The aim of the study is to compare Back School Based Intervention with Cranio- Cervical muscle training in participants with Cervicogenic headache. The study wants to investigate that which intervention helps to mange pain, improve posture and reduce disability. The study aims to answer the question:
* How effective is Back School Based intervention on pain, posture and disability in computer users with Cervicogenic headache compared to Cranio-cervical Muscle Training? Participants will * Attend the treatment sessions of the group in which they are placed. * Take treatment session two times a week for eight weeks. * Participants will be asked about their pain and activities throughout the study.
Participants of both gender.
Participants aged between 19 to 44 years.
Participants having unilateral headache without side shift for>3 months aggravated by neck movement.
Participants with pain intensity ≥3 on a visual analog scale (VAS).
If participants having any history of fractures or previous surgery of the vertebral column, any degenerative and inflammatory arthritis, osteoporosis, dislocations, cervical radiculopathy/myelopathy and any history of whiplash injury.
Participants showing any signs of the five 'D's' or three 'N's.
Parallel
Back School Based Intervention
Other intervention* Patient will receive 2 sessions per week for 8 weeks for a total of 16 sessions. Each session lasted for 35 minutes. * Conventional Physical therapy will be provided in which stretching of the tight muscles which include SCM, upper trapezius, levator scapulae, scalene, sub occipitals, pectoralis minor, and pectoralis major. Neck stretches, chin tucks, scapular squeezes, and upper back strengthening exercises with 5 repetitions will be performed. Trigger points of sub occipitals, SCM, and temporalis are released because they cause headache. * Back School Based Intervention includes both theoretical and practical part. Patients had total of 16 sessions out of which 14 will be practical one and remaining two will be theoretical one. In theoretical part main focus is on the patient education and guidance. In practical part resistive exercises of increase intensity in each session will be performed in which main focus is on the strengthening
Cranio-Cervical muscle Training
Other intervention* Patient will receive 2 sessions per week for 8 weeks for a total of 16 sessions. Each session lasted for 35 minutes. Conventional physical therapy will be same in both groups * Cranio- cervical muscle training session main focus is on the strengthening and posture correction. Cervical flexion, extension and stabilization exercises will be performed which helps to strength muscles and helps to neutralize posture and ultimately disability which is due to headache will be reduced.
Visual Analogue scale
Visual Analogue Scale is used for the measurement of pain.a hand written mark on 10 cm line helps to differentiate pain in different patients. If Patient reports minimum pain level more than 3 than considered as the patient required for study maximum pain level will be 10
Headache Disability Index
Headache Disability Index is used to evaluate the impact of headache on person's daily life activities. It consists of 25 questions. Patient answer the question as yes scored as 4, sometimes as 2 or no as 0. The score interpretation for disability is measured and for mild disability it is 10 to 28, for moderate disability is 30 to 48, for severe disability is 50 to 68 and for complete disability 72 or higher is noticed.
Plumb Line Assessment of Posture
A plumb line is used as reference to measure the abnormality or deviation from posture. It helps to pinpoint those areas of the body which are away from neutral alignment of the body such as rounded shoulder, forward head posture and abnormal tilt of pelvis. Patient reported as deviated or non deviated from neutral posture.
Cervical Flexion Rotation Test
Cervical flexion rotation test is used to determine the presence of joint dysfunction at the C 1/2 level. The cervical spine is fully flexed to avoid rotational movements then rotated to right and left to find out any pain or restrictions in the joints. Pain provocation and limited rotation indicate the positive test result. Maximum range of rotation will be 45 which is considered as normal. Range less than 45 will need to be corrected.
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