Neurology. 2025 Apr 8;104(7_Supplement_1):4224. doi: 10.1212/WNL.0000000000211532. Epub 2025 Apr 7.
ABSTRACT
OBJECTIVE: To conduct interim analyses to assess the feasibility, acceptability, and preliminary impact of a 6-session, in-person, PT-delivered BAR program for patients with migraine.
BACKGROUND: There are accessibility barriers to biofeedback-assisted relaxation (BAR), a Grade A evidence-based migraine preventive treatment, typically delivered by psychologists. Despite having BAR training for other conditions, physical therapists (PTs) do not traditionally deliver BAR for migraine.
DESIGN/METHODS: We conducted a randomized, single-blinded parallel study comparing BAR to Enhanced Usual Care (EUC) in patients with migraine. Between in-person sessions, participants were asked to practice daily. EUC participants were given educational handouts. Both groups completed a daily electronic headache diary. Outcome measures included migraine-related quality of life (MSQv2) and migraine-related disability (MIDAS).
RESULTS: Fifty participants enrolled (BAR=25, EUC=25). The majority (81.0%, 17/21 BAR; 79.2%, 19/24 EUC) agreed/strongly agreed that the electronic headache diary was easy to understand. BAR feasibility data (n=19) showed 89.5% attended 4+ sessions. BAR practice data (n=18) showed 66.7% reported daily practice, and 55.6% reported 10+ minutes of practice/session. Although not statistically significant, the BAR group had greater improvements in each MSQv2 subdomain compared to EUC (Role Function-Restrictive BAR=14.2 vs EUC=6.0, Role Function Preventive BAR=8.3 vs EUC=4.8, Emotional Function BAR=16.8 vs EUC=14.2). The BAR group had a greater mean change in MIDAS compared to EUC (-27.4 + 31.5 vs -5.48 + 22.0; P=0.010).
CONCLUSIONS: Of the patients with migraine who did PT-delivered BAR, the majority practiced daily (up to 10+ minutes/day), and there were clinically significant improvements in migraine-related disability compared to EUC. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff. Disclosure: 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 . Miss Dorf has nothing to disclose. Ms. George has nothing to disclose. The institution of Dr. Fanning has received research support from Abbvie. The institution of Dr. Fanning has received research support from NYC Langone Health . The institution of Dr. Fanning has received research support from Uiversity of SC – Irvine. The institution of Dr. Fanning has received research support from AESARA. Ryan Bostic has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for MIST Research. Mr. Schultz has nothing to disclose.
PMID:40194229 | DOI:10.1212/WNL.0000000000211532
