Effect of Osteopathic Manipulative Treatment for Patients With Chronic Headache
Effect of Osteopathic Manipulative Treatment for Patients With Chronic Headache
Participants with chronic or recurrent headache, unrelated to any known pathology or disease,
 will be randomly assigned to one of four interventions: Osteopathic manipulation of the body
 other than the head, osteopathic manipulation of the head, osteopathic manipulation of the
 head and rest of the body, or light touch on the head only but no manipulation. Measurements
 of heart rate and blood pressure variability, peripheral blood flow, and behavioral changes,
 such as mood, pain duration, intensity and frequency will be assessed.
Sixty subjects will be recruited to participate in the study via word of mouth and mass email
 notification of employees and students at Western University of Health Sciences in Pomona,
 CA.

 Patients will be randomly assigned to 1 of 4 groups for a specific Osteopathic Manipulative
 Treatment (OMT): Compression of Fourth Ventricle (CV4) only, CV4 and subject appropriate OMT,
 subject appropriate OMT only (no CV4), and sham (touch only). There will be 8 subjects per
 OMT group, making it 24 subjects altogether assigned to one of the three OMT groups, and 24
 sham subjects.

 Power analysis for determination of sample sizes: The investigators have no data on
 preliminary studies of the effect of OMT on chronic headaches, and there is only one study of
 the immediate effect on tension type headache patients after CV4, so power analysis is a
 rough estimate at this point for the one week headache symptom evaluation post OMT. From
 preliminary studies in this lab, the investigators can expect for 'CV4 only' 80% of
 participants to have significant still point objective response vs sham treatment which the
 investigators expect will significantly effect about 10% of the participants. There needs to
 be at least 16 subjects in each of two groups assessing this outcome measure, so 16 receiving
 CV4 and 16 sham to detect the 70% difference in still point measure. To detect differences
 between any OMT and sham, since there are three groups receiving OMT of some type, when the
 investigators consider how many in each of these three groups vs the sham group, the
 investigators figured 8 per each OMT group, of which 2 are CV4 (thus 16 get CV4), making it
 24 subjects in the combined OMT groups. Therefore, the investigators need 24 sham subjects to
 make it equal numbers for balanced analysis (OMT vs sham), and to detect differences in the
 OMT interventions and sham interventions. Considering a possibility of 25%, or 12 subjects,
 not responding to the follow up survey at one week, the investigators figured recruitment of
 60 subjects would ensure the investigators would have enough to make our calculations and be
 able to determine if there are significant differences between groups.

 The investigators have no preliminary studies on the effect of OMT or sham on mood in patient
 with headaches, so this part of the study is an exploratory assessment and sample size
 calculations will be able to be performed with the data gathered from this study for
 subsequent studies.
Inclusion Criteria:

 -  chronic or recurrent headaches at least as often as one time per week

 Exclusion Criteria:

 -  recent head trauma

 -  brain disease or pathology

 -  seizure disorder

 -  using beta or alpha blocker medications

 -  allergy to sticky tape used to affix leads to skin