Enduroflex - Relief from Headache

Research & Education

Diagnosis is difficult and cannot be made from the features of a headache alone because the symptoms of many different types of headache overlap. The challenge of determining if the neck is involved has largely been overcome. We are the sum of our experiences – and my clinical experience suggests that cervicogenic dysfunction can be the cause of headache and migraine. It is incumbent to pass on and support this experience with rigorous scientific research, communicating it with headache sufferers.

- Enduring Relief for Headache

ENDUROFLEX is designed to assist physiotherapists assess the endurance capacity of the deep neck flexors and their subsequent rehabilitation in patients with cervicogenic headaches.

Dean Watson completed his Masters research program at The University of South Australia in 19911 and which demonstrated significant deficiency of the deep neck flexors (DNFs) in cervicogenic headache sufferers. Subsequent research has not only confirmed Dean's findings, clinical trials have also demonstrated that rehabilitation of the DNFs decreases the frequency and severity of headache2,3,4,5.

However despite the strength of this research and clinical trial, assessment and rehabilitation of DNF endurance capacity continues to receive little attention. This could indicate a lack of awareness of developments in the literature or a reluctance to incorporate research findings into management regimes6. Also feedback from clinicians has indicated that current methods of assessing and retraining the DNFs is time consuming and non functional.

There is a need to simplify the assessment and rehabilitation procedures without compromising precise feedback... and what if this could be done in a functional way?

- Reliable Assessment

ENDUROFLEX contains two pressure sensors (bladders) embedded in two panels (connected by straps on either side) – one anteriorly underneath the mandible and the other posteriorly occupying the suboccipital space. Each bladder is inflated and the patient then performs cranio cervical flexion. The correct action is indicated by a simultaneous increase in pressure in both sensors. The quality and performance of the movement is monitored from the corresponding gauges.

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References

1. Watson DH, Trott PH.
   • Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia 1993;13:272-84
2. Treleaven J, Jull G, Atkinson L.
   • Cervical musculoskeletal dysfunction in post concussional headache. Cephalalgia 1994 ;14:273-9
3. Barton P, Hayes K.
   • Neck flexor strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache. Arch Phys Med Rehab 1996;77:680-7
4. Jull G, Barrett C, Magee R, Ho P.
   • Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia 1999;19:179-85
5. Jull G, Trott P, Potter H, Zito G, Niere K, Shirley D, Emberson J, Marschner I, Richardson C.
   • A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine 2002;27:1835-1843
6. Grant T, Neire K.
   • Techniques used by manipulative physiotherapists in the management of headaches. Australian Journal of Physiotherapy 2000 46:215-222