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Effect of Guided Imagery on Quality of Life for Patients With Chronic Tension-Type Headache

Authors

  • Lisa K. Mannix MD,

    Corresponding author
    1. From the Department of General Internal Medicine, The Cleveland (Ohio) Clinic Foundation (Drs. Mannix and Solomon and Mr. Chandurkar),
    2. Dr. Mannix is now with the Headache Wellness Center, Greensboro, NC;
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  • Rohit S. Chandurkar BA,

    1. From the Department of General Internal Medicine, The Cleveland (Ohio) Clinic Foundation (Drs. Mannix and Solomon and Mr. Chandurkar),
    2. Mr. Chandurkar is with the University of Health Sciences, College of Osteopathic Medicine, Kansas City, Mo;
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  • Lisa A. Rybicki MS,

    1. Department of Biostatistics and Epidemiology (Ms. Rybicki), The Cleveland (Ohio) Clinic Foundation, and the
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  • Diane L. Tusek RN,

    1. Guided Imagery Program (Ms. Tusek), The Cleveland (Ohio) Clinic Foundation.
    2. Ms. Tusek is with Guided Imagery, Inc, Willoughby, Ohio; and
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  • Glen D. Solomon MD

    1. From the Department of General Internal Medicine, The Cleveland (Ohio) Clinic Foundation (Drs. Mannix and Solomon and Mr. Chandurkar),
    2. Dr. Solomon is with Merck & Company in Cleveland.
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Address all correspondence to Dr. Lisa K. Mannix, Suite 302,510 North Elam Avenue, Greensboro, NC 27403.

Abstract

Objective.—To determine the effect of adjuvant guided imagery on patients with chronic tension-type headache.

Background.—Management of chronic tension-type headache often requires a combination of pharmacological and nonpharmacological therapies. Guided imagery is a relaxation technique based on visualizing pleasant images and body awareness.

Methods.—One hundred twenty-nine patients with chronic tension-type headache completed the Headache Disability Inventory and the Medical Outcomes Study Short Form (SF-36) at their initial visit to a specialty headache center and again 1 month after the visit. In addition to individualized headache therapy, patients listened to a guided imagery audiocassette tape daily for the month. One hundred thirty-one control subjects received individualized therapy without guided imagery.

Results.—Controls and the patients who listened to the guided imagery tape improved in headache frequency, headache severity, patient global assessment, quality of life, and disability caused by headache. More guided imagery patients (21.7%) than controls (7.6%) reported that their headaches were much better (P.004). The guided imagery patients had significantly more improvement than the controls in three of the SF-36 domains: bodily pain (95% CI; guided imagery patients 11.0, controls 0.2), vitality (95% CI; guided imagery patients 10.9, controls l.7), and mental health (95% CI; guided imagery patients 7.8, controls 0.4).

Conclusions.—Guided imagery is an effective adjunct therapy for the management of chronic tension-type headache.

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