ArticleJournal of neurotrauma2021
Feasibility of Smartphone-Delivered Progressive Muscle Relaxation in Persistent Post-Traumatic Headache Patients.
Article in Journal of neurotrauma, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Smartphone-Based Muscle Relaxation for Migraine in the Emergency Department: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Smartphone based behavioral therapy for pain in multiple sclerosis (MS) patients: A feasibility acceptability randomized controlled study for the treatment of comorbid migraine and ms pain.Multiple sclerosis and related disorders · 2020Trial
- Concussion and the Autonomic, Immune, and Endocrine Systems: An Introduction to the Field and a Treatment Framework for Persisting Symptoms.Journal of personalized medicine · 2025Review
- Digital Therapeutics in Migraine Management: A Novel Treatment Option in the COVID-19 Era.Journal of pain research · 2023Review
- Headache providers' perspectives of headache diaries in the era of increasing technology use: a qualitative study.Frontiers in neurology · 2023Article
- Update on Non-Pharmacological Interventions for Treatment of Post-Traumatic Headache.Brain sciences · 2022Review
- Introduction of a smartphone based behavioral intervention for migraine in the emergency department.General hospital psychiatryArticle
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Authors and funding
4 authors at 1 institution in 1 country.
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Abstract
Persistent post-traumatic headache (PPTH) is often the most common injury after mild traumatic brain injury (mTBI), reported by 47-95% of patients. Progressive muscle relaxation (PMR) has level A evidence in preventing migraine and tension headaches. However, research on this behavioral therapy for PPTH, let alone smartphone delivered, is limited. We performed a single-arm study of prospective patients calling our Concussion Center between June 2017 and July 2018. Inclusion criteria were that subjects had to meet International Classification of Headache Disorders, 3rd Edition criteria for PPTH secondary to mTBI, have four or more headache days a month, be age 18-85 years and 3-12 months post-injury, own a smartphone, and not tried headache behavioral therapy within the year. We recorded baseline headache and neuropsychiatric data. Using the RELAXaHEAD smartphone application, which has a headache diary and PMR audio files, participants were instructed to record headache symptoms and practice 20 min of PMR daily. There were three monthly follow-up assessments. There were 49 subjects enrolled. Basic demographics were: 33 (67%) female with mean age 40.1 ± 14.6 [20, 75] years. Of the 49 subjects, 15 (31%) had pre-existing headaches. In 11 (22%) subjects, mTBI was sports related. Subjects reported 17.7 ± 9.3 [4, 31] headache days in the month before enrollment, and 49 (100%) experienced over three concussion symptoms. Participants inputted data in the RELAXaHEAD app on average 18.3 ± 12.0 days [0, 31] the first month. Number of participants who did PMR over four times per week was 12 (24.5%) the first month, 9 (22.5%) the second month, and 6 (15%) the third month. After 3 months, 17 (42.5 %) participants continued doing PMR. Participants cited time constraints, forgetfulness, application glitches, and repetitiveness as obstacles to practicing PMR. It is feasible to get PPTH subjects to practice behavioral therapy through low-cost smartphone-based PMR two times weekly. Future work will assess efficacy and examine how to optimize barriers to PMR.
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