A RANDOMIZED CONTROLLED TRIAL OF

TAI CHI FOR TENSION HEADACHES

Group 2: Rae, Jenna, & Katie

Purpose

The purpose of this study was to determine the effect Tai Chi has on tension headaches

Independent variable= practice of Tai Chi

Dependent variable=level of pain with tension headaches and overall health

Background Info It was found that tension type headaches account

for 78% of all headachesThese can be the result of stress, anxiety,

fatigue, or anger Tai Chi is a Chinese form of exercise that improves

health by changing mental focus, breathing, coordination, and relaxation

Recent articles have shown that it can also help to improve balance, enhance cardiovascular and respiratory function, and improve mental health

Methods (Participants) To be included in the study participants had to be

between the ages of 20 and 65, they had to be able to undergo 30 minutes of exercise a day, and they had to be diagnosed with tension type headaches

Participants were excluded if they had any headaches other than tension type ones (such as migraines), if they have had previous practice of Tai Chi, had severe hearing loss, or if they had respiratory, cardiovascular or neurological problems

Methods (Participants)

The participants were volunteers from the Los Angeles area that responded to advertisements from the UCLA Department of MedicineThey posted listings in the local newspapers

asking for adults experiencing tension headaches that wanted to receive free treatment

Methods (Participants) Out of 122 potential participants only 47 met

all the requirements needed to take place in this study

Only 30 of the 47 participants completed the study5 dropped out because of time delay between

recruitment and intervention. 8 people dropped out of the treatment group during

intervention and 4 dropped out of the control groupIn the end there was a total of 13 people in the

treatment group and 17 people in the control group

Methods (Treatment)

The intervention group received sessions twice a week an hour each for 15 weeks

They were taught the Yang style of Tai Chi (which is the most widely practiced style)

They were taught by an instructor with over 20 years of experience in Tai Chi instruction

Methods (Treatment) Their improvement was determined by the Health-Related

Quality-of-Life Measure and the Headache Impact Measure Health-Related Quality-of-Life Measure focused on eight

domains of health: General health perceptions, physical functioning, role limitations due

to physical problems, bodily pain, energy/fatigue, social functioning, role limitations due to emotion problems, and emotion well-being

HIT was measured by: pain, ability to carry out usual activities, social functioning, energy/fatigue, cognitive functioning, and psychological distress

These tests were given before the first treatment session and then again at week 5, 10, and 15 throughout the intervention period.

Results There were no differences in gender or age

between the 2 groups The intervention improved the scores on

the Health-Related Quality-of-Life measure and reduced headache impact

Six of the outcome variables had significant effects from the intervention: pain, energy/fatigue, social functioning, emotional well-being, the mental health summary score, and the HIT score

External Validity

The results of this study indicate that Tai Chi is effective in reducing headache impact and in improving perceptions of some aspects of physical and mental health

The researchers note that these results apply only to people with tension-type headaches. Other types of headaches weren’t examined.

External Validity

Therefore, given the results, the conclusion that tai chi reduces tension headaches is a reasonable conclusion, showing good external validity!

This makes sense since tension headaches are usually caused by stress, anxiety, or anger which can be reduced by doing something relaxing such as Tai Chi

External Validity NOTE: If the tension headache is caused by fatigue,

doing something such as Tai Chi that will cause the person to exert more energy and tire further, which would only make their headache worse! HOWEVER, fatigue related tension headaches aren’t very common, so this isn’t a concern for this study!

Other types of headaches, such as migraines, may show differing results since they are caused by different things (according to mayo clinic, both genetics and environmental factors play a role) so Tai Chi may have no effect on them, which could be why they weren’t included in the study

Construct Validity for Dependent Variable DP=level of pain with tension headaches

and overall health This construct was defined by two

different tests, the Health-Related Quality-of-Life Measure- which measure one’s overall health and the Headache Impact Measure –which measures pain, ability to carry out usual activities, social functioning, energy/fatigue, cognitive functioning, and psychological distress

Construct Validity for Dependent Variable Threats to DV construct validity: Mono-method bias: Though they used

two tests, there were two dependent variables so there was really only one test for each.

Using multiple tests to assess overall health as well as levels of pain would have helped further strengthen their results.

Construct Validity for Dependent Variable However, this isn’t much of a threat

because the tests they used were good indicators of the constructs

Therefore, the construct validity is strong!

Construct Validity for Independent Variable IV= Practice of Tai Chi This construct was defined by using the Yang

style of Tai Chi which is the most widely used, and therefore is a good measure of the construct

Threats to IV Construct Validity: Mono-operational bias: Only used one form of

Tai Chi. However, the researchers mention that all forms of Tai Chi are very similar in method and movement, so this isn’t really a threat!

Construct Validity for Independent Variable Restricted Generalizability across

constructs: Participants could become injured while participating in the Tai Chi, which would cause them to have to stop treatment, as well as become more stressed and anxious. This would cause their final test results to be lower. However, since Tai Chi is low impact, injury is unlikely so this isn’t really a threat!

Therefore, the construct validity is strong!

Internal Validity The results of this study do show that the

intervention, which in this case would be Tai Chi, causes a change and improvement in the dependent variable, which is better known as tension headaches.

The 47 participants were randomly assigned to two different groups.

The subjects of this case were tested on their HRQOL (health-related quality of life) and HIT (headache status) before, during, and after the study.

Internal Validity This design provides evidence of temporal

precedence by the intervention of Tai Chi taking place before the decrease in tension headaches.

This study also shows covariation because the results show that when there is Tai Chi, there is fewer or less intense tension headaches.

With this study having a multi-group design and random assignment, it eliminates any single or multi-group threats.

Internal Validity

Social Interaction ThreatsDiffusion of Imitation of Treatment

○ The control group, which was put on a Tai Chi wait list, may have learned about the treatment and decided to do it on their own.

Resentful Demoralization○ Upon finding out about the treatment, the

control group members could become more discouraged or angry.

Internal Validity

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