Abstract Details

Title One-Month Feasibility of Progressive Muscle Relaxation (PMR) via Smartphone Application for Post Traumatic Headache (PTH) Patients

Topic Headache

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-025

Objective To assess the feasibility of smartphone based PMR for PTH patients.

Background Approximately 10% of mild traumatic brain injury (TBI) results in persistent post-traumatic headache (PTH). Progressive muscle relaxation (PMR) has level A evidence in preventing migraine and tension headaches. However, research on this behavioral therapy for PTH, let alone smartphone-delivered, is limited.

Design/Methods We performed a single-arm study of prospective patients calling our Concussion Center between June 2017-July 2018. Subjects met ICHD-3 criteria for persistent headache secondary to mTBI, were age 18-85 and 3-12 months post injury, with no prior behavioral treatments for headache in the past year. We assessed neuropsychologic histories. Using the RELAXaHEAD smartphone application, which has an electronic headache diary and PMR audio files, subjects were instructed to record headache symptoms and practice 20 minutes of PMR daily. There was a one-month follow-up assessment.

Results 49 subjects were enrolled, 33 female (67%) with mean age 40.1 ± 14.6 [20-75]. 15 (31%) subjects had pre-existing headaches. 11 (22%) were sports-related. Subjects reported 17.7 ± 9.3 [4-31] headaches days in the month prior to enrollment, and 46 (94%) experienced over three concussion symptoms. In one month, on average, subjects used RELAXaHEAD 18.3 ± 12.0 [0-31] days, and practiced PMR 2.3 ± 1.9 [0-6.6] days weekly. 11 (22.4%) subjects practiced PMR over 4 times weekly. Subjects cited time constraints, forgetfulness, application glitches and repetitiveness as obstacles to practice PMR daily.

Conclusions It is feasible to get persistent PTH subjects to practice behavioral therapy through low cost smartphone based PMR therapy approximately 2 times weekly. Future work will examine how to optimize barriers to doing the PMR and will also assess efficacy.

Authors/Disclosures
Saima Usmani, MD (Rutgers Robert Wood Johnson) PRESENTER	Dr. Usmani has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Laura J. Balcer, MD, MSCE, FAAN (NYU Grossman School of Medicine)	An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children's Hospital of Philadelphia.
Mia T. Minen, MD, FAAN (NYULMC Neurology)	The institution of Dr. Minen has received research support from NIH. Dr. Minen has received intellectual property interests from a discovery or technology relating to health care. Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a First Contact-Primary Care Advisory Board Member with American Headache Society . Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PCORI grant on migraine evidence based map for stakeholders with ECRI .

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