure was performed on the upper part of the trapezius muscle and the levator scapulae muscle.
The patient was in a seated position, hips higher than knees, feet slightly in front of the knees and in full contact with the ground. The therapist stood behind the patient.
Myofascial release of the trapezius was performed unilaterally with a soft fist, while the patient lowered their head forward and slowly rotated, creating a tension line from the middle of the trapezius towards the acromion process. During this time, the patient was asked to turn their head to the opposite side. Then, the therapist applied resistance to the opposite side of the rotation for 10 seconds. MGT was repeated 5 times on the trapezius.
The therapist applied the same unilateral contraction, but the tension line was slightly laterally towards the lower edge of the scapula. The therapist then asked the patient to tilt their head forward to increase resistance on the levator scapula for 10 seconds.
Exercise therapyOther
All patients were given a home exercise program consisting of neck joint range of motion exercises, trapezius stretches, and isometric strengthening exercises for the neck muscles. The home exercise program was initiated with 3 sets of 10 repetitions per day. The exercises were demonstrated practically by the physician, and all patients were given a printed sheet showing how to perform the exercises. Patients were contacted by phone once a week to inquire about their adherence to the exercise program and were encouraged to follow it. Patients with exercise adherence below 75-80% were excluded from the study.
| Study group | Role | What they receive |
|---|---|---|
| Mulligan mobilization technique | Experimental | In addition to mulligan mobilization therapy, which will be given three times a week for four weeks (12 sessions in total), a home exercise program will be provided. Receives: Other: Mulligan mobilization therapy |
| Myofascial release therapy | Experimental | In addition to myofascial release therapy, which will be given three times a week for four weeks (12 sessions in total), a home exercise program will be provided. Receives: Other: Myofascial release therapy |
| A home workout program | Active comparator | A home workout program will be provided three times a week for four weeks (12 sessions in total). Receives: Other: Exercise therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Frequency of cervicogenic headache
To determine the frequency of cervicogenic headaches, patients were given a headache diary.
Measured: Beginning, week 4, and week 8
assessment of pain intensity VAS pain (0-10)
0 no pain, 10 unbearable/maximum pain
Measured: Beginning, week 4, and week 8
Secondary outcomes (3)
Headache impact scale (HIT)
This scale was used to assess how much headaches affected patients' school, home, and social lives.
The score range is 36-78. Higher scores indicate that headaches have a greater impact on your life.
Measured: Beginning, week 4, and week 8
Headache disability inventory/indexi ( HDI )
This 25-item questionnaire helps assess the impact of headaches and their treatment on daily life.
Patients answer the questions on the questionnaire with yes (4 points), sometimes (2 points), and no (0 points).
The total score is calculated out of 0-100. The results are classified as follows: 0-14 points no/very mild disability, 15-36 points mild, 37-60 points moderate, and 61-100 points severe disability.
Measured: Beginning, week 4, and week 8
Assessment of quality of life short form-12
It consists of 12 questions, and the answers to these questions are used to calculate a series of subscales and an overall general health score.
Subscale scores are graded on a scale of 0 to 100. As the score increases from 0 (zero) to 100 (one hundred), it means the health condition is improving.
Measured: Beginning, week 4, and week 8
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Apr 2026
- Study start1 Dec 2025
- Primary completion1 Dec 2025
- Study completion1 Dec 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.
- 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
- Participant
- Enrolment
- 90 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Konya Beyhekim Training and Research Hospital
- Sponsor type
- Other government
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07508410
- Sponsor's protocol ID
- 15520
- Status last verified
- Mar 2026
- First submitted
- 25 Dec 2025
- Last updated
- 2 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 2 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Eficacy of Mulligan Mobilization and Myofascial Release in Patients With Cervicogenic Headache
- ClinicalTrials.gov ID
- NCT07508410
- Acronym / sponsor ID
- 15520
- Conditions
- Cervicogenic Headache
- Keywords
- Neck pain, Massage therapy, Musculoskeletal diseases, Musculoskeletal manipulation, Rehabilitation, Complementary therapies
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 90 participants (estimated)
- Lead sponsor
- Konya Beyhekim Training and Research HospitalOther government
- Study start
- 1 Dec 2025 (actual)
- Primary completion
- 1 Dec 2025 (actual)
- Study completion
- 1 Dec 2026 (estimated)
- First posted
- 2 Apr 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.
Cervicogenic headache (CBH) is defined as a headache caused by a disorder in the cervical spine, bones, discs, or soft tissue elements, which is also accompanied by neck pain.
Unilateral, non-reversible oculo, fronto, temporal pain, pain that increases with poor neck positioning and incorrect neck movements, and may be seen with restricted movement in the upper cervical and occiput regions.
The aim of this thesis is to compare the effectiveness of Mulligan mobilization technique and myofascial release methods used in the treatment of cervicogenic headache through a prospective clinical study.
Detailed description
This study is designed as a prospective, case-control, hospital-based study. Ninety patients aged 18-65 years who present to our hospital with cervicogenic headaches lasting at least 3 months will be included in the study.
Participants will be given full information about the procedure and will provide written informed consent.
The study will be conducted in accordance with the principles outlined in the Helsinki Declaration.
All participants will undergo a comprehensive medical history and a detailed physical examination.
Sociodemographic and clinical data, including age, gender, height, weight, education level, employment status, and income level, will be collected through standardized questionnaires.
A total of 90 patients diagnosed with cervicogenic headache will be randomly assigned to three groups.
Group 1 (n=30) will receive mulligan mobilization therapy three times a week for four weeks (12 sessions total) and a home exercise program.
Group 2 (n=30) will receive myofascial release therapy three times a week for four weeks (12 sessions total), in addition to a home exercise program.
Group 3 (n=30) will receive only a home exercise program three times a week for four weeks (12 sessions total).
All patients will be evaluated at three different time points: before treatment, immediately after treatment is completed, and one month after treatment.
The following assessments will be made during the evaluation process:
To determine the frequency of cervicogenic headaches, patients were given a headache diary.
Head and neck pain in the individuals included in the study was evaluated using the visual analog scale (VAS) before and after treatment.
Participants' functional status was assessed using the headache impact test (HIT-6).
The headache disability inventory/index (HDI) was used to measure the impact of headaches on daily life.
The short form-12 (SF-12) questionnaire was used to assess the patients' quality of life.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Mulligan mobilization technique | Experimental | Other: Mulligan mobilization therapyIn addition to mulligan mobilization therapy, which will be given three times a week for four weeks (12 sessions in total), a home exercise program will be provided. |
| Myofascial release therapy | Experimental | Other: Myofascial release therapyIn addition to myofascial release therapy, which will be given three times a week for four weeks (12 sessions in total), a home exercise program will be provided. |
| A home workout program | Active comparator | Other: Exercise therapyA home workout program will be provided three times a week for four weeks (12 sessions in total). |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Individuals aged 18-65
- Having experienced neck or headache for 3 months
- Meeting the diagnostic criteria for cervicogenic headache;
Key exclusion criteria (12 listed)
- Migraine
- Cluster headache
- Cervical radiculopathy
- Entrapment neuropathy
- Myelopathy
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 |
|---|---|---|
| Mulligan mobilization therapyEach patient was asked to sit comfortably, and the therapist performing the treatment stood beside them. The patient's head was free and positioned between the therapist's right forearm and body, with the therapist standing to the patient's right. The therapist then placed their right index, middle, and ring fingers on the base of the occiput and held their right little finger on the spinous process of C2. Next, gentle pressure was applied ventrally and upward (45 degrees) to the lateral edge of the left thenar process and the right little finger. The gliding motion was applied rhythmically (three times per second) ten times. The therapist continuously slid the joint and actively asked the patient to move their head towards the side where the dysfunction and pain were located. He held the SNAG technique for 10 seconds. This technique was repeated 10 times over approximately 8 minutes. | Other | Mulligan mobilization technique |
| Myofascial release therapyThe procedure was performed on the upper part of the trapezius muscle and the levator scapulae muscle. The patient was in a seated position, hips higher than knees, feet slightly in front of the knees and in full contact with the ground. The therapist stood behind the patient. Myofascial release of the trapezius was performed unilaterally with a soft fist, while the patient lowered their head forward and slowly rotated, creating a tension line from the middle of the trapezius towards the acromion process. During this time, the patient was asked to turn their head to the opposite side. Then, the therapist applied resistance to the opposite side of the rotation for 10 seconds. MGT was repeated 5 times on the trapezius. The therapist applied the same unilateral contraction, but the tension line was slightly laterally towards the lower edge of the scapula. The therapist then asked the patient to tilt their head forward to increase resistance on the levator scapula for 10 seconds. | Other | Myofascial release therapy |
| Exercise therapyAll patients were given a home exercise program consisting of neck joint range of motion exercises, trapezius stretches, and isometric strengthening exercises for the neck muscles. The home exercise program was initiated with 3 sets of 10 repetitions per day. The exercises were demonstrated practically by the physician, and all patients were given a printed sheet showing how to perform the exercises. Patients were contacted by phone once a week to inquire about their adherence to the exercise program and were encouraged to follow it. Patients with exercise adherence below 75-80% were excluded from the study. | Other | A home workout program |
Primary outcome
Frequency of cervicogenic headache
Time frame: Beginning, week 4, and week 8
To determine the frequency of cervicogenic headaches, patients were given a headache diary.
assessment of pain intensity VAS pain (0-10)
Time frame: Beginning, week 4, and week 8
0 no pain, 10 unbearable/maximum pain
3 secondary outcomes
Headache impact scale (HIT)
Time frame: Beginning, week 4, and week 8
Headache disability inventory/indexi ( HDI )
Time frame: Beginning, week 4, and week 8
Assessment of quality of life short form-12
Time frame: Beginning, week 4, and week 8
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 2 Apr 2026.
- Individual participant dataSharing planned: Undecided
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Mulligan mobilization therapy, Myofascial release therapy and Exercise therapy in people with Cervicogenic Headache, run by Konya Beyhekim Training and Research Hospital at 1 site in Turkey (Türkiye).
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 8 inclusion and 12 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: looking for participants now, as of the sponsor's last update on 2 Apr 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 Turkey (Türkiye). 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?
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 BURCU VURAL (+905389507278, burcuvural97@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Frequency of cervicogenic headache (time frame: Beginning, week 4, and week 8). The study lists 2 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 2 Apr 2026.