Effects of Shi Style Cervical Mobilization Versus Sustained Natural Apophyseal Glides on Pain, Strength and Functional Disability in Patients with Cervicogenic Headache

Authors

  • Ayesha Khalid Malik Riphah International University, Islamabad, Pakistan Author
  • Ayesha Habib Lecturer, Iqra University Chak Shahzad Campus, Islamabad, Pakistan Author
  • Ayyaz Ahmad Lecturer, Multan College of Rehabilitation and Allied Health Sciences, Multan, Pakistan Author
  • Hafiza Aroosa Syed Lecturer, Riphah International University Faisalabad, Faisalabad, Pakistan Author
  • Huma Khan Assistant Professor, Sharif Medical and Dental College, Lahore, Pakistan Author
  • Muhammad Haris Assistant Professor, Bahria University of Health Sciences Campus Karachi, Karachi, Pakistan Author

DOI:

https://doi.org/10.61919/n8wffa20

Keywords:

Cervicogenic headache, manual therapy, SNAGs, cervical mobilization, randomized controlled trial, pain, disability.

Abstract

Background: Cervicogenic headache is a secondary headache disorder originating from cervical spine dysfunction, commonly associated with pain, reduced mobility, dizziness, and functional disability, with manual therapy representing a key conservative management strategy. Objective: To compare the effectiveness of Shi-style cervical mobilization and Sustained Natural Apophyseal Glides (SNAGs) on pain intensity, cervical muscle strength, dizziness-related disability, functional disability, and quality of life in patients with cervicogenic headache. Methods: A randomized controlled trial was conducted on 40 participants allocated equally into two groups receiving either Shi-style cervical mobilization or SNAGs over a two-week period, alongside standardized physiotherapy. Outcomes including Numeric Pain Rating Scale (NPRS), pressure biofeedback, Dizziness Handicap Inventory (DHI), Neck Disability Index (NDI), and SF-36 were assessed at baseline and post-intervention. Non-parametric statistical tests were applied with significance set at p < 0.05. Results: Both groups demonstrated statistically significant improvements across all outcomes (p < 0.001). However, Shi-style mobilization resulted in greater reductions in pain (median 6.0 to 2.0 vs 3.0), disability (NDI: 32.0 to 7.0 vs 17.0), and dizziness (DHI: 53.0 to 21.0 vs 23.5), with moderate to large effect sizes (r = 0.42–0.79). Conclusion: Both interventions are effective, but Shi-style cervical mobilization demonstrates superior clinical outcomes and may be considered a more effective treatment approach for cervicogenic headache. 

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Published

2025-12-31

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How to Cite

Effects of Shi Style Cervical Mobilization Versus Sustained Natural Apophyseal Glides on Pain, Strength and Functional Disability in Patients with Cervicogenic Headache. (2025). Link Medical Journal, 3(2), 1-9. https://doi.org/10.61919/n8wffa20

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