4. Discussion
TrPs, headaches, head posture, pain, tension-type, headache, cognitive pain
CERVICOGENIC HEADACHE, CERVICOGENIC HEADACHES, HYPERSENSITIVITY, CCF
This study compared the efficacy of pressure biofeedback-guided DCFM strength training to cervical isometric exercises on pain and functional limitation in patients with cervicogenic headaches. The results of the study indicate that DCFM strength training using pressure biofeedback was more effective at reducing pain intensity and functional limitations, thereby increasing the endurance capacity of the DCFM over a 3-week period for the treatment of CGH. A referred pain reported in any head portion generated by a primary nociceptive source in the musculoskeletal tissues innervated by cervical nerves is defined as CGH by The World Cervicogenic Headache Society (WCHS) [This study provides preliminary evidence that such a trial is feasible. Manual therapy targeted to active TrPs in the sternocleidomastoid muscle may reduce headache and neck pain intensity and boost the motor function of the deep cervical flexors, PPT, and active CROM in persons with CGH and active TrPs in this muscle [Numerous researchers have investigated the anatomic basis of CGH, including the distribution of referred pain, to pinpoint the segmental location of symptomatic joints. Using fluoroscopically guided intraarticular injections, these authors demonstrated that C0-1, C1-2, and C2-3 are the segments most likely to refer pain to a location that would be experienced as a headache [The current scientific evidence supports the use of manual therapy in treating tension-type and cervicogenic headaches; however, the results are inconsistent. These disparate outcomes may be attributable to not all manual therapies being suited for all types of headaches, or not all headache patients will benefit from manual therapy. Based on a nociceptive pain rationale, this research provides examples of manual therapies for tension-type and cervicogenic headaches that modulate central nervous system hypersensitivity, including trigger point therapy, joint mobilization, joint manipulation, exercise, and cognitive pain methods [These results imply that DCFM strengthening exercises employing a pressure biofeedback unit are more beneficial than traditional exercise alone in lowering headache frequency in persons with CGH. The roller massage technique may be recommended to augment the initial ROM and strength of the CCF in individuals with a forward head posture [