Biofeedback and rational-emotive therapy in the management of migraine headache.
Forehead EMG biofeedback, not hand-warming, gave adults lasting migraine relief.
01Research in Context
What this study did
Researchers split adults with migraine into three groups. One group learned to relax forehead muscles with EMG biofeedback. A second group warmed their hands with temperature biofeedback. The third group got temperature training plus talk therapy called Rational-Emotive Therapy.
The team tracked headache counts for three months to see which method helped.
What they found
Only the EMG group kept migraines at two-thirds of baseline or lower. Temperature training, with or without therapy talks, did nothing.
In short, forehead-muscle feedback cut headaches; hand-warming feedback did not.
How this fits with other research
Gardner et al. (1977) showed adults can learn to raise or lower blood pressure 10–15% with free-operant biofeedback. Their early work proved people can control hidden body systems, paving the way for the migraine study.
Wheatley et al. (1978) used a simple biofeedback box plus candy to turn hyperactive kids’ movement up or down. Like the migraine study, they paired biology signals with rewards, showing the method works across ages and targets.
Ellement et al. (2021) used EMG to spot silent teeth-grinding in clients with ID. Their modern protocol echoes the 1979 migraine study: hook up EMG, teach staff, and let the signal guide treatment.
Why it matters
If you serve adults who get migraines, add EMG forehead training to your self-management toolkit. Skip temperature biofeedback—it failed here. One session can teach the client to watch the line, relax the muscle, and cut headache days.
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02At a glance
03Original abstract
Twenty-four migraine patients were randomly assigned to one of four conditions: (a) self-monitoring of headache activity (waiting list), (b) frontalis EMG biofeedback, (c) digit temperature biofeedback, and (d) digit temperature biofeedback plus Rational-Emotive Therapy (RET). Bidirectional control over the target physiological response was assessed through a reversal design in each session. Following at least a four-week baseline, the three biofeedback groups received 8 to 10, 30-minute sessions of bidirectional biofeedback training, scheduled twice a week. Subjects in the combined digit temperature biofeedback plus RET group received three 40-minute sessions of RET as an addition to the third, fifth, and seventh biofeedback sessions. Records of daily home practice were kept throughout treatment and three-month followup. Subjects on the waiting list monitored headaches for at least five months, corresponding to "baseline", "treatment", and three-month followup. Digit temperature biofeedback alone and in conjunction with RET did not prove to be more effective than the control conditions. All the EMG subjects reduced headache activity to two-thirds or less of the baseline level by the third month of followup. Bidirectional digit temperature performance did not improve with training, was demonstrated in only 33% of the biofeedback sessions, was not maintained over time, and was unrelated to improvement in headache activity. EMG subjects reported biofeedback performance to be an easier task and met the performance criterion on 85% of the sessions. The frequency of home practice contributed over 55% of the variance in retrospective estimates of headache improvement but was not related to changes in daily records of headache activity.
Journal of applied behavior analysis, 1979 · doi:10.1901/jaba.1979.12-127