The purpose of this study is to measure the change of range and mobility of upper cervical spines after myofascial release that applied on this region in subjects with cervicogenic headache by using motion analysis system and ultrasonography.
The study used two methods: 1) ultrasound-based motion analysis system to measure movements (including: nodding, chin-up and rotation to right and left) which were generated from upper cervical segments by manual fixation below C2; 2) ultrasonography was used to record the distance change between occiput and the first cervical vertebrae during craniocervical flexion, which presenting the mobility derived from C0 and C1 on sagittal plane. the effects of myofascial release applied to suboccipital muscles and C0-C1 joint in 10 patients with cervicogenic headache were compared with 10 min-rest in a crossover study over 2 separate days. Data of crossover study were analyzed using ANOVA with repeated measure. The scores of subjective tightness during carniocervical test before and after two interventions were examined by Wilcoxon signed ranks test.
Ten patients (34.3±4.4 years; 2 females and 8 males) with cervicogenic headache participated in this study. Their computer use time was 7.4±3.8 hours per day. There were no interactions between the effects of time and group on ranges of motion. The ranges of motion in upper cervical spine in sagittal plane (flexion/extension) suggested a tendency for increasing ranges after myofascial release. However, the difference did not reach the statistical significance in this study with small sample size (p=0.027). A significant interaction was observed between group and time for value of distance change between C0 and C1 (F=50.5, p0.001). The distance change between C0 and C1 significantly increased after myofascial release (p0.001), with no significant changes after 10 minutes rest (p=0.63). The scores of subjective tightness during carniocervical test had significant reduced after myofascial release (p=0.008).
Using ultrasonography to measure the distance change between C0 and C1 could detect the immediate increases of upper cervical range of motion after myofascial release. The results also confirmed that myofascial release could have immediate increase of mobility in C0-C1 segment in individuals with restricted upper cervical range of motion.
This study provided a method to evaluate the movement in C0 and C1 segment other than previous method using radiographic images. It is appropriate for differential diagnosis and assessment of treatment outcome and gave us a reference to improve craniocervical movement pattern in patients with cervicogenic headache.
Ultrasonography
Myofascial release
