School of Therapeutic Sciences, SRH University Heidelberg, Heidelberg, Germany.
J Pain. 2013 Oct;14(10):1196-207. doi: 10.1016/j.jpain.2013.05.006. Epub 2013 Jul 19.
Migraine and tension-type headache have a high prevalence in children and adolescents. In addition to common pharmacologic and nonpharmacologic interventions, music therapy has been shown to be efficient in the prophylaxis of pediatric migraine. This study aimed to assess the efficacy of specific music therapy techniques in the treatment of adolescents with primary headache (tension-type headache and migraine). A prospective, randomized, attention-placebo-controlled parallel group trial was conducted. Following an 8-week baseline, patients were randomized to either music therapy (n = 40) or a rhythm pedagogic program (n = 38) designed as an "attention placebo" over 6 sessions within 8 weeks. Reduction of both headache frequency and intensity after treatment (8-week postline) as well as 6 months after treatment were taken as the efficacy variables. Treatments were delivered in equal dose and frequency by the same group of therapists. Data analysis of subjects completing the protocol showed that neither treatment was superior to the other at any point of measurement (posttreatment and follow-up). Intention-to-treat analysis revealed no impact of drop-out on these results. Both groups showed a moderate mean reduction of headache frequency posttreatment of about 20%, but only small numbers of responders (50% frequency reduction). Follow-up data showed no significant deteriorations or improvements.
This article presents a randomized placebo-controlled trial on music therapy in the treatment of adolescents with frequent primary headache. Music therapy is not superior to an attention placebo within this study. These results draw attention to the need of providing adequate controls within therapeutic trials in the treatment of pain.
未加标签:偏头痛和紧张型头痛在儿童和青少年中的发病率很高。除了常见的药物和非药物干预外,音乐疗法已被证明在预防儿童偏头痛方面有效。本研究旨在评估特定音乐治疗技术在治疗青少年原发性头痛(紧张型头痛和偏头痛)中的疗效。进行了一项前瞻性、随机、对照、平行组试验。在 8 周基线期后,患者被随机分为音乐治疗组(n = 40)或节奏教学计划组(n = 38),这两种治疗均在 8 周内进行 6 次治疗,被设计为“注意力安慰剂”。治疗后(8 周治疗后)以及治疗后 6 个月头痛发作频率和强度的降低作为疗效变量。治疗由同一组治疗师以相同的剂量和频率进行。完成方案的受试者数据分析显示,在任何测量点(治疗后和随访),两种治疗都没有优于另一种治疗(治疗后和随访)。意向治疗分析显示,脱落对这些结果没有影响。两组在治疗后头痛发作频率均有适度的平均降低,约 20%,但仅有少数患者为(频率降低 50%)应答者。随访数据显示没有明显的恶化或改善。
观点:本文介绍了一项针对音乐治疗青少年频发原发性头痛的随机安慰剂对照试验。在本研究中,音乐治疗并不优于注意力安慰剂。这些结果提请注意在疼痛治疗的治疗试验中需要提供适当的对照。