title: A Randomized Pragmatic Clinical Trial of Chiropractic Care for Headaches With and Without a Self-Acupressure Pillow.
abstract: OBJECTIVE
  The purpose of this study was to determine if the addition of a self-acupressure pillow (SAP) to typical chiropractic treatment results in significantly greater improvement in tension-type and cervicogenic headache sufferers.
  
  
  METHODS
  A pragmatic randomized clinical trial was conducted in a chiropractic college teaching clinic. Thirty-four subjects, including tension-type and cervicogenic headache sufferers, 21 to 60 years of age, male or female, completed the study. Group A (n = 15) received typical chiropractic care only (manual therapy and exercises), and group B (n = 19) received typical chiropractic care with daily home use of the SAP. The intervention period was 4 weeks. The main outcome measure was headache frequency. Satisfaction and relief scores were obtained from subjects in the SAP group. Analysis of variance was used to analyze the intergroup comparisons.
  
  
  RESULTS
  Owing to failure of randomization to produce group equivalence on weekly headache frequency, analysis of covariance was performed showing a trend (P = .07) favoring the chiropractic-only group; however, this was not statistically significant. Group A obtained a 46% reduction of weekly headache frequency (t = 3.1, P = .002; d = 1.22). The number of subjects in group A achieving a reduction in headaches greater than 40% was 71%, while for group B, this was 28%. The mean benefit score (0-3) in group B of the use of the SAP was 1.2 (.86). The mean satisfaction rating of users of the SAP was 10.4 (2.7) out of 15 (63%).
  
  
  CONCLUSIONS
  This study suggests that chiropractic care may reduce frequency of headaches in patients with chronic tension-type and cervicogenic headache. The use of a self-acupressure pillow (Dr Zaxx device) may help those with headache and headache pain relief as well as producing moderately high satisfaction with use.
authors.affiliation: Professor, Canadian Memorial Chiropractic College, Research, Toronto, ON, Canada. Electronic address: hvernon@cmcc.ca.
authors.forename: Howard
authors.initials: H
authors.lastname: Vernon
authors.affiliation: Assistant Professor, Canadian Memorial Chiropractic College, Clinical Education, Toronto, ON, Canada.
authors.forename: Cam
authors.initials: C
authors.lastname: Borody
authors.affiliation: Assistant Professor, Canadian Memorial Chiropractic College, Clinical Education, Toronto, ON, Canada.
authors.forename: Glen
authors.initials: G
authors.lastname: Harris
authors.affiliation: Associate Professor, Canadian Memorial Chiropractic College, Clinical Education, Toronto, ON, Canada.
authors.forename: Brad
authors.initials: B
authors.lastname: Muir
authors.affiliation: Assistant Professor, Canadian Memorial Chiropractic College, Clinical Education, Toronto, ON, Canada.
authors.forename: Jarrod
authors.initials: J
authors.lastname: Goldin
authors.affiliation: Research Coordinator, Canadian Memorial Chiropractic College, Division of Research, Toronto, ON, Canada.
authors.forename: Maricelle
authors.initials: M
authors.lastname: Dinulos
mesh_terms: D019050:Acupressure; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic; D008875:Middle Aged; D051298:Post-Traumatic Headache / Q000628:therapy*; D016037:Single-Blind Method; D018781:Tension-Type Headache / Q000628:therapy*; D055815:Young Adult
keywords: Acupressure; Headache; Randomized Clinical Trial; Spinal Manipulative Therapy