Publication Date

Spring 2015

Document Type

Project Summary

Degree Name

Doctor of Physical Therapy


Physical Therapy

First Advisor

Roberta O'Shea, PT, DPT, Ph.D.

Second Advisor

Dale Schuit, PT, Ph.D., MS

Third Advisor

Rebecca K. Wojcik, PT, Ed.D., GCS


Background and Purpose: The purpose of this case report is to describe the interventions and outcomes of a comprehensive physical therapy (PT) treatment program that emphasized addressing musculoskeletal deficits and increasing neuromuscular control, which was theorized to decrease headache (HA) symptoms for a patient with overlapping HA diagnoses.

Case Description: The subject was a 22-year-old Caucasian female with an 8-year history of migraine without aura, chronic migraine, and cervicogenic type headaches. A comprehensive PT program was implemented to address subject’s musculoskeletal deficits, neurological impairments, and functional limitations. Assessments were performed at initial evaluation and two weeks later at re-assessment. Outcome measures utilized were the Headache Disability Inventory (HDI), the Neck Disability Index (NDI), manual muscle testing (MMT), cervical range of motion (ROM) as well the subjective report of HA frequency, duration, and intensity, prescription drug use, and achievement of functional goals.

Outcomes: At the conclusion of the two-week PT program, the subject improved her “worst” HA intensity, cervical ROM and strength, perceived disability scores, and decreased prescription drug use. The subject was able to obtain part-time employment and take community college classes.

Discussion: The findings support the hypothesis that it is possible to influence HA symptoms with a comprehensive PT program that directly addresses the subject’s functional limitations, musculoskeletal deficits, and neuromuscular integration to positively influence one’s quality of life and perceived disability despite complex and overlapping HA diagnoses.