Whittingham W, Ellis W B, Molyneux T P
Faculty of Biomedical and Health Sciences, School of Chiropractic and Osteopathy, R.M.I.T., Melbourne, Australia.
J Manipulative Physiol Ther. 1994 Jul-Aug;17(6):369-75.
The objective of this pilot study was to investigate the effect of spinal manipulation for the relief of chronic headache of cervical origin, utilizing a specific technique, toggle recoil, to treat the two upper cervical vertebrae. This study will help delineate the design for a future, larger study.
Twenty-six patients were accepted for a continuous time series analysis (6 wk) design.
Chiropractic outpatient research clinic.
The patients--16 females (average age 42.1 yr, SD 11.03) and 10 males (average age 52.1 yr, SD 10.69) all had chronic headaches (> 3 mo) with upper cervical joint dysfunction.
All the patients received four upper cervical toggle recoil adjustments over a 2-wk period.
Standardized headache history, daily questionnaires for the duration of the trial, measuring; frequency; and severity of the headache, plain film with dynamic spinal radiographs and motion palpation.
The results indicate statistically significant outcomes (p < .001) that indicate changes in headache frequency, duration and severity in all but two of the patients. The overall duration of headaches decreased from 110 hr pretreatment to 25 hr posttreatment, a decrease of 77%. The overall score for severity dropped from 55 to 22--a 60% improvement in perceived pain. The frequency of headaches over a 2-wk period dropped from 18 to 7, an improvement of 62%.
Since the results of this pilot study were not adequately controlled they cannot be seen as proof supporting the clinical efficacy of manipulation for chronic headaches. However, as a group for duration, severity and frequency all measures were significant. These findings would suggest that further study of upper cervical manipulation for the treatment of chronic headaches with upper cervical joint dysfunction in a randomized, controlled clinical trial is needed.
本初步研究的目的是利用一种特定技术——肘节回冲法，对两个上颈椎进行治疗，以调查脊柱推拿对缓解颈源性慢性头痛的效果。本研究将有助于为未来更大规模的研究确定设计方案。
采用连续时间序列分析（6周）设计，纳入26例患者。
脊椎按摩门诊研究诊所。
患者包括16名女性（平均年龄42.1岁，标准差11.03）和10名男性（平均年龄52.1岁，标准差10.69），均患有慢性头痛（>3个月）且伴有上颈椎关节功能障碍。
所有患者在2周内接受4次上颈椎肘节回冲调整治疗。
标准化头痛病史、试验期间每日问卷，用于测量头痛的频率、持续时间和严重程度，以及动态脊柱X光平片和动态触诊。
结果显示具有统计学意义（p<0.001），表明除两名患者外，所有患者的头痛频率、持续时间和严重程度均有变化。头痛的总持续时间从治疗前的110小时降至治疗后的25小时，减少了77%。严重程度的总分从55降至22——疼痛感知改善了60%。2周内头痛频率从18次降至7次，改善了62%。
由于本初步研究的结果未得到充分控制，因此不能将其视为支持推拿治疗慢性头痛临床疗效的证据。然而，就持续时间、严重程度和频率而言，作为一个整体，所有测量指标均具有统计学意义。这些发现表明，需要在随机对照临床试验中进一步研究上颈椎推拿治疗伴有上颈椎关节功能障碍的慢性头痛的效果。
