Positive Health Online

Abstract

NESTORIUC and MARTIN, Philipps-University of Marburg, Section for Clinical Psychology and Psychotherapy, Gutenbergstr. 18, 35032 Marburg, Germany,  yvonne.nestoriuc@staff.uni-marburg.de, have reviewed (76 references) the efficacy of biofeedback for migraine.

Background

The aim of this study was to meta-analyze the efficacy of biofeedback in treating migraine.

Methodology

A computerized literature search of relevant databases, enhanced by a hand search, identified 86 outcome studies.

Results

A total of 55 studies, including randomized controlled trials as well as pre-post trials, met the inclusion criteria and were integrated. A medium effect size (d =0.58) resulted for all biofeedback interventions and proved stable over an average follow-up phase of 17 months. Also, biofeedback was more effective than control conditions. Frequency of migraine attacks and perceived self-efficacy demonstrated the strongest improvements. Blood-volume-pulse feedback yielded higher effect sizes than peripheral skin temperature feedback and electromyography feedback. Moderator analyses revealed biofeedback in combination with home training to be more effective than therapies without home training. The influence of the meta-analytical methods on the effect sizes was systematically explored and the results proved to be robust across different methods of effect size calculation. Furthermore, there was no substantial relation between the validity of the integrated studies and the direct treatment effects. Finally, an intention-to-treat analysis showed that the treatment effects remained stable, even when drop-outs were considered as nonresponders.

Conclusion

Biofeedback is a safe and effective treatment for migraine.

References

Nestoriuc Y, Martin A. Efficacy of biofeedback for migraine: a meta-analysis. Pain 128 (1-2): 111-127, Mar 2007.