Servikojenik Baş Ağrısında, Servikal Mobilizasyon ve Klinik Pilates Egzersizlerinin Ağrı, Kas Sertliği, Baş-Boyun Kan Akışı ve Postür Üzerine Etkisi

Abstract

This study was conducted to examine the effects of cervical mobilization (CM) and clinical pilates exercises (CPE) on pain, muscle stiffness, head and neck blood flow and posture in individuals with cervicogenic headache (CH). 37 individuals diagnosed with CH were included in the study. Individuals were randomly divided into 3 groups: CM, CPE and CM+CPE. Applications were made three days a week for 6 weeks. Demographic information of the individuals was obtained before treatment. Headache frequency and amount of analgesic use within a month were recorded. Pain intensity with Visual Analog Scale, muscle stiffness with Myoton Pro, internal carotid artery (ICA) and vertebral artery (VA) blood flow with Doppler US, neck-shoulder posture evaluation with Posture Screen application, cervical joint range of motion with CROM device and deep neck flexor muscle (DNFM) endurance with pressure biofeedback stabilizer device were evaluated. Neck Disability Index (NDI) for neck dissability status and Migraine Disability Assessment Scale (MIDAS) for headache disability status were applied. Evaluations were performed before treatment and repeated at week 3 and after treatment. There was no difference between the groups in terms of gender distribution, age and average disease duration (p>0,05). In all groups, after treatment, a decrease in headache parameters, muscle stiffness, postural deviations, neck disability and headache disability values, and an increase in normal cervical joint range of motion and deep neck flexor muscle endurance were found (p<0,05). A significant increase in blood flow was determined in the CM and CM+CPE groups (p<0,05). In intergroup comparisons, significant improvements were observed in the CM+CPE group in headache, muscle stiffness, posture, DBFC endurance, neck disability status and headache disability values compared to the other groups(p<0,05). As a result, In individuals diagnosed with CH, CM and CPE can provide improvement when applied alone. When KPE was applied in addition to SM, it was observed that further improvement in headache could be achieved by increasing head and neck blood flow as postural deviations and muscle stiffness decreased. CM and CPE are physiotherapy approaches that can be used as alternatives in the management of CH.