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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Additional Effects of a Physical Therapy Protocol on Headache Frequency, Pressure Pain Threshold, and Improvement Perception in Patients With Migraine and Associated Neck Pain: A Randomized Controlled Trial

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Bevilaqua-Grossi, Debora [1] ; Goncalves, Maria Claudia [2] ; Carvalho, Gabriela Ferreira [1] ; Florencio, Lidiane Lima [1] ; Dach, Fabiola [3] ; Speciali, Jose Gerald [1] ; Bigal, Marcelo Eduardo [4] ; Chaves, Thais Cristina [1]
Total Authors: 8
[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Biomech Med & Locomotor Aparattus Rehabil, BR-14049 Ribeirao Preto, SP - Brazil
[2] Univ Maranhao Ctr, Physiotherapy Sch, Sao Luis, MA - Brazil
[3] Univ Sao Paulo, Dept Neurosci & Behav Sci, Ribeirao Preto Med Sch, BR-14049 Ribeirao Preto, SP - Brazil
[4] Teva Pharmaceut Ind, Global Clin Dev, Frazer, PA - USA
Total Affiliations: 4
Document type: Journal article
Web of Science Citations: 8

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. (C) 2016 by the American Congress of Rehabilitation Medicine (AU)

FAPESP's process: 11/07952-1 - Administration of amitriptyline isolated versus combined with physical therapy in reducing the intensity and frequency migraine - Randomized Controlled Trial
Grantee:Maria Claudia Gonçalves
Support Opportunities: Scholarships in Brazil - Doctorate