Smartphone-Based Muscle Relaxation for Migraine in the Emergency Department

1. Among adults presenting to the emergency department (ED) with migraine, a smartphone-based progressive muscle relaxation (PMR) program significantly reduced migraine-related disability compared with usual care.

Evidence Rating Level: 1 (Excellent)

Migraine is a common cause of ED visits, but over half of these patients do not have a prior migraine diagnosis and preventive management is rarely initiated at discharge. This 2-group parallel-group randomized control trial evaluated whether a smartphone-based app (RELAXaHEAD) could improve patient-reported migraine outcomes. 94 patients (median age 33 years, 82.6% female) were randomized in a 1:1 fashion to use RELAXaHEAD as a symptom-reporting diary and PMR management vs. as a symptom-reporting diary alone. Patients in the PMR group completed a 5-minute deep-breathing session, a 6-minute PMR session (brief), a 12.5-minute PMR session (full), and an 8.5-minute muscle scan session for a minimum of 60 days during the 90-day treatment period. Patients using PMR had a significantly greater reduction in migraine-related disability (mean change −25.1 vs +6.9; p = 0.01), as measured by the migraine disability assessment. No significant differences were seen in migraine-specific quality of life (MSQv2 questionnaire) or monthly headache days. Overall, app-based PMR reduced migraine-related disability following ED discharge and represents a feasible, low-cost behavioral intervention for migraine management.

Click here to read this study in JAMA Network Open

Image: PD

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