PTRCTNeuroRehabilitation2025

The Treatment of Cervicogenic Headache with Transcranial Direct Current Stimulation and Exercise Therapy: A Randomized Control Trial Evaluating Functional Outcomes.

Kaiden Jobin, Ashley Smith, Christina Campbell and 4 others

PMID 40289459

WHAT IT FOUND

Active brain stimulation added to exercise improved deep neck flexor control more than sham stimulation plus exercise, and this difference held at 12 weeks.

Strength and endurance improved in both groups, so exercise alone likely drove those gains.

Key findings

01Active tDCS combined with exercise therapy produced significantly greater improvement in craniocervical flexion test activation scores compared to sham tDCS plus exercise at post-treatment, 6 weeks, and 12 weeks.

02There were no significant differences between the active and sham tDCS groups for cervical isometric strength, range of motion, or flexor and extensor endurance at any follow-up.

03Both the active and sham tDCS groups showed significant longitudinal improvements in strength and endurance from pre-treatment to follow-up, suggesting exercise therapy alone provided these benefits.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study was a pilot trial with a small sample size (n=32), making it likely underpowered and increasing the risk of type II errors. Ceiling effects were observed in the endurance tests (CFET and CEET), where many participants already exceeded normative values at baseline, potentially masking true differences. Exercise adherence was self-reported, which may lead to over-reporting. Participants were recruited from specialized outpatient chronic pain clinics, which may not represent the broader population with cervicogenic headache. The primary aim of the parent trial was safety and feasibility, not efficacy, so findings should be interpreted with caution.

Declared interests

Funding was provided by the Hotchkiss Brain Institute at the University of Calgary. No other specific conflicts of interest were detailed in the provided text.

The easy way to misread this

Do not interpret the improvement in strength and endurance as a result of tDCS, as both active and sham groups improved similarly, indicating these gains were likely due to the exercise therapy component alone.

Read it on PubMed →