Assessment of Headache Impact Test (HIT-6) Following Nurse-Led Progressive Muscle Relaxation in Multiple Sclerosis: A Controlled Pretest-Posttest Study
| Author | Alireza Salar | en |
| Author | Mehdi Rezvaniamin | en |
| Author | Zahra Pournamdar | en |
| Orcid | Alireza Salar [0000-0002-5280-0283] | en |
| Orcid | Mehdi Rezvaniamin [0000-0003-4951-7767] | en |
| Orcid | Zahra Pournamdar [0000-0001-9859-0106] | en |
| Issued Date | 2026-01-31 | en |
| Abstract | Background: Multiple sclerosis (MS) is a leading cause of non-traumatic neurological disability in young adults, and headaches often intensify the day-to-day burden by worsening headache-related quality of life (QoL). Evidence for low-cost, nurse-delivered behavioral options such as progressive muscle relaxation (PMR) in MS headache care remains limited. We evaluated whether a brief PMR program is associated with lower headache impact on QoL measured by the Headache Impact Test (HIT-6). Methods: In a controlled quasi-experimental, parallel-group, pretest–posttest study (Zahedan, Iran; 2023), adults with neurologist-confirmed MS and recurrent headaches were allocated to PMR (n = 30) or usual care (n = 30). PMR included three nurse-led group sessions (20 - 30 minutes on three consecutive days) plus structured daily home practice for six weeks with weekly telephone support. HIT-6 (range 36 - 78; higher = worse) was collected at baseline and 3 months. Baseline comparability used t-tests/χ². The primary endpoint (3-month HIT-6) was analyzed via ANCOVA adjusting for baseline HIT-6 and MS duration (α = 0.05). Results: Sixty participants completed follow-up (PMR n = 30; Control n = 30). Groups were similar in age and sex; MS duration was longer in PMR. Baseline HIT-6 did not differ. At 3 months, the PMR group showed lower HIT-6 than controls in adjusted analysis: Adjusted Mean Difference (PMR-Control) = -5.64 (95% CI -9.58 to -1.69; p = 0.006; partial η² = 0.128). The adjusted between-group difference in HIT-6 (-5.64 points) exceeded the 3-point MCID, supporting clinical interpretability. Conclusions: A brief, nurse-delivered PMR program with structured home practice was associated with a clinically interpretable reduction in headache impact (HIT-6) at 3 months versus usual care. Given its low cost, safety, and feasibility, PMR appears to be a pragmatic adjunct to multidisciplinary MS services. Larger, multicenter randomized trials with longer follow-up and objective adherence tracking are warranted. | en |
| DOI | https://doi.org/10.5812/jjcdc-167613 | en |
| Keyword | Multiple Sclerosis | en |
| Keyword | Headache | en |
| Keyword | Headache Impact Test (HIT-6) | en |
| Keyword | Progressive Muscle Relaxation | en |
| Keyword | Relaxation Therapy | en |
| Keyword | Nurse-Led Intervention | en |
| Keyword | Quality of Life | en |
| Publisher | Brieflands | en |
| Title | Assessment of Headache Impact Test (HIT-6) Following Nurse-Led Progressive Muscle Relaxation in Multiple Sclerosis: A Controlled Pretest-Posttest Study | en |
| Type | Research Article | en |
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