Effects of cranio-cervical flexion with transcranial direct current stimulation on muscle activity and neck functions in patients with cervicogenic headache

[Purpose] To present an efficient treatment regimen for patients with cervicogenic headache by comparatively analyzing the neck disability index (NDI) and cervical muscle activity after an exercise intervention. [Participants and Methods] Thirty patients with cervicogenic headache were assigned to the cranio-cervical flexion group (n=15) and cranio-cervical flexion plus transcranial direct current stimulation (tDCS) group (n=15). Intervention was administered for four weeks, after which the participants’ NDI and sternocleidomastoid muscle activity were measured. [Results] The treatment group demonstrated a significantly greater change in NDI after the intervention compared to the control group. The treatment group also showed a significantly greater change in sternocleidomastoid muscle activity than the control group. [Conclusion] Our results show that applying tDCS during cranio-cervical flexion exercise can strengthen the sternocleidomastoid muscle more effectively while improving pain and associated functions in patients with cervicogenic headache. These results would contribute towards developing a more efficient treatment for patients with cervicogenic headache.