Freedom from Headaches - Scientific Research

Participant Results

We have taken advantage of one of the key benefits of the internet. The ability to collect and analyze data. Each online participant has a confidential personal file where his/her feedback from each lesson is automatically collected. From this data we continually monitor the efficacy of the program and can generate reports for physicians on the progress of their patients.

We can easily track any aspect of the process which makes it an excellent format for doing research on the applications of health information and skill building online.

Good information is only information if it is not put into action to actually produce change. The course is intended to empower participants to put the information to use in their lives so they can have the results we know are possible.

You can check the statistics of the Headache Relief Training.

Also check out, A Comparison of Two Mass Media Behavioral Training Programs for Chronic Headaches, a paper we wrote about a short study which statistically compares the outcomes of two mass media behavioral training programs, one on the internet and one delivered through more traditional mass media (books, television, radio and cassette tapes).

Scientific Research

Below you will find examples of scientific research which support the validity of this approach. You will notice that home training has been shown to be superior to in-office training and that relaxation training and biofeedback stand as equally effective in many of the studies listed.

Title	Authors	Journal	Abstract
The Role of Regular Home Practice in the Relaxation Treatment of Tension Headache	Edward B. Blanchard, Nancy L. Nicholson, Ann E. Taylor, Bruce D. Steffek, Cynthia L. Radnitz, and Kenneth A. Appelbaum Center for Stress and Anxiety Disorders, University at Albany, State University of New York	Journal of Consulting and Clinical Psychology 1991, Vol 59, No. 3, 467-470	This study evaluated the contribution of regular home practice in the treatment of tension headache (HA) with progressive muscle relaxation (PMR) by giving 14 tension HA sufferers 10 sessions (over 8 weeks) of standard PMR with home practice and application instructions while 13 additional patients received the same PMR training (except for the omission of cue-controlled relaxation) with no home practice or application instruction. A third group of 6 patients merely monitored HA activity. Both treated groups showed significant reduction in HA activity, whereas the symptom monitoring did not change. The 2 treated groups did not differ. On a measure of clinically significant reduction in HA activity (at least 50% reduction in HA activity), however, the group receiving home practice instruction (50%) showed a trend (p= .056) to improve more than did those receiving PMR without home practice (15%).
Long-term Follow-up of Migraine Treatment: Do the Effects Remain up to Six Years?	Jan Lisspers and Lars-Goran Ost Psychiatric Research Center, University of Uppsala, Ulleraker, S-750 17, Uppsala, Sweden	Behav. Res. Ther. VOL. 28, No. 4, pp. 313-322, 1990	Fifty migraine subjects (constituting 79%) of the originally treated sample) participate in a follow-up study to 6 yr. after the end of treatment. Subjects had been treated with different forms of biofeedback methods (skin temperature, BVP of the temporal artery) and applied relaxation training. The assessment included 4 weeks of continuous self-monitoring of headache activity and medication usage, as well as a retrospective self-rating scale. The main results indicated that, on a group basis, headache reductions achieved at the end of treatment persisted for up to 6 yrs. And were indeed enhanced during the follow-up period.
Long-term efficacy of combined relaxation: biofeedback treatments foûÚÊJ chronic headache	Arthur Cott, William Parkinson, Marion Fabich, Michel Bedard and Richard Marlin Departments of Medicine and Psychology, McMaster University, Hamilton, Ontario (Canada)	Pain, 51 (1992) 49-56	Thirty-four patients having chronic idiopathic headaches participated in a long-term study comparing autogenic relaxation training alone (REL) with combinations of relaxation and electromyographic biofeedback (REL + TEMP). Assignment to treatment conditions was balanced on demographics and clinical characteristics, as well as headache classification according to muscle improvements over REL following following the 8-week treatment program, or at 6-month, or 12-month follow-up. However, REL + EMG produced significantly greater reductions in headache activity measures than the REL and REL + TEMP conditions at all post-treatment time points. Headache activity continued to improve over the follow-up period independent of treatment condition. These data indicate that EMG biofeedback augments long-term clinical improvements in headache patients who undergo autogenic relaxation training.
The efficacy and efficiency of a self-administered treatment for adolescent migraine	Patrick J. McGrath, Peter Humphreys, Daniel Keene, John T. Goodman, Maureen A. Lascelles, S. June Cunningham and Phillip Firestone Department of Psychology and the Neurology Service, Children's Hospital of Eastern Ontario (Canada)	Pain, 49 (1992) 321-324	Migraine headaches are frequent in adolescents. Although many adolescents are adequately treated palliatively with analgesics, an important subgroup requires prophylactic treatment. Medical treatments for adolescents with frequent severe headaches is often problematic. Prophylactic pharmacological treatments are often shunned by adolescents and their parents because of concern over drug usage. Moreover, propranolol, the most widely used prophylactic drug with adults, is frequently not effective. Psychological interventions are effective but are costly and often not available. A randomized controlled trial was undertaken to evaluate the efficacy and efficiency of a predominantly self-administered treatment that could be delivered in a very cost-efficient format. Eighty seven adolescents (63 females and 24 males) ranging in age from 11 to 18 years were randomly assigned to receive a self-administered treatment, the same treatment delivered by a therapist or a control treatment. Self-administered and clinic treatment were equally effective and superior to the control treatment. However, the self-administered treatment was substantially more efficient. Both active treatments were durable to 1-year follow-up.
A Comparison of Muscle Relaxation and Electromyogram Biofeedback Treatments for Muscle Contraction Headache	Margaret A. Chesney, Stanford Research Institute and John L. Shelton, Colorado State University	J. Behav. Ther. & Exp. Psychiat. Vol. 7, pp. 221-225, 1976	The separate and combined effects of muscle relaxation and biofeedback in the treatment of muscle contraction headaches were examined. The results indicate that a muscle relaxation treatment, and a combined muscle relaxation and biofeedback treatment were equally more effective than either a biofeedback treatment alone or a no-treatment control in reducing headache frequency. Further, both the muscle relaxation treatment, and the combined muscle relaxation and biofeedback treatment were significantly more effective in reducing headache duration than the biofeedback treatment. However, with regard to headache severity, the combined treatment was the only procedure to be significantly more effective than the no-treatment control.
Differential Effectiveness of Electromyo- graph Feedback, Verbal Relaxation Instructions, and Medication Placebo with Tension Headaches	Daniel, J. Cox, Andrew Freundlich, and Robert G. Meyer Psychology Clinic, University of Louisville, USA	Journal of Consulting and Clinical Psychology,1975, Vol. 43, No. 6, 892-898	Twenty-seven adults from the general population with chronic tension headaches were divided into three groups. Nine were assigned to auditory electromyograph (EMG) feedback, 9 to progressive relaxation instructions, and 9 to placebo treatment. Subjects came for 2 weeks of pre- and post treatment assessment, with 4 intervening weeks of treatment. Measures were taken on headache frequency, intensity and duration, frontalis EMG recordings, medication intake, locus of control, and additional psychosomatic complaints. Comparison of post assessment and 4-month follow-up data indicated that biofeedback and verbal relaxation instructions were equally superior to the medicine placebo on all measured variables in the direction of clinical improvement, except for shifts in locus of control. All groups experienced equally significant shifts toward internality.
The Long-Term Therapeutic Significance of the Addition of Electromyo- graphic Biofeedback to Relaxation Training in the Treatment of Tension Headaches	A. Cott, J.A. Goldman, R.P. Pavloski, G/J. Kirschberg, M. Fabich St. Joseph's Hospital	Behavior Therapy 12, 556-559 (1981)	The long-term effects of therapist-delivered relaxation training alone (N=4) versus relaxation training plus frontalis EMG feedback (N=4) on self-monitoring reports of headaches and medication ingestion were assessed. Eight tension headache sufferers seeking traditional medical treatment from a neurologist served as subjects. Mean hours of pain per day, headache severity, and medication ingestion were significantly lower in both groups following treatment. These results were maintained at a 1-year follow-up for hours of pain per day and medication ingestion. There were no main effects due to EMG feedback and no interactions indicating no benefit of adding EMG feedback to relaxation training.
Noninvasive Treatment of Vascular and Muscle Contraction Headache: A Comparative Longitudinal Clinical Study	Barry A. Reich, Ph.D. Director, Comprehensive Pain Program, Nassau Pain and Stress Center, Mineola, NY	Headache 29:34-41, 1989	The purpose of this investigation was to evaluate the long-term course of non-invasively treated chronic headache. A total of 1015 adult patients with primary diagnosis of vascular/migraine or muscle contraction headache participated in the study investigating symptom frequency and severity over a 36 month period after receiving treatment. Treatment consisted of either: relaxation training (stepwise relaxation/ hypnosis/ autogenic training/ cognitive behavioral therapy); biofeedback (thermal /photoplethysmograph /EMG); micro-electrical therapy (TENS/Neurotransmitter Modulation) or multimodal treatment (combination of any of the above treatments). Seven hundred and ninety-three patients returned sufficient data to be included in the analysis. Patients were randomly assigned to treatment groups and received either short term intervention (15 or less treatments) or long term intervention (greater than 15 treatments). Results indicate that all treatment conditions significantly reduced frequency and intensity of cephalalgia. Repeated measure analysis of variance indicated that grouping variables of Biofeedback treatment, symptoms being evidenced less than 2 years and receiving over 15 treatment sessions best predicted successful intervention.

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