Saurabh Kumar,
depertment of Faculty of Physiotherapy, SGT University, Gurugram Haryana, India.
M. Ejaz Hussain, depertment of Faculty of Allied Health Sciences, SGT
University, Gurugram Haryana, India. Sonia Pawaria, depertment of Department of
Physiotherapy, Gurugram University, Gurugram Haryana, India. Wrote a research
article, Multimodal Physiotherapy for Migraine Rehabilitation. Entitled, Rehabbing
migraine: A pilot study on multimodal physiotherapy for pain, strength,
disability, posture, and quality of life. This research paper published by the International Journal of Biosciences | IJB. an open access scholarly research journal on
Biosciences. under the affiliation of the International Network For
Natural Sciences| INNSpub. an open access multidisciplinary research journal
publisher
Abstract
Migraine is a severe headache that causes throbbing, pulsing head pain on one side of the head. The headache phase of a migraine usually lasts at least four hours, but it can also last for days. Considering the multitude of contributing factors to migraine, a multimodal treatment may be an effective therapeutic option. The purpose of this study was to evaluate the benefits of the multimodal approach, including cervical spine traction, myofascial release, trigger point release, relaxation exercise, stretching and strengthening exercises, in the treatment of patients with migraine. Sixteen 18-55 years old individuals both male and female diagnosed with migraine were randomly assigned into two groups; Group A (control group, n = 8) who received Active ROM of Cervical and active stretching exercises only the multimodal approach or group B (experimental group, n = 8) who received the multimodal approach. The trial evaluated the cutaneous allodynia, craniovertebral angle (CVA), disability, posture, cervical deep flexor strength and quality of life at baseline, end of 4th weeks and end of 8th weeks after intervention. Following the 8 weeks, multimodal exercise program significant improvements in cervical deep flexor strength, posture, disability and quality of life were observed in intervention group compared to the control group. Finding of the present study showed that a multimodal exercise program improving problems associated with migraine in patients.
Introduction
Migraine is a
neurological disease considered as the second leading cause of disability,
affecting over one billion people globally (de Almeida Tolentino et al., 2021).
It is characterized by severe, recurring headaches on one or both sides of the
head. The headaches can last for hours to days and are often accompanied by
nausea, vomiting, and sensitivity to light and sound (Yan et al., 2012; Cutrer,
2010). Migraine, without aura is a type of headache that occurs in episodes and
tends to recur. It has symptoms and features that make it different from types
of headaches such as cluster headaches or tension type headaches. It's common
for individuals to have a combination of migraines with and without aura
(Sharpe et al., 2019). The International Classification of Headache Disorders
3rd Edition provides criteria, for this condition (HIS 2018). It has an
influence, on the disability of individuals under the age of 50 than any other
condition and it is also acknowledged by the World Health Organization as a primary
contributor, to disability (Carvalho et al., 2020). Migraine attacks can be
different from person to person in terms of how often they occur, how severe
they are, and how long they last. Stress can make migraine attacks worse in all
of these ways. Migraines often lead to disability, can result in missed work.
These attacks are an occurrence, in the brain that can last for hours or even
days happening repeatedly (Ruschel and De Jesus 2023; Lawler et al., 2006)
People with migraines often experience hypersensitivity to touch (allodynia)
and increased pain sensitivity (sensitization), especially in the face, back of
the head, and neck (Lawler et al., 2006). Research shows that 80% of people
with migraines also experience neck pain. This is more common than nausea,
another common migraine symptom. Neck pain can worsen migraines and make
medication less effective. It can also be triggered by tension in the neck
muscles. Studies have shown that people with migraines have imbalances in their
neck muscles, especially when they do activities that require force. Migraines
affect about 10-12% of the population and can significantly impact their
ability to work, live, and participate in social activities (Carvalho et al.,
2020; Luedtke et al., 2020; Ferracini et al., 2017).
Both pharmaceutical and
non-pharmacological treatments are available to reduce headache episodes their
frequency and intensity. Pharmacological therapy appears to be effective for
prophylaxis and some acute cases. However, occasionally treatment is
unsuccessful or has negative effects, and some patients end up with chronic
illnesses. Chronic headaches increase the number of medical visits and can even
result in drug overuse headache, which costs the healthcare system expense.
Physiotherapy, which includes many modalities such aerobic exercise, manual
therapy, electric stimulation, therapeutic pain neuroscience education, and
relaxation therapy, is a non-pharmacological treatment for migraine (Lipton et
al., 2008). After reviewing the literature, more than 90% of patients reporting
migraine have cervical musculoskeletal dysfunction (Carvalho et al., 2020).
Despite the prevalence, functional impairment, and economic consequences of
migraine sufferers, there is a substantial gap in the literature exists,
failing to provide sufficient and high-quality evidence to effectively guide
the conservative management of migraine (Luedtke et al., 2020). From a clinical
perspective, considering the diversity of the contributing factors to migraine,
a multimodal treatment might be considered as an effective therapeutic option.
Nevertheless, there is a lack of randomized clinical trials evaluating the
efficacy of this approach. Therefore, this research aimed to investigate the
effects of a multimodal approach on various clinical outcomes in migraine.
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