Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study

Abstract

Background More than 2/3 of children and adolescents in Germany regularly suffer from headaches. Headache-related limitations in everyday life, school drop-out and educational impairment are common. Structured therapy programs for young headache patients are widely missing. Methods One hundred eleven patients with frequent migraine and/or tension type headache were treated in a 15 hour group program in afternoons, parallel with school, parents received 7 hours of therapy. At the beginning of the program (T0), 6 (T1) and 12 months (T2) after completion, data on headache related disability (PedMidas), headache frequency, intensity, and pediatric pain disability score (PPDI) were prospectively collected to investigate the effects of the therapy. Results Seventy-five patients (9-19 years, median = 14; 66.7% female) and their parents provided patient reported outcome measures showing at T1 (65 patients) and T2 (47 patients) reduced headache frequency (last 3 months headache days median T0: 30 days; T1: 18 days, reduction of median 12 days since T0; T2: 13 days, reduction of median 17 days since T0). Linear mixed models revealed significant reduction (T0/T1 p = 0,002; T0/T2 p = 0,001). Reduced headache disability has been reported at T1 and T2 (PedMidas median T0 = 30, T1 = 15, T2 = 7; p < 0,001, p < 0,001 respectively). Follow up data of a subgroup of patients 24 months after the treatment point to sustainable effects. Conclusions The interdisciplinary multimodal headache therapy program DreKiP reduces headache frequency and headache related disability significantly 6-12 months following its completion. Trial registration DRKS00027523, retrospectively registered.

Exploring the efficacy of neuro-linguistic programming in alleviating school challenges among primary schoolchildren in Lebanon

“…In the present study, NLP intervention significantly decreased headaches, stomachaches, and other sickness. An earlier study in Germany revealed an improvement in the daily function of migraine patients after receiving an interdisciplinary outpatient therapy program [20] . While medical treatments like medications and procedures are often essential, non-medical interventions can complement these approaches and contribute to a holistic pain management strategy [21] .…”

Gender-specific results of the Dresden children and adolescents headache program DreKiP

“…140 Kinder und Jugendliche nahmen von Januar 2018 bis Juni 2022 am interdisziplinären multimodalen ambulanten Therapieprogramm DreKiP (Dresdner Kinder- und Jugendkopfschmerzprogramm) teil. Ein Teil der hier auf geschlechterspezifische Therapieantwort untersuchten Kohorte wurde bereits in der Gesamtheit ausgewertet und publiziert [ 22 ]. Die Therapiegruppen wurden nach dem Alter gebildet (9- bis 10-Jährige, 11- bis 13-Jährige, 14- bis 16-Jährige, 17- bis 19-Jährige).…”

“…DreKiP besteht aus 8 Therapiemodulen für Patienten, darunter Kopfschmerzaufklärung, Stressbewältigung, Entspannungstechniken, körperliche Fitness, Klettertherapie als Selbstwirksamkeitstraining, Kunsttherapie, Riechtraining als Edukation zum Einfluss von Sinnesreizen und Achtsamkeitstraining [siehe [ 22 , 23 ]]. Elternworkshops mit dem Schwerpunkt Edukation finden an 4 Terminen parallel statt.…”

“…Daher haben wir ein interdisziplinäres multimodales ambulantes Therapieprogramm entwickelt, bestehend aus einer Kopfschmerzschulung und einer Vielzahl von praktischen Therapien, um individuelle Ansätze für junge Kopfschmerzpatienten zu ermöglichen [ 22 , 23 ]. Primäres Ziel der Studie ist es, geschlechtsabhängig therapiebedingte Veränderungen in der Kopfschmerzfrequenz und der kopfschmerzbedingten Beeinträchtigung 6 und 12 Monate nach der therapeutischen Intervention zu erfassen.…”

Tension-Type Headache in Children and Adolescents

“…These techniques have demonstrated efficacy in the treatment of pediatric headache [ 78 ] and are well accepted by patients and parents because of the very low risk of adverse effects in comparison with pharmacological treatments [ 79 ]. A recent interdisciplinary multimodal therapy program (which involved eight modules regarding headache education, stress management, relaxation techniques, physical activation, mindfulness and sensory training) showed reduced headache frequency and disability at six and twelve months after completion [ 80 ]. The best-known behavioral treatments for TTH are electromyographic (EMG) biofeedback and thermal biofeedback [ 81 , 82 ], which have shown greater responses in children than in adults [ 77 ].…”