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Treatment of Migraine: A Randomized Clinical Trial
Lemstra M, Stewart B, Olszynski WP
Posted: January 2003  
Headache 2002; 42:845-854

Objective:   To test the effectiveness of a multidisciplinary management program for migraine treatment in a group, low cost, nonclinical setting.

Methods:   Eighty men and women were randomly assigned to 1 of 2 groups. The intervention group consisted of a neurologist and physical therapist intake and discharge, 18 group-supervised exercise therapy sessions, 2 group stress management and relaxation therapy lectures, 1 group dietary lecture, and 2 massage therapy sessions. The control group consisted of standard care with the patientís family physician. Outcome measures included self-perceived pain intensity, frequency, and duration; functional status; quality of life; health status; depression; prescription and nonprescription medication use; and work status. Outcomes were measured at the end of the 6-week intervention and at a 3-month follup-up.

Results:   Forty-one of 44 patients from the intervention group and all 36 patients from the control group completed the study. There were no statistically significant differences between the 2 groups before intervention. Intention to treat analysis revealed that the intervention group experienced statistically significant changes in self-perceived pain frequency, pain intensity, pain duration, functional status, quality of life, health status, pain related disability, and depression; these differences retained their significance at the 3-month follow-up. There were no statistically significant changes in medication use or work status.

Conclusions:   Positive health related outcomes in migraine can be obtained with a low cost, group, multidisciplinary intervention in a community based nonclinical setting.