title: Manual examination in the diagnosis of cervicogenic headache: a systematic literature review.
abstract: METHODS
  Systematic literature review.
  
  
  OBJECTIVE
  To evaluate the diagnostic validity of manual examination techniques used to diagnose cervicogenic headache (CGH).
  
  
  BACKGROUND
  Cervicogenic headache is a specific type of headache that originates from the cervical spine and is typically chronic in nature. Diagnostic criteria for CGH have been established by the International Headache Society (IHS) and are cited extensively in the literature. Diagnosis of CGH through manual examination is a more recent practice. To our knowledge, no systematic review of manual diagnosis of CGH has been performed.
  
  
  METHODS
  Searches of electronic databases (CINAHL, Cochrane Library, Medline, PEDro, Scopus, and SPORTDiscus) were conducted for research studies from July 2003 to February 2014. The GRADE approach was used to determine the quality of each paper.
  
  
  RESULTS
  Twelve papers that fulfilled the inclusion and exclusion criteria were identified (12 observational studies). The level of evidence ranged from very low to low, and recommendations for use of specific manual techniques ranged from weak to strong.
  
  
  CONCLUSIONS
  Despite low levels of evidence, manual examination of the cervical spine appears to aid the diagnostic process related to CGH and can be implemented by both experienced and inexperienced examiners.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Howard
authors.affiliation: Department of Physical TherapyThomas Jefferson University, Philadelphia, PA, USA.
authors.forename: William
authors.initials: W
authors.lastname: Behrns
authors.affiliation: Department of Physical TherapyThomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Melanie Di
authors.initials: MD
authors.lastname: Martino
authors.affiliation: Department of Physical TherapyThomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: DiMambro
authors.affiliation: Department of Physical TherapyThomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: McIntyre
authors.affiliation: Department of Physical TherapyThomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Shurer
keywords: Cervical headache; Cervicogenic headache; Diagnosis; Manual examination; Physical examination