Administration of amitriptyline isolated versus combined with physical therapy in reducing the intensity and frequency migraine - Randomized Controlled Trial

Abstract

The main objective of this study is to evaluate the additional effect of physiotherapy on the frequency and intensity of migraine. Will be included 50 patients with migraine according to criteria of International Classification of Headache Disorders (2004), randomly selected from the outpatient headache and pains of Craniofacial Hospital of the Medical School of Ribeirão Preto (HCFMRP), female, aged 18 and 55, with at least two seizures and a maximum of 12 days of pain per month, which are in prophylactic treatment with amitriptyline up to 25 mg for at least 3 months. Will be excluded women with diagnoses of other concomitant headache, uncontrolled systemic disease and who have physical therapy in the last one year for specific region or craniocervical posture. Patients will be randomized secretly divided into two groups: G1 and G2 amytriptiline physiotherapy + amitriptyline. All will be assessed before and after treatment when the pressure pain threshold, thermal sensory threshold, neck mobility, impact of headache, the quality of life and allodynia. Between 30 and 60 days after surgery all patients will be re-evaluated when the threshold of pressure pain, neck mobility and thermal sensory threshold. The assessor will be blind for the groups to which patients belong. During the intervention period and follow up all patients fill out the headache diary to assess the frequency, intensity of migraine and analgesic. Physical therapy treatment will consist of diaphragmatic breathing training, pompage, sliding myofascial and stretching the neck muscles. Patients receive physical therapy twice a week for eight weeks, totaling 16 sessions. Patients will be advised of the possibility of participating in one of two types of treatment and signed a consent form. This project was submitted for approval by the Research Ethics Committee and after approval of HCFMRP will be registered on the platform of the International registration of clinical trials Clinical Trials Registry Platform - ICTRP. The data will be analyzed according to intention to treat with the help of the Centre for Quantitative Methods (CEMEQ), Hospital das Clinicas, Faculty of Medicine of Ribeirao Preto