Effects of cranio-cervical flexion with transcranial direct current stimulation on muscle activity and neck functions in patients with cervicogenic headache.
Seung Kyu Park, Dae Jung Yang, Je Ho Kim and 4 others
PMID 30774200WHAT IT FOUND
Adding transcranial direct current stimulation to cranio-cervical flexion exercise for four weeks improved neck disability and lowered sternocleidomastoid muscle activity more than the same exercise without stimulation in 30 cervicogenic headache patients.
The study was small, so use cautiously.
Key findings
01In 30 patients with cervicogenic headache, adding transcranial direct current stimulation to cranio-cervical flexion exercise for four weeks produced a significantly greater improvement in neck disability than cranio-cervical flexion exercise without stimulation.
02Neck disability scores, where higher means more disability, were lower after treatment in the stimulation group (17.9) than in the cranio-cervical flexion group (18.9).
03Sternocleidomastoid muscle activity also decreased more in the stimulation group, ending at 36.4%RVC versus 39.5%RVC in the cranio-cervical flexion group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study included only 30 patients, and the authors state this limits generalization. The intervention lasted only four weeks, so it gives no information about longer-term benefit. The control group received exercise without stimulation, so the study cannot separate the effect of transcranial direct current stimulation from the exercise programme. The paper says patients were randomly assigned, but it does not describe how allocation was concealed or whether participants and assessors were unaware of group. One trained physical therapist delivered and assessed all interventions, so results may not apply to other therapists or settings.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as proof that transcranial direct current stimulation alone treats cervicogenic headache. The stimulation group also received standard extension and cranio-cervical flexion exercise, and the study had only 30 patients over four weeks, so the effect of stimulation cannot be separated from the exercise programme.