Katie Fleischman1, Inna Zaslavsky Khazan1
Background and aims: Pediatric headache is one of the most common psychophysiological conditions affecting children and adolescents. Cognitive behavioral therapy (CBT) offers an efficacious way of alleviating this challenging-to-treat condition. Electromyography (EMG) biofeedback has been shown to be efficacious in the treatment of tension type headache, while Heart rate variability (HRV) biofeedback has shown to be an effective intervention for a variety of psychophysiological disorders (Tan et al., 2016); yet, has not been systematically investigated as a treatment for headaches. This pilot study aims to determine whether HRV and EMG biofeedback combined with CBT show promise in the treatment of headaches.
Methods: 30 cases of pediatric patients between the ages of 8-20 will be evaluated in this study. Medical record chart review will be conducted in order to determine age, gender, headache type, headache frequency, severity, and duration. Descriptive and quantitative methods will be utilized to investigate nominal data containing each individual’s HRV and EMG treatment baseline (TB), throughout the treatment (Tx) and at treatment end point (TE).
Results: Multivariate analysis of variance (MANOVA) to explore whether HRV and EMG values vary depending on the type of headache, compare baseline HRV and EMG values to final outcome HRV and EMG values and to determine whether participants' scores on the frequency and severity of headache symptom were significantly different at the TE compared to theTB. Multiple regression analysis will be utilized to determine whether the number of sessions each participants received is associated with a reduction in the frequency and severity of headache symptoms.
Conclusions: Trends in analysis thus far show the combination of HRV and EMG biofeedback along with brief CBT psychotherapy show promising results in the treatment of pediatric pain.
Relevant citations: Tan, Gabriel, Shaffer, Fredric, Lyle, Randell & Teo, Irene. (2016). Evidence-based practice in biofeedback & Neurofeedback (3rd edition). Association for Applied Psychophysiology and Biofeedback (AAPB), Wheat Ridge CO.