Article

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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS