title: Dose response for chiropractic care of chronic cervicogenic headache and associated neck pain: a randomized pilot study.
abstract: OBJECTIVE
  To acquire information for designing a large clinical trial and determining its feasibility and to make preliminary estimates of the relationship between headache outcomes and the number of visits to a chiropractor.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Private practice in a college outpatient clinic and in the community.
  
  
  METHODS
  Twenty-four adults with chronic cervicogenic headache.
  
  
  METHODS
  Patients were randomly allocated to 1, 3, or 4 visits per week for 3 weeks. All patients received high-velocity low-amplitude spinal manipulation. Doctor of Chiropractics could apply up to 2 physical modalities at each visit from among heat and soft tissue therapy. They could also recommend modification of daily activities and rehabilitative exercises. Outcomes included 100-point Modified Von Korff pain and disability scales, and headaches in last 4 weeks.
  
  
  RESULTS
  Only 1 participant was insufficiently compliant with treatment (3 of 12 visits), and 1 patient was lost to follow-up. There was substantial benefit in pain relief for 9 and 12 treatments compared with 3 visits. At 4 weeks, the advantage was 13.8 ( P = .135) for 3 visits per week and 18.7 (P = .041) for 4 visits per week. At the 12-week follow-up, the advantage was 19.4 (P = .035) for 3 visits per week and 18.1 (P = .048) for 4 visits per week.
  
  
  CONCLUSIONS
  A large clinical trial on the relationship between pain relief and the number of chiropractic treatments is feasible. Findings give preliminary support for the benefit of larger doses, 9 to 12 treatments, of chiropractic care for the treatment of cervicogenic headache.
authors.affiliation: Center for Outcome Studies, Western States Chiropractic College, Portland, OR, USA. mhaas@wschiro.edu
authors.forename: Mitchell
authors.initials: M
authors.lastname: Haas
authors.forename: Elyse
authors.initials: E
authors.lastname: Groupp
authors.forename: Mikel
authors.initials: M
authors.lastname: Aickin
authors.forename: Alisa
authors.initials: A
authors.lastname: Fairweather
authors.forename: Bonnie
authors.initials: B
authors.lastname: Ganger
authors.forename: Michael
authors.initials: M
authors.lastname: Attwood
authors.forename: Cathy
authors.initials: C
authors.lastname: Cummins
authors.forename: Laura
authors.initials: L
authors.lastname: Baffes
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006261:Headache / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic / Q000706:statistics & numerical data; D008875:Middle Aged; D019547:Neck Pain / Q000150:complications / Q000628:therapy*; D009819:Office Visits / Q000706:statistics & numerical data; D010865:Pilot Projects; D011446:Prospective Studies