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Controlled evaluation of the addition of cognitive strategies to a home-based relaxation protocol for tension headache
Appelbaum KA, Blanchard EB, Nicholson NL, Radnitz C, Kirsch C, Michultka D, Attanasio V, Andrasik F, Dentinger MP
Behavior Therapy 1990 Summer;21(3):293-303
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Chronic tension headache sufferers were randomized in the approximate ratio of 2:2:1 to one of three regimens: (1) progressive muscle relaxation (PMR) training delivered as a largely home-based treatment; (2) PMR plus selected cognitive stress coping techniques, again delivered as a largely home-based treatment; or (3) a headache monitoring, wait-list control condition. All patients monitored headaches daily for at least 4 weeks before and after treatment. In general, the two active treatment groups were significantly improved relative to the wait-list control group on measures of reduction in headache activity and reduction in headache medication, derived from a daily headache diary, and on measures of clinically significant improvement. The two active treatment groups did not differ from each other on any measure. Thus, it appears that the addition of limited cognitive stress-coping techniques to PMR did not add significantly to treatment outcome utilizing the protocol described.

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