Débora Bevilaqua-Grossi1, Maria Claudia Gonçalves2, Gabriela Ferreira Carvalho3, Lidiane Lima Florencio3, Fabíola Dach4, José Geraldo Speciali3, Marcelo Eduardo Bigal5, Thaís Cristina Chaves3. 1. Ribeirao Preto Medical School, Department of Biomechanics, Medicine and Locomotor Aparattus Rehabilitation, University of São Paulo, Ribeirao Preto, SP, Brazil. Electronic address: deborabg@fmrp.usp.br. 2. Physiotherapy School, University of Maranhao Center, Sao Luis, MA, Brazil. 3. Ribeirao Preto Medical School, Department of Biomechanics, Medicine and Locomotor Aparattus Rehabilitation, University of São Paulo, Ribeirao Preto, SP, Brazil. 4. Ribeirao Preto Medical School, Department of Neuroscience and Behavioral Sciences, University of São Paulo, Ribeirao Preto, SP, Brazil. 5. Global Clinical Development, Teva Pharmaceutical Industries, Frazer, PA.
Abstract
OBJECTIVE: To evaluate the additional effect provided by physical therapy in migraine treatment. DESIGN: Randomized controlled trial. SETTING:Tertiary university-based hospital. PARTICIPANTS: Among the 300 patients approached, 50 women (age range, 18-55y) diagnosed with migraine were randomized into 2 groups: a control group (n=25) and a physiotherapy plus medicationgroup (n=25) (N=50). INTERVENTIONS: Both groups received medication for migraine treatment. Additionally, physiotherapy plus medication patients received 8 sessions of physical therapy over 4 weeks, comprised mainly of manual therapy and stretching maneuvers lasting 50 minutes. MAIN OUTCOME MEASURES: A blinded examiner assessed the clinical outcomes of headache frequency, intensity, and self-perception of global change and physical outcomes of pressure pain threshold and cervical range of motion. Data were recorded at baseline, posttreatment, and 1-month follow-up. RESULTS: Twenty-three patients experienced side effects from the medication. Both groups reported a significantly reduced frequency of headaches; however, no differences were observed between groups (physiotherapy plus medication patients showed an additional 18% improvement at posttreatment and 12% improvement at follow-up compared with control patients, P>.05). The reduction observed in the physiotherapy plus medication patients was clinically relevant at posttreatment, whereas clinical relevance for control patients was demonstrated only at follow-up. For pain intensity, physiotherapy plus medication patients showed statistical evidence and clinical relevance with reduction posttreatment (P<.05). In addition, they showed better self-perception of global change than control patients (P<.05). The cervical muscle pressure pain threshold increased significantly in the physiotherapy plus medication patients and decreased in the control patients, but statistical differences between groups were observed only in the temporal area (P<.05). No differences were observed between groups regarding cervical range of motion. CONCLUSIONS: We cannot assume that physical therapy promotes additional improvement in migraine treatment; however, it can increase the cervical pressure pain threshold, anticipate clinically relevant changes, and enhance patient satisfaction.
RCT Entities:
OBJECTIVE: To evaluate the additional effect provided by physical therapy in migraine treatment. DESIGN: Randomized controlled trial. SETTING: Tertiary university-based hospital. PARTICIPANTS: Among the 300 patients approached, 50 women (age range, 18-55y) diagnosed with migraine were randomized into 2 groups: a control group (n=25) and a physiotherapy plus medication group (n=25) (N=50). INTERVENTIONS: Both groups received medication for migraine treatment. Additionally, physiotherapy plus medication patients received 8 sessions of physical therapy over 4 weeks, comprised mainly of manual therapy and stretching maneuvers lasting 50 minutes. MAIN OUTCOME MEASURES: A blinded examiner assessed the clinical outcomes of headache frequency, intensity, and self-perception of global change and physical outcomes of pressure pain threshold and cervical range of motion. Data were recorded at baseline, posttreatment, and 1-month follow-up. RESULTS: Twenty-three patients experienced side effects from the medication. Both groups reported a significantly reduced frequency of headaches; however, no differences were observed between groups (physiotherapy plus medication patients showed an additional 18% improvement at posttreatment and 12% improvement at follow-up compared with control patients, P>.05). The reduction observed in the physiotherapy plus medication patients was clinically relevant at posttreatment, whereas clinical relevance for control patients was demonstrated only at follow-up. For pain intensity, physiotherapy plus medication patients showed statistical evidence and clinical relevance with reduction posttreatment (P<.05). In addition, they showed better self-perception of global change than control patients (P<.05). The cervical muscle pressure pain threshold increased significantly in the physiotherapy plus medication patients and decreased in the control patients, but statistical differences between groups were observed only in the temporal area (P<.05). No differences were observed between groups regarding cervical range of motion. CONCLUSIONS: We cannot assume that physical therapy promotes additional improvement in migraine treatment; however, it can increase the cervical pressure pain threshold, anticipate clinically relevant changes, and enhance patient satisfaction.
Authors: Pierre Côté; Jan Hartvigsen; Iben Axén; Charlotte Leboeuf-Yde; Melissa Corso; Heather Shearer; Jessica Wong; Andrée-Anne Marchand; J David Cassidy; Simon French; Gregory N Kawchuk; Silvano Mior; Erik Poulsen; John Srbely; Carlo Ammendolia; Marc-André Blanchette; Jason W Busse; André Bussières; Carolina Cancelliere; Henrik Wulff Christensen; Diana De Carvalho; Katie De Luca; Alister Du Rose; Andreas Eklund; Roger Engel; Guillaume Goncalves; Jeffrey Hebert; Cesar A Hincapié; Maria Hondras; Amanda Kimpton; Henrik Hein Lauridsen; Stanley Innes; Anne-Laure Meyer; David Newell; Søren O'Neill; Isabelle Pagé; Steven Passmore; Stephen M Perle; Jeffrey Quon; Mana Rezai; Maja Stupar; Michael Swain; Andrew Vitiello; Kenneth Weber; Kenneth J Young; Hainan Yu Journal: Chiropr Man Therap Date: 2021-02-17
Authors: Dina Karvounides; Maya Marzouk; Alexandra C Ross; Juliana H VanderPluym; Christina Pettet; Ali Ladak; Jason Ziplow; Carlyn Patterson Gentile; Scott Turner; Marissa Anto; Rebecca Barmherzig; Madeline Chadehumbe; Jocelyn Kalkbrenner; Carrie P Malavolta; Michelle A Clementi; Trevor Gerson; Christina L Szperka Journal: Headache Date: 2020-12-31 Impact factor: 5.887