Evidence Table 2Efficacy of Behavioral Treatment*

StudyTreatment Type# Imprv’d/N (%)**Mean ValuesOC MeasureEffect Size
NBefore TreatmentAfter Treatment% Improvement
Anderson, Basker, and Dalton, 1975Prochlorperazine (Stemetil®)-24-----
Hypnotherapy-23-----
Andrasik, Blanchard, Neff, et al., 1984Regular contact (thermal BF or relax. [PMR])11/16 (69%)16-----
Booster treat. (thermal BF or relax. [PMR])12/15 (80%)15-----
Andreychuk and Skriver, 1975Self-hypnosis-1087.555.10.37HI-
Thermal BF + relax. (AT phrases-9132.124.10.82HI-
Barrios, 1980Relax. (PMR)-84.003.750.06HF
Thermal BF + AT phrases-76.574.000.39HF
Social skills (beh. mgmt)-96.893.560.48HF
Bild and Adams, 1980Control (WL)-62.402.000.17HF
EMG BF-62.201.400.36HF0.79 (0.08 to 1.49)
Blanchard, Andrasik, Appelbaum, et al., 1985(Migraine-only)Relax. (PMR) + thermal BF (clinic-based)9/21 (43%)212.291.420.38HI-
Relax. (PMR) + thermal BF (home-based)10/18 (56%)182.261.210.46HI-
Blanchard, Andrasik, Appelbaum, et al., 1985(Mixed M + TTH)Relax. (PMR) + thermal BF (clinic-based)12/22 (55%)224.262.650.38HI-
Relax. (PMR) + thermal BF (home-based)14/26 (54%)264.602.540.45HI-
Blanchard, Appelbaum, Nicholson, et al., 1990Control (WL)2/17 (12%)172.482.310.07HI
Thermal BF + relax. (PMR) (home-based)12/20 (40%)303.022.340.23HI0.01 (−0.59 to 0.60)
Thermal BF + relax. (PMR) + cog. ther. (home-based)13/29 (45%)293.212.310.28HI0 (−0.6 to 0.6)
Blanchard, Appelbaum, Radnitz, et al., 1990Control (WL)6/30 (20%)302.512.53−0.01HI
Placebo (pseudomeditation)9/24 (38%)243.071.940.37HI0.18 (−0.36 to 0.72)
Thermal BF + relax. (PMR)17/32 (53%)323.532.050.42HI0.15 (−0.35 to 0.65)
Thermal BF + relax. (PMR) + cog. ther.15/30 (50%)303.371.900.44HI0.19 (−0.31 to 0.70)
Blanchard, Nicholson, Radnitz, et al., 1991Control (WL)1/13 (8%)132.983.44−0.15HI
Thermal BF + relax. (AT phrases) + no home practice)11/23 (48%)233.762.920.22HI0.12 (−0.56 to 0.80)
Thermal BF + relax. (AT phrases) + home practice)12/23 (52%)233.912.650.32HI0.18 (−0.50 to 0.86)
Blanchard, Theobald, Williamson, et al., 1978Control (WL)-100.850.660.22HI
Relax. (PMR) + home practice6/11 †† (55%)10 ††0.980.170.83HI0.88 (−0.4 to 1.8)
Thermal BF + relax. (AT phrases) + home practice9/13 †† (69%)10††0.700.210.70HI0.80 (−0.11 to 1.7)
Brown, 1984Placebo (subconscious reconditioning)-131.001.07−0.07HI
Response group (relax.)-131.000.500.50HI1.06 (0.24 to 1.88)
Daly, Donn, Galliher, et al., 1983Relax. ([PMR] + AT phrases)6/11 (55%)110.680.630.08HI
EMG BF + relax. (AT phrases)7/10 (70%)100.590.250.58HI
Thermal BF + relax. (AT phrases)8/10 (80%)100.760.370.51HI
Friedman and Taub, 1984Control (WL)-10-----
Relax.-826.725.30.03HF-
Thermal BF + relax. (AT phrases)-711.38.90.21HF-
Gauthier, Côté, and French, 1994Thermal BF + no home practice2/9 (22%)92.672.73−0.02HI-
Thermal BF + home practice5/8 (63%)83.181.850.42HI-
Gauthier, Lacroix, Côté, et al., 1985Control (WL)N/S711.810.20.14HF
Thermal BF5/8 (63%)813.65.50.60HF0.73 (−0.32 to 1.8)
Holroyd, France, Cordingley, et al., 1995Relax. + thermal BF-145.212.630.50HI-
Relax. + thermal BF + propranolol HCl-136.111.830.70HI-
Holroyd, Holm, Hursey, et al., 1988Ergotamine tartrate + compliance training (home-based)11/18 (61%)187.554.810.36HI-
Thermal BF + relax. (home-based)10/19 (53%)197.794.590.41HI-
Ilacqua, 1994Guided imagery-9-----
Combined (thermal BF + guided imagery)-10-----
Thermal BF + relax.-9-----
Janssen and Neutgens, 1986(Migraine-only)Relax. (AT phrases)-N/S0.720.590.18HI-
Relax. (PMR)-N/S0.830.560.33HI-
Janssen and Neutgens, 1986(Mixed M + TTH)Relax. (AT phrases)-N/S0.640.580.09HI-
Relax. (PMR)-N/S0.870.510.41HI-
Jurish, Blanchard, Andrasik, et al., 1983Thermal BF + relax. (PMR) (clinic-based, both HA groups combined)11/21 (52%)213.452.130.38HI-
Thermal BF + relax. (PMR) (home-based, minimal therapist-contact, both HA groups combined)15/19 (79%)193.591.470.59HI-
Kewman and Roberts, 1980Control (WL)-111.231.00.19HF
Thermal BF (increase temp.)-110.980.850.13HF0.08 (−0.76 to 0.91)
Lacroix, Clarke, Bock, et al., 1983Relax. (PMR)74.001.501.63HF
EMG BF92.502.000.20HF
Thermal BF84.000.550.86HF
Lake, Rainey, and Papsdorf, 1979Control (WL)61.001.17−0.17HI
EMG BF61.000.480.52HI1.61 (0.31 to 2.91)
Thermal BF + relax.61.000.700.30HI1.09 (−0.12 to 2.30)
Thermal BF + cog. ther. (RET)61.000.790.21HI0.89 (−.29 to 2.08)
Machado and Gómez de Machado, 1985Control (WL)78.8010.6−0.20HF
Relax. (modified PMR)52.601.200.54HF
Relax. (modified PMR) + thermal BF76.000.800.87HF
Mathew, 1981(Migraine-only)Control (abortive ergotamine)333.402.720.20HI
Propranolol384.121.570.62HI
Amitriptyline323.932.280.42HI
Biofeedback (thermal + EMG) + relax.313.502.280.35HI
Propranolol + amitriptyline384.081.470.64HI
Propranolol + biofeedback-334.221.10.74HI-
Amitriptyline + biofeedback-383.781.890.48HI-
Propranolol + amitriptyline + biofeedback-304.311.170.73HI-
Mathew, 1981(Mixed M + TTH)Control (abortive ergotamine)-358.126.60.18HI-
Propranolol-386.73.240.52HI-
Amitriptyline-317.783.120.60HI-
Biofeedback (thermal + EMG) + relax.-318.064.200.48HI-
Propranolol + amitriptyline-367.362.510.69HI-
Propranolol + biofeedback-346.322.410.62HI-
Amitriptyline + biofeedback-397.102.420.66HI-
Propranolol + amitriptyline + biofeedback-377.841.890.76HI-
McGrady, Wauquier, McNeil, et al., 1994Placebo (self-relax.)3/12 (25%)121.191.24−0.04HI
EMG BF + thermal BF + relax. (AT phrases)6/11 (55%)111.281.000.22HI0.11 (−0.71 to 0.93)
Mitchell and Mitchell, 1971 (Study 1)Relax. (PMR) application-71.000.760.24HF-
Relax. + cog. ther. (combined desensitization)-71.000.240.76HF-
Mitchell and Mitchell, 1971 (Study 2)Control (WL)-51.000.930.07HF-
Relax. + cog. ther. (systematic desensitization)-51.000.590.41HF-
Mullinix, Norton, Hack, et al., 1978Placebo (false thermal BF)1/5 (20%)51.000.920.08HI
Thermal BF2/6 (33%)61.000.780.21HI0.25 (−0.94 to 1.44)
Nicholson and Blanchard, 1993Control (WL)-51.000.900.10HI
Relax. (PMR) + cog. ther. (stress-coping or problem-solving) + thermal BF-51.000.540.46HI0.91 (−0.39 to 2.21)
Passchier, van der Helm-Hylkema, and Orlebeke, 1985Control (WL)-11-----
Cog. ther. (stress-coping) + relax. (PMR)-11-----
Cog. ther. (stress-coping) + relax. (PMR) + thermal BF-15-----
Penzien, Johnson, Carpenter, et al., 1990Propranolol6/11 (55%)11-----
Relax. + thermal BF + cog. ther. (coping skills, home-based)5/11 (46%)11-----
Reading, 1984Placebo (false EMG SF)-7-----
EMG SF (frontalis)-7-----
Thermal BF-7-----
Richardson and McGrath, 1989Control (WL)3/17 (18%)1715.5315.200.02HF§
Cog. ther. + relax. (PMR)-Minimal therapist contact5/15 (33%)1514.510.50.28HF§
Cog. ther. + relax. (PMR)-Clinic-based7/15 (47%)1515.478.320.46HF§
Sargent, Solbach, Coyne, et al., 1986Control (WL)-346.335.790.09HF-
Relax. (AT phrases)-346.845.860.14HF-
EMG BF-346.955.270.24HF-
Thermal BF-346.995.510.21HF-
Sorbi and Tellegen, 1984Relax. (AT phrases) + cog. ther. (stress-coping)-100.200.0940.53HF
Relax. (AT phrases) + cog. ther. (stress-coping) + thermal BF-110.270.150.44HF
Sorbi and Tellegen, 1986Relax. (AT phrases)-130.190.110.40HF
Cog. ther. (stress mgmt)-160.120.080.31HF
Sovak, Kunzel, Sternbach, et al., 1981Drug therapy (propranolol + analgesics)-20-----
Thermal SF + relax. (AT phrases)-28-----
Wittchen, 1983Control (WL)-103.53.00.14Freq. of disabling HAs
Psychological ther.-102.41.70.29Freq. of disabling HAs0.29 (−0.59 to 1.17)
Acupuncture ther.-103.41.60.53Freq. of disabling HAs§§
*

Key: AT = autogenic; beh. = behavioral; SF = biofeedback; cog. = cognitive; EMG = electromyograph; freq. = frequency; HA = headache; HCL = hydrogen chloride; HF = headache frequency; HI = headache index; imprv’d = improved; M = migraine; mgmt = management; N = number of subjects; OC = outcome; PMR = progressive muscle relaxation; relax. = relaxation; RET = Rational Emotive Therapy; temp. = temperature; ther. = therapy; treat. = treatment; TTH = tension-type headache; WL = wait-listed

**

The “# Imprv’d/N (%)” and “N (Mean Value)” may occasionally differ because the efficacy data for each may have been derived at different times in the study (patients may have dropped out, thus reducing the number).

Data from trial were included in meta-analysis, but this study does not provide an effect size for a comparison with a control group.

††

Treatment numbers are from a later timepoint than those of “number improved”; numbers do not match because some patients dropped out.

§

Trial was included in meta-analysis, but an effect size could not be calculated because data were stratified by headache severity.

§§

Treatment was discussed in text but not included in the meta-analysis.

Key: AT = autogenic; beh. = behavioral; SF = biofeedback; cog. = cognitive; EMG = electromyograph; freq. = frequency; HA = headache; HCL = hydrogen chloride; HF = headache frequency; HI = headache index; imprv’d = improved; M = migraine; mgmt = management; N = number of subjects; OC = outcome; PMR = progressive muscle relaxation; relax. = relaxation; RET = Rational Emotive Therapy; temp. = temperature; ther. = therapy; treat. = treatment; TTH = tension-type headache; WL = wait-listed

The “# Imprv’d/N (%)” and “N (Mean Value)” may occasionally differ because the efficacy data for each may have been derived at different times in the study (patients may have dropped out, thus reducing the number).

Data from trial were included in meta-analysis, but this study does not provide an effect size for a comparison with a control group.

Treatment numbers are from a later timepoint than those of “number improved”; numbers do not match because some patients dropped out.

Trial was included in meta-analysis, but an effect size could not be calculated because data were stratified by headache severity.

Treatment was discussed in text but not included in the meta-analysis.

From: Evidence Tables

Cover of Behavioral and Physical Treatments for Migraine Headache
Behavioral and Physical Treatments for Migraine Headache.
Technical Reviews, No. 2.2.
Goslin RE, Gray RN, McCrory DC, et al.

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