Nilsson N, Christensen H W, Hartvigsen J
Institute of Medical Biology (Biomechanics), Faculty of Health Science, University of Odense, Denmark.
J Manipulative Physiol Ther. 1997 Jun;20(5):326-30.
To study whether the isolated intervention of high-speed, low-amplitude spinal manipulation in the cervical spine has any effect on cervicogenic headache.
Prospective randomized controlled trial with a blinded observer.
Ambulatory outpatient facility in an independent research institution.
Fifty-three subjects suffering from frequent headaches who fulfilled the International Headache Society criteria for cervicogenic headache (excluding radiological criteria). These subjects were recruited from 450 headache sufferers who responded to newspaper advertisements.
After randomization, 28 of the group received high-velocity, low-amplitude cervical manipulation twice a week for 3 wk. The remaining 25 received low-level laser in the upper cervical region and deep friction massage (including trigger points) in the lower cervical/upper thoracic region, also twice a week for 3 wk.
The change from week 1 to week 5 in analgesic use per day, in headache intensity per episode and in number of headache hours per day, as registered in a headache diary.
The use of analgesics decreased by 36% in the manipulation group, but was unchanged in the soft-tissue group; this difference was statistically significant (p = .04, chi 2 for trend). The number of headache hours per day decreased by 69% in the manipulation group, compared with 37% in the soft-tissue group; this was significant at p = .03 (Mann-Whitney). Finally, headache intensity per episode decreased by 36% in the manipulation group, compared with 17% in the soft-tissue group; this was significant at p = .04 (Mann-Whitney).
Spinal manipulation has a significant positive effect in cases of cervicogenic headache.
研究颈椎高速、低幅度脊柱推拿的单独干预对颈源性头痛是否有任何影响。
采用盲法观察者的前瞻性随机对照试验。
独立研究机构的门诊设施。
53名经常头痛且符合国际头痛协会颈源性头痛标准（不包括放射学标准）的受试者。这些受试者是从450名回应报纸广告的头痛患者中招募的。
随机分组后，该组中的28人每周接受两次高速、低幅度颈椎推拿，持续3周。其余25人接受上颈部低强度激光照射以及下颈部/上胸部区域的深部摩擦按摩（包括触发点），同样每周两次，持续3周。
头痛日记中记录的从第1周到第5周每天的镇痛药使用量、每次头痛的强度以及每天的头痛小时数的变化。
推拿组的镇痛药使用量减少了36%，而软组织组则没有变化；这种差异具有统计学意义（p = .04，趋势卡方检验）。推拿组每天的头痛小时数减少了69%，而软组织组为37%；这在p = .03时具有显著性差异（曼-惠特尼检验）。最后，推拿组每次头痛的强度降低了36%，而软组织组为17%；这在p = .04时具有显著性差异（曼-惠特尼检验）。
脊柱推拿对颈源性头痛病例有显著的积极作用。
