The interest of SNAGs mobilisations in the treatment of cervicogenic headaches ; Intérêt des mobilisations de type SNAGs dans le traitement des céphalées cervicogéniques

Introduction: Cervicogenic headaches are multifactorial disorders that are among the three more frequent types of headaches. They are caused by a disorder of the cervical structures, leading to a referred pain in the head area that can be amplified by psychological factors. Sustained Natural Apophyseal Glides (SNAGs) from the Mulligan concept could reduce symptoms due to its possible mechanical and neurophysiological effects. Objective: Determine the interest of SNAGs mobilisations in the treatment of cervicogenic headaches.Methods: Research were carried out until 02/20/2022 on several databases: Pubmed, PEDro, TRIP, Google Scholar, WEBscience, EMBASE, Aix Marseille University library, Cochrane library, Clinical trial.gov, Science direct and KINEdoc. To be eligible, these studies had to be written in French or in English. In addition, they had to study patients suffering from cervicogenic headaches treated using SNAGs mobilisations. Methodological quality was assessed using the PEDro scale for randomised clinical trials (RCTs) and the JBI Critical Appraisal Checklist for Case Series (CS) included. All the results were synthesized as several tables and analysed qualitatively.Results: Finally, 5 studies were included, 4 RCTs and 1 CS involving 237 patients. Across all included studies, SNAGs mobilisations would result in an improvement of outcomes related to headaches attack, cervical range motion, activity and participation restriction. However, the effect of SNAGs seems equivalent to that of Natural Apophyseal Glides (NAGs) or that of dry needling. The most significant effect had been achieved when combining the interventions.Discussion: This review seems to demonstrate a positive effect of SNAGs mobilisations on all outcomes assessed. However, the quality of evidence is considered low for headache attack outcomes, and very low for cervical range motion, as well as activity restriction outcomes. Finally, due to the great heterogeneity of these studies and biases found, better quality studies are required to ...