Analysis of the upper cervical spine stiffness during axial rotation: A comparative study among patients with tension-type headache or migraine and asymptomatic subjects.
BACKGROUND
Many studies reported the implication of the cervical musculoskeletal system in patients with tension type headache and migraine. The objective of this study is to investigate the upper cervical spine stiffness features in axial rotation among headache patients in comparison with a healthy population.


METHODS
48 subjects including 30 migraine patients with/without aura and 18 patients with tension-type headache, aged between 18 and 60years (mean 36, SD 11years) have been evaluated. Stiffness measurements were carried out for passive axial rotation using a torque meter device. The flexion-rotation test was used to emphasize assessment of the upper cervical spine.


RESULTS
Neither the stiffness nor the neutral zone varies between different populations studied. Passive range of motion in axial rotation is unilaterally reduced in symptomatic subjects (p=0.001). Considering the elastic zone, right and left motion magnitude was significantly lower for clinical groups compared to the control group.


CONCLUSIONS
Stiffness seems not to be altered among tension type headache and migraine patients. However, patients seem prone to display a larger right-left asymmetry of axial rotation and a reduction in the motion range tolerance, emphasizing the likely link between the cervical discomfort and these pathologies. Any difference is observed in the elastic behavior of the upper cervical spine between the two primary headache populations. However, further investigations are needed to confirm these previous results taking various specific clinical characteristics into consideration.
Department of Osteopathic Sciences, Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium; Laboratory of Functional Anatomy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium. Electronic address: pdugaill@ulb.ac.be.
P-M
PM
Dugailly
Department of Osteopathic Sciences, Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium.
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A
Decuyper
Department of Osteopathic Sciences, Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium.
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W
Salem
Department of Osteopathic Sciences, Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium.
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A
De Boe
Department of Physiotherapy, University of Valencia, Valencia, Spain.
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GV
Espí-López
Department of Osteopathic Sciences, Research Unit in Osteopathy, Faculty of Motor Sciences, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Y
Y
Lepers
D000328:Adult; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D018781:Tension-Type Headache / Q000503:physiopathology*; D055815:Young Adult