Background & Aims
Migraine is a widespread and disabling primary headache disorder [1, 2]. Medical care is provided in neurological and primary care clinics and specialized headache centers. Over 70% of migraine patients complain of concomitant neck pain [3, 4], which is not only an additional burden but is also hypothesized to be a triggering and maintaining factor [5]. Increased sensitivity of pericranial structures can potentially increase the frequency of attacks and promote the chronification of migraine [6, 7]. Previous studies have found a high prevalence of musculoskeletal dysfunction in migraine patients based on a standardized six-test examination [8] and that the response to palpation of the upper cervical spine may help identify migraine subtypes [9].
The aim is to derive recommendations for which patient group app-based self-exercises are a potentially effective intervention. This should lead to better and more targeted care for migraine patients in the long term.
Methods
This multicenter study will include 260 migraine patients. It will investigate whether app-based self-training in addition to usual medical care can contribute to a reduction in the number of headache days per month, as measured by a headache diary that must be available for a period of three previous months at the beginning of the study. An initial physiotherapeutic examination of the pericranial structures assesses whether people with an altered sensitivity of these structures benefit more from the intervention. Secondary outcome measures are the Allodynia Symptom Checklist, the Headache Management Self-Efficacy Scale, the Headache Impact Test, the Fear of Attacks in Migraine Inventory, the Neck Disability Index and the Depression Anxiety Stress Scale. The measurement points are 3, 6 and 12 months after the physiotherapy examination. Multiple linear regression is used to create a model that explains the variability of headache days per month.
Results
Training of participating physiotherapists and recruitment of migraine patients had not yet begun at the time of abstract submission. At the time of the congress, we will present the baseline data and the results for the primary and secondary outcome parameters for the first follow-up measurement of all participants included and analyzed so far. Furthermore, we will present a preliminary regression model that explains the variability of headache days per month.
Conclusions
The presentation of baseline data and preliminary outcomes at the congress will facilitate discussion and collaboration among researchers in the field of headache medicine. The data is expected to indicate whether the app-based movement exercises can contribute to the reduction of cervical pain and improved body awareness and whether this can contribute to a reduction in headache days per month and the impairment caused by migraine.
References
1.Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015., 2016. . Lancet Lond. Engl. 388, 1545–1602. https://doi.org/10.1016/S0140-6736(16)31678-6
2.Stovner, L., Hagen, K., Jensen, R., Katsarava, Z., Lipton, R., Scher, A., Steiner, T., Zwart, J.-A., 2007. The Global Burden of Headache: A Documentation of Headache Prevalence and Disability Worldwide. Cephalalgia 27, https://doi.org/193–210. 10.1111/j.1468-2982.2007.01288.x
3.Ashina, S., Bendtsen, L., Lyngberg, A.C., Lipton, R.B., Hajiyeva, N., Jensen, R., 2015. Prevalence of neck pain in migraine and tension-type headache: a population study. Cephalalgia Int. J. Headache 35, 211–219. https://doi.org/10.1177/0333102414535110
4.Lampl C, Rudolph M, Deligianni CI, et al. Neck pain in episodic migraine: Premonitory symptom or part of the attack? J Headache Pain 2015; 16: 566–570. https://doi.org/10.1186/s10194-015-0566-9
5.Özer, G., Benlier, N., 2020. Neck pain: is it part of a migraine attack or a trigger before a migraine attack? Acta Neurol. Belg. 120, 289–293. https://doi.org/10.1186/s10194-015-0566-9
6.Basedau, H., Nielsen, T., Asmussen, K., Gloss, K., Mehnert, J., Jensen, R.H., May, A., 2021. Experimental evidence of a functional relationship within the brainstem trigeminocervical complex in humans. Pain. https://doi.org/10.1097/j.pain.0000000000002417
7.Carvalho, G.F., Chaves, T.C., Goncalves, M.C. et al. (2014) Comparison between neck pain disability and cervical range of motion in patients with episodic and chronic migraine: a cross-sectional study. J Manipulative Physiol Ther, 37, 641-646. https://doi.org/10.1016/j.jmpt.2014.09.002
8.Luedtke, K., Starke, W., May, A., 2018. Musculoskeletal dysfunction in migraine patients. Cephalalgia Int. J. Headache 38, 865–875. https://doi.org/10.1177/0333102417716934
9.Luedtke, K., May, A., 2017. Stratifying migraine patients based on dynamic pain provocation over the upper cervical spine. J. Headache Pain 18, 97. https://doi.org/10.1186/s10194-017-0808-0
Presenting Author
Arne Vielitz
Poster Authors
Arne Vielitz
MSc PT
University of Luebeck
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Migraine