The Development of Mindful-Based Dance Movement Therapy Intervention for Chronic Pain: A Pilot Study With Chronic Headache Patients

Abstract

Chronic pain is of significant global concern. There is growing evidence that body–mind therapies and psychological approaches can contribute toward changing chronic pain perceptions. This is the first model described in the literature that combines a mindfulness-based approach with dance movement therapy and explores the potential psychological and pain-related changes for this client population. In this paper, the results from the pilot study are presented involving patients with chronic headache recruited in an outpatient rehabilitation setting.Methods: In this pilot study, 29 patients (n = 29) with chronic headache were randomized to either the Mindful-Based Dance Movement Therapy (MBDMT) group or the waiting list control group (treatment as usual, TAU). The MBDMT group was offered 10 sessions in a clinical outpatient rehabilitation setting for 5 weeks. Data were collected pre- and post-intervention and 16 weeks after the intervention was finished. The Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire−9 (PHQ-9), Five Facet Mindfulness Questionnaire (FFMQ), and Numeric Rating Scale (NRS) were used as outcome measures.Results: The working model of MBDMT identifies nine therapeutic mechanisms (safe therapeutic environment, mindfulness skills, body awareness, relaxation/releasing, distancing and staying with discomfort, meaning making, self-regulation, acceptance and integration, creative process). Per-protocol analysis reveals statistically significant reduction of pain intensity and depression scores in favor of the MBDMT group, and these improvements were maintained in the follow-up assessment.Conclusions: The results suggest that MBDMT is a feasible and promising therapy approach for chronic pain patients. The pilot study offered sufficient information and preliminary results in the desirable direction to enable the researchers to move to a randomized controlled trial (RCT) stage in order to establish the efficacy of the intervention.Clinical Trial Registration: The study was registered in the www.researchregistry.com, registry (5483).

Development and feasibility of a mindfulness-based dance/movement therapy intervention for chronic low back pain

“…Growing evidence supports the positive effects of DMT on various physical and mental health outcomes (e.g., depression, anxiety, mobility, body image, quality of life) ( 41 , 43 , 44 ). Several studies have explored the potential of DMT in various chronic pain management contexts ( 25 , 28 , 45 , 46 ). However, the current body of research lacks randomized controlled trials (RCTs) and often exhibits limited methodological rigor.…”

“…This includes the absence of standardized treatment manuals/protocols and a lack of evaluation of treatment fidelity, which collectively contribute to the insufficient evidence supporting the efficacy of DMT for chronic pain management. Furthermore, while evidence regarding the effect of mindfulness on cLBP has been established ( 47 , 48 ), and fundamental mindfulness principles are inherent in DMT theories, only one study has, to date, explored the integration of two approaches within the context of cLBP care ( 46 ). Building upon prior research indicating the role of DMT in addressing maladaptive pain cognitions and activity avoidance, we hypothesized that teaching and incorporating mindfulness skills directly and explicitly (such as focusing on the present moment, one's body, and the experience of pain, alongside non-judgmental acceptance) within the framework of DMT could further enhance the treatment's effect on tackling fear-avoidance cycle.…”

A Preliminary Analysis on the Feasibility and Short-Term Efficacy of a Phase-III RCT on Mindfulness Added to Treatment as Usual for Patients with Chronic Migraine and Medication Overuse Headache

“…Several studies have been published in recent years that address the use of mindfulness in headache disorders. The majority of these studies were, however, on mixed populations of patients with EM and CM together [ 20 , 21 , 22 , 23 ], or EM only [ 24 , 25 , 26 ], whereas other studies mixed patients with different kinds of primary headaches [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. To the best of our knowledge, few studies from our group have addressed mindfulness in patients with CM-MOH [ 34 , 35 , 36 , 37 ].…”

“…Almost all studies performed a comparison against no treatment, treatment as usual (TaU) or waitlist [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ], with the exception of one study that was based on a single group [ 37 ]. Headache frequency was used as an outcome of treatment in almost all studies [ 20 , 21 , 22 , 24 , 25 , 26 , 34 , 35 , 36 , 37 ], with the variation over time being significant in the majority of the studies [ 21 , 22 , 25 , 26 , 34 , 35 , 36 , 37 ].…”

“…A superior reduction in migraines compared to the control condition was found by Simshäuser and colleagues [ 26 ], who compared the longitudinal course of headache frequency between patients allocated to receive mindfulness-based cognitive therapy adapted for migraines against waitlist patients. The remaining studies generally addressed measures of perceived pain, QoL, impact or disability as the main outcomes [ 23 , 27 , 28 , 29 , 31 , 32 , 33 ].…”