Abstract
Although biofeedback in the treatment of migraine and tension-type headache has been widely researched, there is little research examining biofeedback therapy in posttraumatic headache (PTH). In this retrospective study, 40 subjects with PTH who had received biofeedback-assisted relaxation at our headache clinic were questioned at least 3 months following the completion of therapy. Subjects were queried about improvements in headache, increases in ability to relax and cope with pain, and overall benefits, lasting effectiveness, and continued use of biofeedback in daily life. Results indicate 53% reported at least moderate improvement in headaches; 80% reported at least moderate improvement in ability to relax and cope with pain; 93% found biofeedback helpful to some degree; 85% felt headache relief achieved through biofeedback had continued at least somewhat; and 95% stated they were continuing to use biofeedback skills in daily life. A correlation analysis revealed a negative relationship between response to biofeedback and increased chronicity of the disorder. In other words, the more chronic the disorder, the poorer the response to treatment. A stepwise regression analysis found that chronicity of the disorder and number of treatment sessions significantly affected response to treatment. Data suggest that biofeedback-assisted relaxation should at least be considered when planning treatment strategies for posttraumatic headache.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Adler, C. S., & Adler, S. M. (1976). Biofeedback psychotherapy for the treatment of headaches: A 5-year follow-up.Headache, 16, 189–191.
Adler, C. S., & Adler, S. M. (1985). Physiological feedback and psychotherapeutic intervention for migraine: A ten year follow-up. In O. Sjastaad, V. Pfaffenrath, & P. O. Lundberg (Eds.),Updating in headache (pp. 246–253). Heidelberg: Springer Verlag.
Adler, C. S., Adler, S. M., & Packard, R. C. (1987). Psychological, use of biofeedback and other self-regulatory techniques. In C. S. Adler, S. M. Adler, & R. C. Packard (Eds.),Psychiatric aspects of headache, (pp. 349–368). Baltimore: Williams & Wilkins.
Andrasik, F., & Blanchard, E. B. (1987). The biofeedback treatment of tension headache. In J. P. Hatch, J. G. Fisher, & J.D. Rugh (Eds.),Biofeedback: Studies in clinical efficacy (pp. 281–323). New York: Plenum.
Andrasik, F., Blanchard, E. B., Neff, D. F., & Rodichok, L. D. (1984). Biofeedback and relaxation training for chronic headache: A controlled comparison of booster treatments and regular contacts for long-term maintenance.Journal of Consulting and Clinical Psychology, 54, 609–615.
Bell, N. W., Abramowitz, S. I., Folkins, C. H., Spensley, J., & Hutchinson, G. L. (1983). Biofeedback, brief psychotherapy, and tension headache.Headache, 23, 162–173.
Blanchard, E. B., & Andrasik F. (1987). Biofeedback treatment of vascular headache. In J. P. Hatch, J. G. Fisher, & J. D. Rugh (Eds.),Biofeedback: Studies in clinical efficacy (pp. 1–79). New York: Plenum.
Blanchard, E. B., and Andrasik, F., Appelbaum, K. A., Evans, D. D., Jurish, S. E., Teders, S. J., Rodichok, L. D., & Barron, K. D. (1985). The efficacy and cost-effectiveness of minimal-therapist-contact, nondrug treatments of chronic migraine and tension headache.Headache, 25, 214–220.
Blanchard, E. B., Andrasik, F., Neff, D. F., Arena, J. G., Ahles, T. A., Jurish, S. E., Pallmeyer, T. P., Saunders, N. L., Teders, S. J., Barron, K. D., & Rodichok, L. D. (1982a). Biofeedback and relaxation training with three kinds of headache: Treatment effects and their prediction.Journal of Consulting and Clinical Psychology, 50, 562–575.
Blanchard, E. B., Andrasik, F., Neff, D. F., Jurish, S. E., & O'Keefe, D. M. (1981). Social validation of the headache diary.Behavior Therapy, 12, 711–715.
Blanchard, E. B., Andrasik, F., Neff, D. F., Teders, S. J., Pallmeyer, T. P., Arena, J. G., Jurish, S. E., Saunders, N. L., Ahles, T. A., & Rodichok, L. D. (1982b). Sequential comparisons of relaxation training and biofeedback in the treatment of three kinds of chronic headache or, the machines may be necessary some of the time.Behaviour Research and Therapy, 20, 469–481.
Brenner, C., Friedman, A. P., Merritt, H. H., & Denny-Brown, D. E. (1944). Post-traumatic headache.Journal of Neurosurgery, 1, 379–391.
Brown, S. J., Fann, S. R., & Grant, I. (1994). Postconcussional disorder: Time to acknowledge a common source of neurobehavioral comorbidity.Journal of Neuropsychiatry and Clinical Neurosciences, 6, 15–22.
Budzynski, T. H., Stoyva, J. M., & Adler, C. S. (1970). Feedback-induced muscle relaxation: Application to tension headache.Behavior Therapy and Experimental Psychology, 1, 205–211.
Cahn, T., & Cram, J. R. (1980). Changing measurement instrument at follow-up: A potential source of error.Biofeedback and Self-Regulation, 5, 265–273.
Diamond, S. (1979). Biofeedback and headache.Headache, 19, 180–184.
Diamond, S., Medina, J., Diamond-Falk, J., & De Veno, T. (1979). The value of biofeedback in the treatment of chronic headache: A five-year retrospective study.Headache, 19, 90–96.
Diamond, S., & Montrose, D. (1984). The value of biofeedback in the treatment of chronic headache: A four-year retrospective study.Headache, 24, 5–18.
Duckro, P. N., Tait, R., Margolis, R. B., & Silversintz, S. (1985). Behavioral treatment of headache following occupational trauma.Headache, 25, 328–331.
Elkind, A. H. (1992). Posttraumatic headache. In S. Diamond & D. J. Dalessio (Eds.),The practicing physician's approach to headache, (5th ed., pp. 146–161). Baltimore: Williams & Wilkins.
Evans, R. W. (1992). Some observations on whiplash injuries.Neurologic Clinics, 10, 975–979.
Evans, R. W. (1994). The postconcussion, syndrome: 130 years of controversy.Seminars in Neurology, 14, 32–39.
Headache Classification Committee of the International Headache Society. (1988). Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain.Cephalagia 8 (Suppl 7), 1–96.
Kraus, J. F., & Nourjah, P. (1988). The epidemiology of mild uncomplicated brain injury.Journal of Trauma, 28, 1637–1643.
McGrady, A. V., Bernal, G. A., Fine, T., & Woerner, M. P. (1983). Posttraumatic head and neck pain: A multimodal treatment approach.Journal of Holistic Medicine, 5, 130–138.
Medina, J. L. (1992). Efficacy of an individualized outpatient program in the treatment of chronic posttraumatic headache.Headache, 32, 180–183.
Morgan, A. S. (1989). Traumatic brain injury: Improved functional recovery.Journal of the National Medical Association, 81, 1133–1137.
Olson, P. R. (1988). A long-term, single-group follow-up study of biofeedback therapy with chronic medical and psychiatric patients.Biofeedback and Self Regulation, 13, 331–346.
Packard, R. C., & Ham, L. P. (1993). Posttraumatic headache: Determining chronicity.Headache, 33, 133–134.
Packard, R. C., & Ham, L. P. (1994). Posttraumatic headache.Journal of Neuropsychiatry and Clinical Neurosciences, 6, 229–236.
Packard, R. C. (1993). Life stress, personality factors, and reactions to headache. In D. J. Dalessio & S. D. Silberstein (Eds.),Wolff's headache and other head pain (6th ed., pp. 462–482). New York: Oxford.
Packard, R. C. (1992). Posttraumatic headache: Permanency and relationship to legal settlement.Headache, 32, 496–500.
Packard, R. C. (1994). Posttraumatic headache.Seminars in Neurology, 14, 40–45.
Schwartz, M. S. (1995). Headache: Selected issues and considerations in evaluation and treatment. In M. S. Schwartz & Associates,Biofeedback: A practitioner's guide (2nd ed., pp. 313–353). New York: Guilford.
Speed, W. G. (1986). Post-traumatic headache. In S. Diamond & D. J. Dalessio (Eds.),The practicing physician's approach to headache (4th ed., pp. 113–119). Baltimore: Williams & Wilkins.
Author information
Authors and Affiliations
Additional information
We wish to express our appreciation to Sandra Tomlinson Becky Kinloch, and C. M. Bundrick for their assistance in this project.
Rights and permissions
About this article
Cite this article
Ham, L.P., Packard, R.C. A retrospective, follow-up study of biofeedback-assisted relaxation therapy in patients with posttraumatic headache. Biofeedback and Self-Regulation 21, 93–104 (1996). https://doi.org/10.1007/BF02284689
Issue Date:
DOI: https://doi.org/10.1007/BF02284689