Efficacy of a Mulligan Concept Sustained Natural Apophyseal Glide Technique for Cervicogenic Headache: A Critically Appraised Topic

Clinical Question: In adults with cervicogenic headache (CGH), what are the effects of a clinician-applied Mulligan Concept C1-C2 rotational sustained natural apophyseal glide on cervicogenic symptomology? Clinical Bottom Line: Both Level 2b and Level 4 evidence of Grade B quality exists to support using the C1-C2 rotational sustained natural apophyseal glide to decrease CGH severity and participant-reported neck disability immediately posttreatment, while also increasing cervical range of motion in adult patients with CGH headaches and a positive flexion-rotation test. Further research should examine the long-term effects of the C1-C2 rotational sustained natural apophyseal glide technique on cervical range of motion, flexion-rotation test results, and CGH frequency and severity. In addition, the flexion-rotation test should be explored as a standard diagnostic assessment in CGH cases.