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 headaches
 These 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 Medicine
 They 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 study

 5 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 group
 In 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 HealthRelated 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 Threats
 Diffusion 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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