OZKS_2- The effect of a standardized active stretching and exercise program compared and combined with osteopathic manipulative therapy in patients with cervicogenic headache

INTERVENTION: Group 1: Five findings‐based osteopathic manipulative treatments are carried out in a period of 3 months. After this, the conditions change and the group receives five standardized, active stretching and training sessions in a second time interval of 3 months. The learned exercise program is to be continued 2 Xa week on one's own. In the third 3‐month interval there is no further therapy, the patients are encouraged to continue the program on their own. Group 2: The treatment condition is in reverse order: Group 2 first receives five standardized, active stretching and training sessions in a time interval of 3 months. After this the conditions change and in the second time interval of 3 months the group receives five findings‐oriented, osteopathic manipulative treatments. The learned exercise program is to be continued twice a week on the group's own for the entire study period. In the third 3‐month interval, similar to group 1, no further therapy takes place. CONDITION: Cervicalgia IHS‐Classification, ICHD‐3; 11.2.1 cervicogenic headache ; M54.2 M54.2 PRIMARY OUTCOME: Decrease in headache symptomatology as measured by the Neck Disability Index at the measurement cycles T0.0; T0.1; T1; T2 (3 month past T0.1); T3 (6 month past T0.1); T4 (9 month past T0.1). SECONDARY OUTCOME: Decrease in headache symptoms measured by Headache Impact Test 6. ; Increase in upper cervical spine mobility, measured by Zebris CMS 10 and the Flexion‐Rotation test in supine position. ; Effect on medication adherence measured by Medication quantification Scale (MQS). ; Effect on headache‐related work absenteeism, measured by standardized headache calendar. ; Effect on visual acuity, measured by Landolt rings. INCLUSION CRITERIA: age 18‐55 unilateral or bilateral headache according to ICHD‐3 for more than 3 months. NDI(NDI score) above 22.5%. Limited flexion‐rotation test (FRT of =32° to one side.