Progressive Muscle Relaxation Delivered by Smartphone App Acceptable for Migraine

A smartphone application delivering guided progressive muscle relaxation was a both an accessible and acceptable form of therapy for patients with migraine.

A smartphone application (app) delivering guided progressive muscle relaxation was an acceptable form of therapy for migraine and was associated with small to moderate declines in migraine-related disability, according to study results published in Headache.

Patients with migraine are increasingly in need of accessible and effective prevention and management strategies. This study sought to evaluate the feasibility and accessibility of a progressive muscle relaxation provided via a smartphone application app for this population.

Study researchers enrolled adult patients with migraine and at least 4 headache days per month in this non-blinded pilot trial. Participants were given access to the RELAXaHEAD app that included an electronic headache diary. They then randomly assigned patients to either a version of the app that provided progressive muscle relaxation (intervention arm; n=77) or another version of the app that did not provide progressive muscle relaxation (control arm; n=62).

The primary outcomes were feasibility, or adherence to the intervention and diary entries, as well as acceptability, or satisfaction. Exploratory analyses were conducted to determine whether participants experienced a change in the Migraine Disability Assessment Scale (MIDAS) scores.

The mean age of the study population was 41.7 years (standard deviation, ±12.8 years), and 78% of patients presented with moderate-severe disability. In the first 6 weeks, participants in the progressive muscle relaxation group practiced the intervention between 2 and 4 times per week (mean duration per session, 11.1±8.3 minutes).

Based on scores from a 1 to 5 Likert scale, participants said they thought the app was easy to use (mean, 4.3±0.7). Additionally, participants said they would be happy to use the smartphone app-delivered progressive muscle relaxation intervention again (mean, 4.3±0.6).

Compared with patients in the control group who only used the electronic diary, those who used the progressive muscle relaxation intervention had a greater decline in mean MIDAS scores (-8.7 vs -22.7, respectively); however, this decline was not statistically significant (P =.100).

Limitations of the study were the small sample size, the inclusion of patients who had been on preventive treatment (53.6%), and potential selection bias, all of which may have impacted the study’s results.

The study researchers concluded that additional research “studies might examine whether the other level A evidence-based behavioral therapies,” such as cognitive behavioral therapy and biofeedback, “might be introduced for migraine prevention in the primary care setting.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Minen MT, Adhikari S, Padikkala J, et al. Smartphone-delivered progressive muscle relaxation for the treatment of migraine in primary care: A randomized controlled trial. Headache. Published online November 16, 2020. doi:10.1111/head.14010