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Musculoskeletal Impairment in Headaches Attributed to Rhinosinusitis

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StatusNot yet recruiting
Sponsors
Des Moines University
Collaborators
Texas Tech University
University of Hartford
Youngstown State University
American Academy of Orthopaedic Manual Physical Therapists

Keywords

Abstract

Neck pain, neck muscle weakness, and limited neck range of motion have been shown in individuals with sinus headaches. Individuals in this previous study self-diagnosed their sinus headaches. It is unknown whether or not individuals who have been diagnosed with sinus headaches according to diagnostic criteria also present with musculoskeletal impairments.
The purpose of this study is to determine if musculoskeletal neck impairments are present in individuals diagnosed with headaches attributed to rhinosinusitis compared to people without headaches.
Upper cervical range of motion can be measured using different tests. The side bend rotation test has been suggested as potentially more useful than the flexion rotation test in individuals with hyper-laxity, however, has not been examined in a symptomatic population.
A secondary purpose is to compare the side bend rotation test to the cervical flexion rotation test in people with varying degrees of joint laxity.

Description

Design: Observational, case control Background: A recent study showed neck pain, neck muscle weakness, and limited neck range of motion in individuals who reported having sinus headaches. These impairments are also associated with cervicogenic headaches (headaches originating in the neck), but had not previously been shown in people with sinus headaches.

Because the individuals in this previous study self-diagnosed their sinus headaches, it is possible that they did not have sinus headaches but rather had a different kind of headache. It is unknown whether or not individuals who have been diagnosed with sinus headaches according to diagnostic criteria also present with musculoskeletal impairments.

Purpose 1: The purpose of this study is to determine if musculoskeletal neck impairments are present in individuals diagnosed with headaches attributed to rhinosinusitis (sinus headaches) compared to people without headaches. Question: Do people with diagnosed with headaches attributed to rhinosinusitis have neck pain or impairments in neck strength, neck range of motion, or segmental neck joint mobility compared to people without headaches?

Background for question 2: Upper cervical range of motion can be measured using the flexion-rotation test or the side bend rotation test. The side bend rotation test has been suggested as potentially more useful in individuals with hyper-laxity, however, has not been examined in a symptomatic population.

Purpose 2: To compare the side bend rotation test to the cervical flexion rotation test and manual joint assessment in people with varying degrees of joint laxity. Question: What is the diagnostic accuracy of the side bend rotation test compared to the index tests of the flexion rotation test and manual joint assessment?

Dates

Last Verified: 12/31/2019
First Submitted: 01/05/2020
Estimated Enrollment Submitted: 01/06/2020
First Posted: 01/08/2020
Last Update Submitted: 01/26/2020
Last Update Posted: 01/28/2020
Actual Study Start Date: 01/31/2020
Estimated Primary Completion Date: 11/30/2022
Estimated Study Completion Date: 11/30/2022

Condition or disease

Headache

Intervention/treatment

Other: No intervention will be administered. We are only performing tests and measures.

Phase

-

Arm Groups

ArmIntervention/treatment
Headache Attributed to Rhinosinusitis Group (HAR)
No interventions will be provided.
Headache-Free Control Group (Control)
No interventions will be provided.

Eligibility Criteria

Ages Eligible for Study 18 Years To 18 Years
Sexes Eligible for StudyAll
Sampling methodNon-Probability Sample
Accepts Healthy VolunteersNo
Criteria

Inclusion criteria for the headache attributed to rhinosinusitis (HAR) group:

- HAR has been present for at least 12 weeks OR

- Participant has had at least 4 HAR over the past 12 months without persistent symptoms between (chronic or recurrent)

- Diagnosis of headache attributed to rhinosinusitis (or sinus headaches) according to International Classification of Headache Disorders (ICHD-3)

Exclusion criteria for the HAR group:

- History of surgery to the cervical spine

- Whiplash injury within the past 5 years or any persistent symptoms attributable to a whiplash associated disorder

- Diagnosis of any headache type other than sinus headache with exception of an occasional, mild headache for which they have not sought medical care.

Exclusion criteria for the non-headache group (NHA):

- Any history of headaches for which they have sought medical care

Outcome

Primary Outcome Measures

1. range of motion [Day 1]

measured with a cervical range of motion device (CROM)

Secondary Outcome Measures

1. Pain Level [Day 1]

visual analogue scale

2. disability [Day 1]

Neck Disability Index (self-report questionnaire)

3. headache impact [Day 1]

Headache Impact Test (self-report questionnaire)

4. sino-nasal outcome test (SNOT-22) [Day 1]

self-report questionnaire

5. Cervical side bend rotation test [Day 1]

neck range of motion side bending first, then rotating the head and neck

6. cervical flexion rotation test [Day 1]

neck range of motion flexing first, then rotating

7. segmental joint mobility [Day 1]

manual segmental joint examination

8. neck flexor endurance [Day 1]

neck flexor muscle endurance test in supine

9. Beighton score [Day 1]

a series of range of motion tests to measure hyper-laxity of joints

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