Effects of Cranial Base Release and Upper Cervical Spine Mobilization in Patients with Migraine Headache: A Two group pretest posttest randomized pilot clinical trial

BACKGROUND: Migraine is a common chronic disorder causing recurrent attacks and thus resulting in severe complications. Patients with migraine headache suffer with reduced quality of life in turn having low productivity in workplaces, causing a burden on them.

AIM: The aim of the study is to determine the effects of Cranial base release (CBR) combined with upper cervical spine mobilization and CBR only in patients with migraine.

MATERIALS AND METHODS: A two group pre post pilot study was conducted. Total numbers of 12 patients suffering with migraine headache were recruited for the study. Age group of the patients is taken from 18-30 years. Patients were randomly allocated in two groups - Group A and Group B. In group A, Cranial Base Release with upper cervical spine Mobilization at (C0-C3) were given as a treatment while in group B only Cranial Base Release was as a treatment. In both the groups, treatment duration was 20 minutes for 2 weeks, 6 sessions were given for alternate days. Outcome measures used for Pre-test Post-test comparison were Pressure Algometer for measuring Pain Pressure Threshold and Headache Disability Index (HDI) for calculating Disability Index.

RESULTS: To determine the normality Shapiro Wilk was used, as the sample size was less than 50. Data following normal distribution. Paired t test was used for within the group analysis and Independent t test was used for between the group analysis. Effect size was calculated form Effect Size Index. No statistically significant difference were noted in post Headache Disability Index and Algometer values (P>0.05). Effect size predicts huge effect size in post HDI values in Group 1 as compared with the group 2.

CONCLUSION: Both the treatments help in reducing pain and disability in patients suffering with migraine.

背景：偏头痛是一种常见的慢性疾病，其特征为反复发作，进而导致严重的并发症。患有偏头痛头痛的患者生活质量显著降低，进而导致工作场所的生产力下降，从而对他们造成负担。
目标：本研究旨在确定颅底释放术（CBR）结合上颈椎关节松动术以及仅使用CBR对偏头痛患者的影响。
材料与方法：进行了一项两组的前后对照试点研究。共招募了12名患有偏头痛头痛的患者参与研究。患者年龄范围为18-30岁。患者被随机分配到两组——A组和B组。在A组中，接受了颅底释放术与上颈椎（C0-C3）关节松动术作为治疗方案，而在B组中，仅接受了颅底释放术作为治疗方案。两组的治疗时长均为两周，每次治疗20分钟，每隔一天进行一次，共6次。用于前后测试比较的结局指标包括压力测痛仪，用于测量疼痛压力阈值，以及头痛残疾指数（HDI），用于计算残疾指数。
结果：由于样本量小于50，因此使用了Shapiro-Wilk检验以确定数据的正态性。数据符合正态分布。配对t检验用于组内分析，独立t检验用于组间分析。通过效应量指数计算效应量。在头痛残疾指数和测痛仪值方面未观察到统计学上的显著差异（P>0.05）。效应量预测在组1的头痛残疾指数的效应量相较于组2有巨大的预测值。
结论：两种治疗方案均有助于减轻偏头痛患者的疼痛和残疾。