Primary Topic: Mind-body (including meditation and yoga)
Mindfulness-based stress reduction and yoga for treating chronic headache: systematic reviews and meta-analyses.
Dennis Anheyer, MA, University of Duisburg-Essen, Essen, Germany; Matthew J Leach, PhD, University of South Australia, Adelaide, Australia; Petra Klose, PhD; Gustav Dobos, MD PhD; Holger Cramer, PhD, University of Duisburg-Essen, Essen, Germany
Late Breaker: No
Mindfulness-based stress reduction (MBSR) and yoga are two mind-body techniques frequently used to treat pain-related conditions, but their effects on headache symptoms remain uncertain. The aim of this presentation is to report the findings of two systematic reviews examining the efficacy and safety of MBSR and yoga in patients with chronic headache (i.e. migraine and/or tension-type headache).
We searched MEDLINE/PubMed, Scopus, The Cochrane Library, and PsychINFO to June 15 2017. Only randomized controlled trials (RCTs) comparing MBSR or yoga with usual care or an active comparator, and reporting headache frequency, duration and/or intensity as primary outcomes, were eligible. Two reviewers independently extracted data on study characteristics, patients, interventions, and outcome measures. Risk of bias was assessed using the Cochrane Risk of Bias Tool.
After full-text screening, 4 RCTs with a total of 177 patients treated with MBSR and 5 RCTs with a total of 251 patients treated with yoga were eligible for quantitative analysis. While yoga significantly reduced headache frequency (5 RCTs; SMD: -1.97 [95%CI: -2.75 to -1.19]), duration (4 RCTs; SMD: -1.46 [95%CI: -2.54 to -0.37]) and intensity (5 RCTs; SMD: -3.44 [95%CI: -6.08 to -0.79]) in comparison to usual care, no evidence was found for MBSR in reducing any of these outcomes when compared to usual care. Only one study on MBSR reported safety-related data, while none of the studies on yoga reported such data.
Evidence supports the recommendation of yoga (but not MBSR) as an adjunctive therapy for patients suffering from chronic headaches. However, since study quality was mainly low, more rigorous RCTs are necessary to underpin this recommendation.