The Effect of Suboccipital Myofascial Release Technique on Cervical Muscle Strength of Patients With Cervicogenic Headache

Purpose: To determine whether Myofascial Release (MFR) technique in upper cervical region is more effective than using conventional exercises to improve cervical muscle strength in patients with cervicogenic headache. Design: Randomized Controlled Trial. Setting: An outpatient physical therapy clinic, University of social welfare and rehabilitation science, Iran. Methods: We conducted a prospective, randomized controlled, and single blinded trial on 34 patients with cervicogenic headache, aged 15-75 years, which assigned randomly to exercise group (n=17, mean(SD) age=38(11.31) years) and suboccipital myofascial release group (n=17, mean(SD) age=38.88(9.38) years). Ten treatment sessions, 6 times a week for each group were applied. Outcome measures were isometric cervical muscle strength (flexors, extensors, right and left rotators and lateral flexors) measured by force gauge. Results: Statistical analysis (paired t test) revealed a significant improvement in cervical muscle strength after treatment in the MFR and exercise groups compared with before treatment (P<0.05). Based on ANCOVA results, pretest scores as controlling factor, no significant difference was found between two groups after 10 treatment sessions with regard to all variables (P>0.05) except cervical flexors strength (P=0.021) and cervical left rotators strength (P=0.031). Conclusion: Pain and myofascial stiffness can be an impediment for full muscle interference in contraction and application of suboccipital MFR and common exercises can be effective techniques in restoring cervical muscle strength, especially in cervical rotatory movements.