The Efficacy of Tai Chi Training for the Prophylaxis of Migraine in Chinese Women

Migraine is a disabling neurological condition, characterized by attacks of headache and associated symptoms such as photophobia, nausea, and vomiting. In Hong Kong, the overall prevalence is around 12.5%. People with repeated migraine attacks are pain and personal suffering, have impaired social and personal life, and increased financial cost of medication. More nonpharmacologic prophylactic treatments are needed to reduce the high disease burden. As a body-mind exercise, Tai Chi's potential therapeutic efficacy on the prophylaxis of migraine has caught our attention. The investigators propose to conduct a two-arm individual level randomized controlled trial. Local women diagnosed with episodic migraine between 18-65 years will be randomly assigned to one of two groups: 1) a Tai Chi training ("TC"); or 2) a waiting list control group ("control"). The control group will receive a "delayed" Tai Chi training at the end of the trial. A total of 60 participants will be randomized and the intervention period will be 12 weeks with another 12-week follow-up. Number of attacks per month (frequency of attack), intensity and duration of headache, stress, sleep quality and quantity, fatigue, HRQoL, and body composition will be measured at baseline and at 12 weeks and 24 weeks. The primary outcomes are the difference in frequency of attack from baseline to the 12 weeks after randomization, and the proportion of patients with at least a 50% reduction of the number of attacks per month. The intervention effect will be estimated by calculating the differences of outcomes from baseline to the end of the trial between the intervention and control groups using intention-to-treat analysis.

Inclusion criteria

• Female, aged 18-65 years;
• Have a clinical diagnosis of episodic migraine according to ICHD-II criteria at least 2 months prior to enrollment;
• At least one of the following migraine characteristics is met: nausea, vomiting, photophobia, or phonophobia;
• Able to undertake designated level of Tai Chi exercise;
• Live in Hong Kong, can read and speak Cantonese or Putonghua.

Exclusion criteria

• Severe migraine attacks with disabilities that cannot perform moderate intensity physical activity;
• Secondary headache and other neurological disease;
• More than 5 days of non-migrainous headache per month;
• Experience with Tai Chi practice after diagnosis of migraine;
• Regular performance of Tai Chi or other body-mind exercises (yoga, biofeedback, medication, etc.);
• Undergoing other alternative therapeutic treatments during recruitment period, or received other alternative therapeutic treatments in the past 12 weeks;
• Pregnancy, lactation period, or currently using contraceptives;
• Use of pharmacological prophylactic treatment for migraine in the past 12 weeks;
• Drug abuse, take antipsychotic or antidepressant drugs, or take analgesics for other chronic pain more than 3 days a month in the past 12 weeks;
• Epilepsy, or have a psychiatric disease.