title: Pacing as a treatment modality in migraine and tension-type headache.
abstract: OBJECTIVE
  To review the pacing literature; describe the use of pacing in a specialty headache clinic; and provide client feedback regarding the effectiveness of pacing in headache self-management.
  
  
  METHODS
  The evidence for this report was derived from a structured literature review, an established pacing intervention program for patients with headache, and patient self-report questionnaire.
  
  
  RESULTS
  There are frequent references to pacing in the chronic pain and rheumatic disease literature, but no universal definition and, until recently, few outcome studies. References to pacing in the headache literature are limited. For a small sub-group of clients at a specialty headache clinic (n = 20), pacing principles taught by occupational therapists were reported to prevent increases in headache intensity (70%); decrease headache intensity (65%), and shorten the duration of a headache (40%). Additionally, 70% of respondents used pacing to prevent headache onset. Pacing was seen to contribute to increased quality of life, headache self-efficacy, function, and independence. There were a variety of opinions regarding the most helpful pacing components. The most frequently endorsed were identify and prioritize responsibilities; balance activity and rest; schedule regular rest breaks; and delegate or eliminate tasks.
  
  
  CONCLUSIONS
  Pacing appears to play an important role in headache self-management. More pacing research is required in both headache and chronic pain populations.
authors: Foothills Medical Center, Calgary Headache Assessment and Management Program, Calgary, Alberta, Canada. allison.mclean@albertahealthservices.ca
authors: Allison
authors: A
authors: McLean
authors: Kathryn
authors: K
authors: Coutts
authors: Werner J
authors: WJ
authors: Becker
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D019468:Disease Management; D006801:Humans; D008881:Migraine Disorders / Q000523:psychology / Q000628:therapy*; D012648:Self Care; D018781:Tension-Type Headache / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome