Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Mar;43(3):2021-2029.
doi: 10.1007/s10072-021-05491-w. Epub 2021 Aug 5.

Instrumental assessment of physiotherapy and onabolulinumtoxin-A on cervical and headache parameters in chronic migraine

Manuela Deodato  1   2   3 , Antonio Granato  4   5 , Caterina Borgino  4 , Alessandra Galmonte  4 , Paolo Manganotti  4   5
Affiliations
Observational Study

Instrumental assessment of physiotherapy and onabolulinumtoxin-A on cervical and headache parameters in chronic migraine

Manuela Deodato et al. Neurol Sci. 2022 Mar.

Abstract

Introduction: The purpose of the present study is to compare the effect of the physiotherapy to onabolulinumtoxin-A, and their combination, in relation to cervical and headache parameters in patients with chronic migraine.

Methods: This is an observational cohort study conducted by a headache center and a physiotherapy degree course on 30 patients with chronic migraine. The patients were distributed in three groups of treatments for three months: onabolulinumtoxin-A only, physiotherapy only, and onabolulinumtoxin-A plus physiotherapy. The patients were evaluated, before and after each treatment, using the following: the postural assessment software SAPO for the forward head posture; the CROM goniometer for the cervical range of motion; the Migraine Disability Assessment Score for headache parameters.

Results: After 3 months of each treatment, the scores obtained for the headache-related disability and the frequency of migraine decreased significantly for all groups, but the pain intensity scores changed significantly only in the onabolulinumtoxin-A (p = 0.01) and in the onabolulinumtoxin-A plus physiotherapy groups (p = 0.007). On the other hand, the forward head posture was reduced significantly in the physiotherapy (p = 0.002) and in the onabolulinumtoxin-A plus physiotherapy groups (p = 0.003). The cervical range of motion increased significantly in certain directions in the physiotherapy group and in the onabolulinumtoxin-A plus physiotherapy groups.

Conclusions: The physiotherapy improved the cervical parameters. The onabolulinumtoxin-A decreased pain intensity. As a consequence, it can be said that the combined treatment was more useful than a mono-therapy alone. From our results, it can be concluded that onabolulinumtoxin-A plus physiotherapy could be a good option in the management of chronic migraine.

Keywords: Cervical range of motion; Chronic migraine; Forward head posture; Onabolulinumtoxin-A; Physiotherapy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Forward head posture (FHP). FHP in onabotulinumtoxin-A only (BoNT-A), onabotulinumtoxin-A plus physiotherapy (BoNT-A+PT), and physiotherapy only (PT) at the first evaluation (T1) and at the end of each treatments (T2); Wilcoxon non-parametric test *p < 0.05; **p < 0.01
Fig. 2
Fig. 2
Cervical range of motion (CROM): flexion in onabotulinumtoxin-A only (BoNT-A), onabotulinumtoxin-A plus physiotherapy (BoNT-A+PT), and physiotherapy only (PT) at the first evaluation (T1) and at the end of each treatments (T2); Wilcoxon non-parametric test *p < 0.05; **p < 0.01
Fig. 3
Fig. 3
Cervical range of motion (CROM): extension in onabotulinumtoxin-A only (BoNT-A), onabotulinumtoxin-A plus physiotherapy (BoNT-A+PT), and physiotherapy only (PT) at the first evaluation (T1) and at the end of each treatments (T2); Wilcoxon non-parametric test *p < 0.05; **p < 0.01
Fig. 4
Fig. 4
Migraine Disability Assessment Score (MIDAS): MIDAS-B intensity of headache attack (on a scale of 1–10) in the previous 3 months, in onabotulinumtoxin-A only (BoNT-A), onabotulinumtoxin-A plus physiotherapy (BoNT-A+PT), and physiotherapy only (PT) at the first evaluation (T1) and at the end of each treatments (T2); Wilcoxon non-parametric test *p < 0.05; **p < 0.01
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 - The Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32279-7/fulltext. Access - PMC - PubMed
    1. Charles A. The pathophysiology of migraine: implications for clinical management. Lancet Neurol. 2018;17:174–182. doi: 10.1016/S1474-4422(17)30435-0. - DOI - PubMed
    1. Fusco M, D’Andrea G, Miccichè F, et al. Neurogenic inflammation in primary headaches. Neurol Sci. 2003;24:s61–s64. doi: 10.1007/s100720300043. - DOI - PubMed
    1. Aguggia M, Saracco MG. Pathophysiology of migraine chronification. Neurol Sci. 2010;31:15–17. doi: 10.1007/s10072-010-0264-y. - DOI - PubMed
    1. Panerai AE. Is migraine a disorder of the central nervous system? Neurol Sci. 2013;34:33–35. doi: 10.1007/s10072-013-1363-3. - DOI - PubMed

Publication types