Smartphone-Based App for Muscular Relaxation Significantly Reduces Migraine-Related Disability in Emergency Room Settings

Findings from a randomized clinical trial (NCT04281030) showed that a smartphone-based self-management program targeted at progressive muscle relaxation (PMR), dubbed RELAXaHEAD, significantly reduced migraine-related disability compared with enhanced usual care over 3 months in patients with migraine after emergency department discharge.¹ These results support initiating nonpharmacologic treatment in individuals with migraine following emergency department visits to improve patient-reported outcomes.

Among 94 patients randomized (control, n = 48 and PMR, n = 46), 69 participants (73%) had 1 or more follow-up Migraine Disability Assessment Scale (MIDAS) scores and constituted the modified intent-to-treat population (control, n = 35; PMR, n = 34). Newly published in JAMA Network Open, the mean change in MIDAS scores from baseline to 3 months differed between the treatment groups (PMR, 25.09 [SD, 29.64] vs control, 6.86 [SD, 59.61]; P = .01). Notably, PMR nearly doubled the number of respondents improving by 5 or more MIDAS points (28 of 34 [SD, 82.4%] vs 16 of 35 [SD, 45.7%] respondents; P = .002).

"Migraine disability impacts people's quality of life, work and their families. Our study describes simple, safe relaxation exercises that one can do that really reduce migraine-related disability," said lead author Mia T. Minen, MD, MPH, associate professor in the Departments of Neurology and Population Health at NYU Grossman School of Medicine and director of Headache Research at NYU Langone Health, told NeurologyLive^®.

READ MORE: RELIEV-CM Pilot Study Data Further Support ShiraTronics’ Neuromodulation Device to Treat Chronic Migraine

In the trial, researchers recruited patients aged 18 to 65 years (median age, 33 years [IQR, 26-45]; women, n = 57 [82.6%]) who visited NYU Langone Health’s emergency department for headache between June 2019 to October 2021 who met migraine criteria and self-reported 4 or more migraine days per month. Participants in the PMR group listened to the app-based PMR for 60 days whereas those in the control group used the app as a symptom diary. The primary outcome of the study was the change in migraine-related disability, as measured by MIDAS. Secondary outcomes included the change in migraine-specific quality of life (MSQv2) and monthly headache days (MHDs).

Authors reported no differences between the PMR and control group in any MSQv2 domains from baseline to the last observation carried forward (used for missing data), including the role function–preventive domain (mean, 16.9 [SD, 24.5] vs 11.3 [SD, 25.9]), emotional function domain (26.5 [SD, 26.9] vs 19.8 [SD, 38.5]), and role function–restrictive domain (18.1 [SD, 22.7] vs 18.7 [SD, 26.8]). Moreover, results revealed that the mean change in MHDs from baseline to 3 months did not differ between the treatment groups (PMR, 2.9 [SD, 8.0]; 23 days vs control, -1.6 [SD, 6.5]; 25 days).

"The RELAXaHEAD app is meant to reduce migraine disability and hopefully reduce the rate at which patients return to the emergency department for migraine," Minen said in a statement.² "While the study did not find significant differences in the number of monthly headache days, the PMR group’s improvement in disability is really meaningful." As for next steps, NYU Langone noted that Minen and her team are performing a large-scale clinical study to investigate the study app in patients with migraine, not in from the emergency department but in primary care settings.

REFERENCES
1. Minen MT, Seng EK, Friedman BW, et al. Smartphone-Based Muscle Relaxation for Migraine in the Emergency Department: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(10):e2534221. Published 2025 Oct 1. doi:10.1001/jamanetworkopen.2025.34221
2. Smartphone-Based Relaxation Program Reduces Disability for Emergency Department Migraine Patients. News release. October 16, 2025. Accessed October 23, 2025. https://nyulangone.org/news/smartphone-based-relaxation-program-reduces-disability-emergency-department-migraine-patients