In the Journals

Relaxation app shows potential in managing migraine

Image of Mia Minen
Mia Minen

People with migraine who used a smartphone app that guides users through progressive muscle relaxation techniques at least twice a week experienced fewer headache days per month, according to a study published in Nature Digital Medicine.

“Patients and providers have difficulty finding people trained in the Level A evidence-based treatments for migraine prevention (cognitive behavioral therapy, biofeedback, progressive muscle relaxation therapy),” Mia T. Minen, MD, MPH, assistant professor in the department of neurology and director of headache services at NYU Langone Health, told Healio Psychiatry. “Also, patients have difficulty attending behavioral therapy because of the high costs of the individual treatment sessions and the time required to attend such sessions.”

However, a smartphone app-based intervention like this one, known as RELAXaHEAD, may have the potential to address lack of access in receiving care, according to Minen.

In a single-arm pilot study, Minen and colleagues examined the feasibility and acceptability of smartphone app-based progressive muscle relaxation (PMR) for migraine, whether app-based PMR reduces headache days, and potential predictors of app and/or PMR use.

“Very few apps are being studied for neurologic conditions, and many of the apps out there on the market were not developed by medical providers,” Minen said. “The RELAXaHEAD app is unique in that we developed it with input from headache specialists and people with migraine.”

Adults with migraine with four or more headache days per month and no previous behavioral migraine therapy in the past year completed a daily headache diary and PMR for 20 minutes each day for 90 days. Participants recorded the frequency and severity of their headaches in the headache diary and the app recorded how long and often patients used PMR.

woman on smartphone   
Source: Adobe Stock

Of 51 patients enrolled (94% female), 63% had severe migraine disability at baseline. Based on responses to satisfaction surveys, participants reported that the app was easy to use, relevant to their condition, kept their interest and they would be happy to use the app as well as do the relaxation again.

Overall, each participant played PMR on average 22 ± 21 days, with a mean per session duration of 11 ± 7 min, according to the results. Over 90 days, 47% of total PMR uses per week among the 51 participants were one or more times per week and 35% of uses were two or more times per week.

On average, participants who did PMR 2 or more days each week in the first month had 4 fewer headache days the next month compared with the first month, while those who did PMR less than 2 days each week in the first month had only two fewer headache days the next month.

“We believe this is the first study to examine whether we might be able to deliver smartphone based behavioral therapy to people with migraine,” Minen told Healio Psychiatry.

“We think this study paves the way for examining how mobile health (mhealth) tools can be used to have scalable, accessible forms of evidence based behavioral therapy for migraine,” she continued. “This is important because the behavioral therapies are safe, effective and have enduring benefits. They can work alone, and they can work alongside migraine medications — not just for an additive benefit, but for a synergistic benefit.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.

Image of Mia Minen
Mia Minen

People with migraine who used a smartphone app that guides users through progressive muscle relaxation techniques at least twice a week experienced fewer headache days per month, according to a study published in Nature Digital Medicine.

“Patients and providers have difficulty finding people trained in the Level A evidence-based treatments for migraine prevention (cognitive behavioral therapy, biofeedback, progressive muscle relaxation therapy),” Mia T. Minen, MD, MPH, assistant professor in the department of neurology and director of headache services at NYU Langone Health, told Healio Psychiatry. “Also, patients have difficulty attending behavioral therapy because of the high costs of the individual treatment sessions and the time required to attend such sessions.”

However, a smartphone app-based intervention like this one, known as RELAXaHEAD, may have the potential to address lack of access in receiving care, according to Minen.

In a single-arm pilot study, Minen and colleagues examined the feasibility and acceptability of smartphone app-based progressive muscle relaxation (PMR) for migraine, whether app-based PMR reduces headache days, and potential predictors of app and/or PMR use.

“Very few apps are being studied for neurologic conditions, and many of the apps out there on the market were not developed by medical providers,” Minen said. “The RELAXaHEAD app is unique in that we developed it with input from headache specialists and people with migraine.”

Adults with migraine with four or more headache days per month and no previous behavioral migraine therapy in the past year completed a daily headache diary and PMR for 20 minutes each day for 90 days. Participants recorded the frequency and severity of their headaches in the headache diary and the app recorded how long and often patients used PMR.

woman on smartphone   
Source: Adobe Stock

Of 51 patients enrolled (94% female), 63% had severe migraine disability at baseline. Based on responses to satisfaction surveys, participants reported that the app was easy to use, relevant to their condition, kept their interest and they would be happy to use the app as well as do the relaxation again.

Overall, each participant played PMR on average 22 ± 21 days, with a mean per session duration of 11 ± 7 min, according to the results. Over 90 days, 47% of total PMR uses per week among the 51 participants were one or more times per week and 35% of uses were two or more times per week.

On average, participants who did PMR 2 or more days each week in the first month had 4 fewer headache days the next month compared with the first month, while those who did PMR less than 2 days each week in the first month had only two fewer headache days the next month.

“We believe this is the first study to examine whether we might be able to deliver smartphone based behavioral therapy to people with migraine,” Minen told Healio Psychiatry.

“We think this study paves the way for examining how mobile health (mhealth) tools can be used to have scalable, accessible forms of evidence based behavioral therapy for migraine,” she continued. “This is important because the behavioral therapies are safe, effective and have enduring benefits. They can work alone, and they can work alongside migraine medications — not just for an additive benefit, but for a synergistic benefit.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.