Abstract
Introduction: Research into the pathophysiology of cervicogenic headache (CEH) has identified connections between cervical dysfunction, proprioception, and balance deficits. The primary aim of this study is to identify any differences in balance in patients with neck pain with and without CEH. Secondary aims include identifying differences in range of motion (ROM), deep neck flexor endurance, and self-reported functional levels via three separate questionnaires. Methods: Subjects were recruited using convenience sampling, and were divided into two groups based on the presence of CEH. Each group contained 20 subjects. Balance was measured with the Neurocom Sensory Organization Test (SOT) three times during six weeks of standard physical therapy intervention. Data regarding cervical ROM, deep neck flexor endurance, Headache Disability Index (HDI), Neck Disability Index (NDI), and Visual Analog Score (VAS) were collected as well. Results: Forty subjects total enrolled and completed the six-week treatment period consisting of manual therapy and therapeutic exercise. MANOVA analysis showed no statistically significant differences among the two groups. A slower rate of SOT improvement was noted in the NP/HA group compared to the NP Group. HDI was most consistently correlated with the SOT, yet deep neck flexor endurance (NFMET) also showed a positive correlation with SOT. Repeated measures ANOVA showed improvements after treatment in cervical ROM, NFMET, HDI, NDI, and VAS in all subjects. At weeks 3 and 6 of treatment, cervical ROM had a positive correlation with NFMET. Conclusion: There was no significant difference in balance in neck pain patients with and without CEH. A standard six-week rehabilitation program for neck pain patients can improve cervical ROM, deep neck flexor endurance, HDI scores, NDI scores, and VAS scores. Further research should quantify effects of manual therapy and exercise combined with balance and proprioception training in both patient populations.