Expectation benefit index
traumas, headaches, headache, trauma
DYSFUNCTION
The principal investigator (SL) presented two fictive cases, representing her expectations of the highest and the lowest chance of a favorable outcome following chiropractic manipulation. These cases were based on her clinical experience after 30 years’ experience with chiropractic manipulation of children and followed three lines of arguments:Children may benefit most from chiropractic manipulation if the cause of the headache is of biomechanical origin with no other underlying conditions or the lifestyle and/or psychosocial environment of the child.Previous trauma (particularly to the neck) may have affected the spine and acted as precursors for a mechanical dysfunction where chiropractic manipulation treatment is indicated.Chiropractic manipulation treatment will benefit, as many other types of treatment, from a healthy lifestyle of the patient. In our context this may be an active lifestyle of the child with enough physical activity, limited screen time, and sufficient psycho-social supportThe two cases were described as follows:Case 1—most favorable outcome:Age 7–12 (before puberty)Participate in sport, average or elite, or other leisure time activities/hobbiesScreen time not above averageLikely to have reported at least one traumaCase 2—least favorable outcome:Age 13–14No sport or other leisure time activityScreen time above average of age matched peersNo trauma reported (maybe due to lack of physical activity)Daily headachesThis expectation let us define the following Age: one point if ≤ 9 and half point if ≤ 12Sport activity: one point if more than 0 days per weekScreen time: one point if not above normal levelTrauma experience: one point if at least two traumas reported or one requiring treatment, and half point if at least one trauma reported.Frequency of headaches: One point if not “nearly daily”.