Department of Neurology, NYU Langone Health, New York, NY, USA.
Department of Population Health, NYU Langone Health, New York, NY, USA.
Headache. 2020 Nov;60(10):2232-2246. doi: 10.1111/head.14010. Epub 2020 Nov 16.
Scalable, accessible forms of behavioral therapy for migraine prevention are needed. We assessed the feasibility and acceptability of progressive muscle relaxation (PMR) delivered by a smartphone application (app) in the Primary Care setting.
This pilot study was a non-blinded, randomized, parallel-arm controlled trial of adults with migraine and 4+ headache days/month. Eligible participants spoke English and owned a smartphone. All participants were given the RELAXaHEAD app which includes an electronic headache diary. Participants were randomized to receive 1 of the 2 versions of the app-one with PMR and the other without PMR. The primary outcomes were measures of feasibility (adherence to the intervention and diary entries during the 90-day interval) and acceptability (satisfaction levels). We conducted exploratory analyses to determine whether there was a change in Migraine Disability Assessment Scale (MIDAS) scores or a change in headache days.
Of 139 participants (77 PMR, 62 control), 116 (83%) were female, mean age was 41.7 ± 12.8 years. Most patients 108/139 (78%) had moderate-severe disability. Using a 1-5 Likert scale, participants found the app easy to use (mean 4.2 ± 0.7) and stated that they would be happy to engage in the PMR intervention again (mean 4.3 ± 0.6). For the first 6 weeks, participants practiced PMR 2-4 days/week. Mean per session duration was 11.1 ± 8.3 minutes. Relative to the diary-only group, the PMR group showed a greater non-significant decline in mean MIDAS scores (-8.7 vs -22.7, P = .100) corresponding to a small-moderate mean effect size (Cohen's d = 0.38).
Smartphone-delivered PMR may be an acceptable, accessible form of therapy for migraine. Mean effects show a small-moderate mean effect size in disability scores.
需要可扩展、可及的偏头痛预防行为疗法形式。我们评估了在初级保健环境中通过智能手机应用程序（app）提供渐进性肌肉松弛（PMR）的可行性和可接受性。
这是一项针对偏头痛和每月 4+头痛天数的成年人的非盲、随机、平行臂对照试验。合格的参与者会说英语且拥有智能手机。所有参与者都被给予了 RELAXaHEAD 应用程序，其中包括一个电子头痛日记。参与者被随机分配到接受 2 个应用程序版本中的 1 个 - 一个带有 PMR，另一个没有 PMR。主要结果是评估可行性（干预措施的依从性和 90 天间隔内的日记条目）和可接受性（满意度水平）的措施。我们进行了探索性分析，以确定 Migraine Disability Assessment Scale（MIDAS）评分是否有变化或头痛天数是否有变化。
在 139 名参与者（77 名 PMR，62 名对照组）中，116 名（83%）为女性，平均年龄为 41.7±12.8 岁。大多数患者 108/139（78%）有中重度残疾。使用 1-5 分的李克特量表，参与者认为该应用程序易于使用（平均 4.2±0.7），并表示他们很高兴再次参与 PMR 干预（平均 4.3±0.6）。在前 6 周内，参与者每周练习 PMR 2-4 天。每次会议的平均持续时间为 11.1±8.3 分钟。与仅日记组相比，PMR 组的平均 MIDAS 评分下降更大，但无统计学意义（-8.7 与-22.7，P=0.100），对应的是中等小的平均效应大小（Cohen's d=0.38）。
智能手机提供的 PMR 可能是一种可接受的、可及的偏头痛治疗形式。平均效果显示残疾评分的中等小平均效应大小。
