RECRUITING

Manipulation and Dry Needling in Patients With Cervicogenic Headache and WAD II

Conditions

Cervicogenic Headache Whiplash Injuries Headache Whiplash

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The purpose of this research is to compare two different approaches for treating patients with cervicogenic headaches associated with type II whiplash associated disorder: non-thrust mobilization and exercise versus thrust manipulation and dry needling. Physical therapists commonly use all of these techniques to treat cervicogenic headaches. This study is attempting to find out if one treatment strategy is more effective than the other.

Official Title

Upper Cervical Spine Manipulation and Dry Needling Versus Conventional Physical Therapy in Patients With Cervicogenic Headache and Type II Whiplash Associated Disorder: a Multi-center Randomized Clinical Trial

Quick Facts

Study Start:2024-05-01

Study Completion:2026-05-01

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT06502951

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years to 65 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
1. Subacute (\> 4 weeks) or chronic type II whiplash associated disorder. Neck pain and headache following motor vehicle accident with reduced range of motion \& point tenderness. 2. Diagnosis of cervicogenic headache as defined by Cervicogenic Headache International Study Group criteria. 3. Headache frequency of at least one per week since the whiplash injury. 4. Headache intensity of greater than 2/10 on the NPRS. 5. Neck pain intensity of greater than 2/10 on the NPRS. 6. Neck Disability Index score of greater than 10/50 on the NDI.	1. WAD I (neck pain, but no physical signs), WAD III (neck pain and neurological signs), WAD IV (neck pain + fracture/dislocation). 2. Positive screen for cervical radiography (Canadian C-Spine Rules). 3. Bilateral headaches (typical of tension type headaches). 4. Diagnosis / signs \& symptoms of concussion (confusion, disorientation, or impaired consciousness; loss of memory for events immediately before or after the MVA; and one or more of the following: nausea, vomiting, visual disturbances, vertigo, gait and/or postural imbalance, and impaired memory and/or concentration). 5. Diagnosis of fibromyalgia. 6. Presence of any of the following atherosclerotic risk factors: hypertension, diabetes, heart disease, stroke, transient ischemic attack, peripheral vascular disease, smoking, hypercholesterolemia, or hyperlipidemia. 7. Red flags noted in the patient's Neck Medical Screening Questionnaire (i.e., tumor, fracture, metabolic diseases, RA, osteoporosis, prolonged history of steroid use, etc.). 8. Diagnosis of cervical spinal stenosis. 9. Bilateral upper extremity symptoms. 10. Evidence of central nervous system involvement, to include hyperreflexia, sensory disturbances in the hand, intrinsic muscle wasting of the hands, unsteadiness during walking, nystagmus, loss of visual acuity, impaired sensation of the face, altered taste, the presence of pathological reflexes (i.e. positive Hoffman's and/or Babinski reflexes). 11. Two or more positive neurologic signs consistent with nerve root compression, including any two of the following: 1. Muscle weakness involving a major muscle group of the upper extremity. 2. Diminished upper extremity deep tendon reflex of the biceps, brachioradialis, triceps or superficial flexors 3. Diminished or absent sensation to pinprick in any UE dermatome. 12. Prior surgery to the head, neck, or thoracic spine. 13. Physical therapy or chiropractic treatment for neck pain and/or headache in the past 3 months. 14. Any condition that might contraindicate spinal manipulative therapy or dry needling.

Inclusion Criteria

Exclusion Criteria

1. Subacute (\> 4 weeks) or chronic type II whiplash associated disorder. Neck pain and headache following motor vehicle accident with reduced range of motion \& point tenderness.
2. Diagnosis of cervicogenic headache as defined by Cervicogenic Headache International Study Group criteria.
3. Headache frequency of at least one per week since the whiplash injury.
4. Headache intensity of greater than 2/10 on the NPRS.
5. Neck pain intensity of greater than 2/10 on the NPRS.
6. Neck Disability Index score of greater than 10/50 on the NDI.

1. WAD I (neck pain, but no physical signs), WAD III (neck pain and neurological signs), WAD IV (neck pain + fracture/dislocation).
2. Positive screen for cervical radiography (Canadian C-Spine Rules).
3. Bilateral headaches (typical of tension type headaches).
4. Diagnosis / signs \& symptoms of concussion (confusion, disorientation, or impaired consciousness; loss of memory for events immediately before or after the MVA; and one or more of the following: nausea, vomiting, visual disturbances, vertigo, gait and/or postural imbalance, and impaired memory and/or concentration).
5. Diagnosis of fibromyalgia.
6. Presence of any of the following atherosclerotic risk factors: hypertension, diabetes, heart disease, stroke, transient ischemic attack, peripheral vascular disease, smoking, hypercholesterolemia, or hyperlipidemia.
7. Red flags noted in the patient's Neck Medical Screening Questionnaire (i.e., tumor, fracture, metabolic diseases, RA, osteoporosis, prolonged history of steroid use, etc.).
8. Diagnosis of cervical spinal stenosis.
9. Bilateral upper extremity symptoms.
10. Evidence of central nervous system involvement, to include hyperreflexia, sensory disturbances in the hand, intrinsic muscle wasting of the hands, unsteadiness during walking, nystagmus, loss of visual acuity, impaired sensation of the face, altered taste, the presence of pathological reflexes (i.e. positive Hoffman's and/or Babinski reflexes).
11. Two or more positive neurologic signs consistent with nerve root compression, including any two of the following:
1. Muscle weakness involving a major muscle group of the upper extremity.
2. Diminished upper extremity deep tendon reflex of the biceps, brachioradialis, triceps or superficial flexors
3. Diminished or absent sensation to pinprick in any UE dermatome.
12. Prior surgery to the head, neck, or thoracic spine.
13. Physical therapy or chiropractic treatment for neck pain and/or headache in the past 3 months.
14. Any condition that might contraindicate spinal manipulative therapy or dry needling.

Contacts and Locations

Study Contact

James Dunning, PhD, DPT

CONTACT

801-707-9056

jamesdunning@hotmail.com

Ian Young, DSc, PT

CONTACT

912-433-3531

tybeewellness@gmail.com

Principal Investigator

James Dunning, PhD, DPT

PRINCIPAL_INVESTIGATOR

American Academy of Manipulative Therapy

Study Locations (Sites)

Alabama Physical Therapy & Acupuncture

Montgomery, Alabama, 36117

United States

Collaborators and Investigators

Sponsor: Alabama Physical Therapy & Acupuncture

James Dunning, PhD, DPT, PRINCIPAL_INVESTIGATOR, American Academy of Manipulative Therapy

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2024-05-01

Study Completion Date2026-05-01

Study Record Updates

Study Start Date2024-05-01

Study Completion Date2026-05-01

Terms related to this study

Keywords Provided by Researchers

Headache
Whiplash

Additional Relevant MeSH Terms

Cervicogenic Headache
Whiplash Injuries