Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial

Autor(es)

de Almeida Tolentino, Gabriella ^[1] ; Lima Florencio, Lidiane ^[2] ; Ferreira Pinheiro, Carina ^[1] ; Dach, Fabiola ^[3] ; Fernandez-de-las-Penas, Cesar ^[2] ; Bevilaqua-Grossi, Debora ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Hlth Sci, 3900 Bandeirantes Ave Monte Alegre, BR-14049900 Sao Paulo, SP - Brazil

^[2] Univ Rey Juan Carlos, Dept Phys Therapy Occupat Therapy Rehabil & Phys, Alcorcon - Spain

^[3] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Neurosci & Behav Sci, Ribeirao Preto, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: BMC Neurology; v. 21, n. 1 JUN 29 2021.
• Citações Web of Science: 0

Resumo

Background: Non-pharmacological approaches for the management of migraine exhibit low to moderate effectiveness due to a lack of high-quality randomized clinical trials. In fact, previous studies applied isolated techniques, which were not representative of common clinical practice. A multimodal approach for migraine may benefit these patients more than isolated approaches. This randomized clinical trial aims to determine the effectiveness of a multimodal protocol combining manual therapy, exercise, and therapeutic pain neuroscience education versus the application of manual therapy or pain neuroscience education alone in patients with migraine. Methods: This clinical trial will include 75 individuals of both sexes, aged between 18 and 55 years, with migraine. Participants will be randomized into three groups: the therapeutic pain neuroscience education (TPNE; n = 25) group, the manual therapy (MT; n = 25) group, and the multimodal (MM; n = 25) group. The TPNE group will receive one orientation session on migraine and pain self-management, and recommendations for daily active stretching and walking, with subsequent therapist monitoring. The MT group will receive manual therapies targeting musculoskeletal disorders of the cervical spine. The MM group will receive manual therapies targeting musculoskeletal disorders of the cervical spine, active neck exercises, and therapeutic pain neuroscience education. The treatment period will last 12 weeks. The primary outcome will be the headache impact, measured using the Headache Impact Test (HIT-6). Secondary outcomes will include migraine frequency and intensity, cervical mobility and strength parameters, neck pain-related disability, kinesiophobia, cutaneous allodynia, pain-related catastrophizing, quality of life, and self-perception of change. All outcomes will be evaluated at the fourth, eighth, and twelfth weeks of the treatment period. Primary and secondary clinical outcomes, such as headache impact, frequency, and intensity, will also be evaluated at the 1-, 2-, and 4-month follow-ups. Discussion: The results of this randomized clinical trial may provide high-quality clinical evidence of the effects of non-pharmacological treatment options for the management of migraine. (AU)

• Processo FAPESP: 20/10091-7 - Efeito da terapia manual associada à um programa de exercícios dos músculos cervicais e educação em dor em pacientes com migrânea: um ensaio clínico randomizado por três braços
• Beneficiário: Gabriella de Almeida Tolentino
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto