Migraine, which affects over 14% of the global population, often leads to an increased number of visits to the Emergency Department (ED). This is due to the acute pain and complex accompanying symptoms, such as nausea and photo/phonophobia (sensitivity to light and noise). Despite the assistance received in the ED, many patients do not receive long-term prophylactic treatment, which leads to repeat visits and chronic discomfort.
To eliminate this therapeutic gap, the smartphone application RELAXaHEAD was tested as part of a randomized clinical trial. This program offers patients the integration of Progressive Muscle Relaxation (PMR)—a proven behavioral therapy method—with a migraine diary, which promotes effective self-monitoring and management of the condition.
How Does RELAXaHEAD Work?
RELAXaHEAD requires patients to complete daily audio sessions, which include the following elements:
A 5-minute deep breathing exercise
A short 6-minute PMR session
A full 12.5-minute PMR session
An 8.5-minute muscle scanning session
PMR exercises teach the patient systematic control of muscle groups, with sequential tension and relaxation, thereby reducing the episodes of migraine attacks and alleviating symptoms. The migraine diary integrated into the application allows patients to record symptoms, medications, and other relevant parameters, which contributes to an in-depth analysis of their condition.
Study Results:
The clinical trial involved 69 adult patients (aged 18 to 65) who were treated in the Emergency Department of NYU Langone Health due to a migraine exacerbation. Patients were randomly assigned: the test group used RELAXaHEADalong with PMR, and the control group used a version of the application that only included the diary.
82.4% of patients using PMR achieved a clinically significant improvement in functional disability caused by migraine, which is almost twice the rate of the control group (45.7%) and increases the chances of improving functional disability by about 10 times. Furthermore, the frequency with which patients performed the exercises was directly proportional to the therapeutic effect received, which confirms the existence of a “dose-response” mechanism.
The study had certain methodological limitations, including a relatively small sample size and a significant loss of participants during the observation phase (partially linked to the COVID-19 pandemic). Also, during the study period, the application was only available in English, which limited the scale of its potential use.
Future plans include large-scale validation of the method in primary healthcare facilities, where the majority of migraine patients are treated. This offers millions of people an improved model for managing this neurological disorder.
Source: JAMA
