Physical therapy and migraine: musculoskeletal and balance dysfunctions and their relevance for clinical practice

Author(s)

Carvalho, Gabriela Ferreira ^{[1, 2, 3]} ; Schwarz, Annika ^[1] ; Szikszay, Tibor Maximilian ^[2] ; Adamczyk, Waclaw Marceli ^{[2, 4]} ; Bevilaqua-Grossi, Debora ^[1] ; Luedtke, Kerstin ^{[2, 4]}

Affiliation

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Hlth Sci, Ribeirao Preto - Brazil

^[2] Univ Lubeck, Acad Physiotherapy Pain & Exercise Res, Dept Orthoped & Trauma Surg, Med Sect, Ratzeburger Allee 160, D-23562 Lubeck - Germany

^[3] Univ Hamburg Eppendorf, Dept Syst Neurosci, Hamburg - Germany

^[4] Jerzy Kukuczka Acad Phys Educ, Lab Pain Res, Katowice - Poland

• Document type: Review article
• Source: BRAZILIAN JOURNAL OF PHYSICAL THERAPY; v. 24, n. 4, p. 306-317, JUL-AUG 2020.
• Web of Science Citations: 0

Abstract

Background: Migraine is a primary headache with high levels of associated disability that can be related to a variety of symptoms and comorbidities. The role of physical therapy in the management of migraine is largely unknown. Therefore, the aim of this review is to highlight and critically discuss the current literature and evidence for physical therapy interventions in individuals with migraines. Methods: A narrative review of the literature was performed. Results: Physical therapists assessing and treating patients with migraine should focus on two primary aspects: (1) musculoskeletal dysfunctions, and (2) vestibular symptoms/postural control impairment. Signs and symptoms of musculoskeletal and/or vestibular dysfunctions are prevalent among individuals with migraines and different disability levels can be observed depending on the presence of aura or increment of the migraine attacks. Conclusion: A proper physical examination and interview of the patients will lead to a tailored treatment plan. The primary aim regarding musculoskeletal dysfunctions is to reduce pain and sensitization, and physical therapy interventions may include a combination of manual therapy, exercise therapy, and education. The aim regarding postural control impairment is to optimize function and reduce vestibular symptoms, and interventions should include balance exercises and vestibular rehabilitation. However, consistent evidence of benefits is stilt lacking due to the lack of and therefore need for tailored and pragmatic clinical trials with high methodological quality. (C) 2019 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved. (AU)

• FAPESP's process: 18/12024-5 - Influence of neck disfunction on joint position sense, dizziness and balance of patients with migraine
• Grantee: Gabriela Ferreira Carvalho
• Support type: Scholarships abroad - Research Internship - Post-doctor