Comparing Virtual Reality and Yoga for Tension-type headache in children.

INTERVENTION: Intervention1: Virtual Reality based Meditation: The study will involve virtual reality based meditation sessions of 45 minutes conducted twice a week for 4 weeks During each session participants will use a head mounted virtual reality device to engage in guided meditation and relaxation exercises within immersive nature based environments incorporating calming visuals relaxation tasks and structured meditation techniques to promote mental relaxation and reduce pain related anxiety Applications such as TRIPP VR or Mindful VR will be used to deliver synchronized audio visual cues making the intervention a safe engaging and effective approach for reducing stress in children with pain related anxiety. Intervention2: Yoga: The yoga intervention will consist of sessions lasting 45 minutes conducted twice weekly over a period of 4 weeks The program will include physical postures designed to reduce muscle tension and improve posture such as Balasana Paschimottanasana Viparita Karani and Marjaryasana Bitilasana Along with asanas breathing exercises will be incorporated to regulate autonomic function and reduce stress including Nadi Shodhana Bhramari Sheetali and Sheetkari and deep diaphragmatic breathing The sessions will follow clear and consistent instructions while allowing children to adapt comfortably to the intervention setting to promote relaxation and overall calmness Control Intervention1: Control: In the control group participants will be provided with educational materials on paediatric tension type headache covering topics such as headache triggers healthy lifestyle habits sleep hygiene stress management and posture correction Baseline and post intervention assessments will be conducted using the same outcome measures as the intervention groups including pain intens CONDITION: PRIMARY OUTCOME: 1.Headache Impact Test ; 2.Child Pain Anxiety Symptoms Scale ; 3.Pain Catastrophizing Scale for ChildrenTimepoint: 1.Headache Impact Test ; 2.Child Pain Anxiety Symptoms Scale ; 3.Pain Catastrophizing Scale for Children all outcomes for pre‐intervention and Post intervention for 4 weeks. SECONDARY OUTCOME: Numerical Pain Rating ScaleTimepoint: Numerical Pain Rating Scale for pre‐intervention and Post intervention for 4 weeks. INCLUSION CRITERIA: School going children of both genders aged fourteen to sixteen years from government and private schools and colleges in Belagavi city diagnosed with paediatric tension type headache as per ICHD three criteria who are willing to provide assent and participate in the study and have the ability to understand Hindi English or Marathi language with a headache frequency of two or more episodes per week for three months and who are able to participate in yoga or virtual reality meditation