RT Journal Article
SR Electronic
T1 A standardized osteopathic manipulative technique for the treatment of chronic migraine headaches
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 5587
DO 10.1370/afm.22.s1.5587
VO 21
IS Supplement 3
A1 Burke, Kyle
A1 Blaker, Joshua
A1 Zgierska, Aleksandra
A1 Lennon, Robert
YR 2023
UL http://www.annfammed.org/content/21/Supplement_3/5587.abstract
AB Context: In the US, 40 million people suffer from migraines; 8% have debilitating chronic migraines (CM). Standard care such as topiramate, onabotulinumtoxin A, and calcitonin gene-related peptide monoclonal antibodies are not universally effective and cause adverse effects (AE). Non-pharmacologic treatments such as osteopathic manipulative treatment (OMT) are reported effective and may minimize AEs but current studies are limited by non-uniformity of treatment protocols.Objective: To evaluate the feasibility of a standardized OMT procedure for CM and gather preliminary data on its effectiveness in a primary care setting.Study Design & Analysis: Prospective, single-arm feasibility study. Changes were evaluated using MANOVA to 95% confidence with f distribution for effect size.Setting: Outpatient clinical research center.Population Studied: Adults aged 18 to 60 seen within the last three years for chronic migraine (ICD 10 code G43.709) with no recent or ongoing treatment with topiramate or onabotulinumtoxin A.Intervention/Instrument: Participants received up to 5 biweekly treatments (minimum 3) of five 1-minute standardized myofascial release movements and completed 1- and 3-month post-treatment assessments.Outcome Measures: Primary: study completion rate and treatment satisfaction. Secondary: changes between baseline and 1-month, and baseline and 3-month scores on: Headache Impact Test (HIT-6) and the Migraine Specific Quality of Life Questionnaire (MSQ); changes between baseline and 3-month score on the Migraine Disability Assessment Test (MIDAS).Results: All 11 participants (mean age 47 years; 10 female, 1 male) completed the baseline, 1-, and 3-month assessments and ≥3 treatments. Treatment satisfaction was high (4.7/5). Improvements between baseline and 1-month were: HIT-6: 3.4->3.1 (p<.05, ηp2=0.16 (large effect)); MSQ: 2.9->2.2 (p=.087, ηp2=0.12 (medium effect)). Improvements between baseline and 3-month were: HIT-6: 3.4->2.9 (p=.074, ηp2=0.13 (medium effect)); MSQ: 2.9->2.0 (p=0.39, ηp2=0.09 (medium effect)); MIDAS: 9.1->5.6 (p<.05, ηp2=0.19 (large effect)).Conclusions: A standardized OMT protocol is feasible for chronic migraine treatment, with significant large effect size improvements on HIT-6 and MIDAS scores, and non-significant but medium effect size improvement on the MSQ. Improvements on the HIT-6 and MSQ wane over time. Further studies are warranted to confirm generalizability and characterize the extinction coefficient of efficacy.