Smartphone-Based Muscle Relaxation for Migraine in the Emergency Department: A Randomized Clinical Trial

Area of Science:

• Neurology
• Digital Health
• Pain Management

Background:

• The emergency department (ED) is a key healthcare touchpoint for initiating nonpharmacologic migraine treatments.
• Smartphone applications offer a scalable platform for patient self-management of chronic conditions like migraine.
• Progressive Muscle Relaxation (PMR) is a recognized nonpharmacologic technique for managing stress and pain.

Purpose of the Study:

• To evaluate the efficacy of a smartphone-based PMR program for migraine self-management.
• To compare patient-reported outcomes in migraine patients using PMR via smartphone app versus enhanced usual care.
• To assess the impact of PMR on migraine-related disability, quality of life, and headache frequency.

Main Methods:

• A randomized clinical trial involving 94 adult patients with migraine visiting EDs.
• Participants were assigned to either a smartphone app with PMR (intervention) or a symptom diary app (control).
• Outcomes measured included changes in Migraine-Disability Assessment Scale (MIDAS) scores, quality of life (MSQv2), and monthly headache days (MHDs) at 3-month follow-up.

Main Results:

• The PMR group showed a significantly greater reduction in MIDAS scores compared to the control group (P=.01).
• A higher proportion of patients in the PMR group experienced a clinically significant improvement in disability (82.4% vs 45.7%, P=.002).
• No significant differences were observed in migraine-specific quality of life or monthly headache days between the groups.

Conclusions:

• A PMR-based self-management program delivered via smartphone app can lead to clinically significant reductions in migraine-related disability.
• This digital health intervention represents a viable nonpharmacologic strategy for patients with migraine post-ED discharge.
• Further research may explore optimizing PMR delivery and its long-term effects on comprehensive migraine management.