Comparison of static and dynamic balance measurements among chronic and episodic migraine patients

Abstract

Background: Migraine is one of the most frequent and incapacitating headaches, with a high degree of impairment of balance control and postural stability. Objective: To investigate the effects of episodic and chronic migraine on postural balance through using static and dynamic balance tests. Methods: The study included 32 chronic and 36 episodic migraine patients and a control group of 36 healthy volunteers. Right/left single-leg static and dynamic balance tests were performed in each group with eyes open and closed using a posturographic balance platform (Techno-body Prokin). Results: No significant difference was found among episodic and chronic migraine patients and control subjects with regard to eyes-open and eyes-closed area values (eyes-open area values: p=0.559, p=0.414 and p=0.906; eyes-closed area values: p=0.740, p=0.241 and p=0.093, respectively). However, the area values were significantly higher in episodic and chronic migraine patients than in the control group, which indicates that migraine patients may have lower balance performance. Perimeter values were relatively higher which supports the idea that migraine patients have lower balance performance. Additionally, the average number of laps was significantly lower among migraine patients than in the control group, which also implies that migraine patients may have lower balance performance. Conclusion: Although no significant difference was detected between chronic and episodic migraine patients and the control group and between chronic and episodic migraine patients with regard to balance performance, chronic migraine patients seemed to have relatively lower performance than episodic migraine patients. Further studies with larger numbers of patients are needed, to investigate the relationship between these parameters and balance.

Postural control impairment in patients with headaches—A systematic review and meta‐analysis

“…Both assessors had an excellent agreement (interclass correlation coefficient = 0.96, 95% CI: 0.89-0.98, p < 0.0001). Eleven studies 5,[34][35][36][37][38][39][40][41][42][43] were assessed as having low risk of bias, and 11 other studies 9,10,44-52 a moderate risk of bias. All studies used valid and reliable outcome measures, which were clearly described in both the Methods and Results sections.…”

“…All studies used valid and reliable outcome measures, which were clearly described in both the Methods and Results sections. The main source of bias included the lack of sample representativity of the entire po pulation, 5,9,10,34,35,[37][38][39]42,[44][45][46][47][48][49][50][51][52] unblinded assessor, 5,9,10,[34][35][36][40][41][42][43][44][45][46][47][48][49][50][51][52] inadequate adjustment for confounders, 9,36,40,41,44,45,[48][49][50][51] and lack of sample size justification. 9,10,34,…”

“…Twenty studies evaluated patients with migraine, 10,34-52 2 with tension-type headache 9,10 and 1 with cervicogenic headache. 5 Patients with headaches were diagnosed according to the first edition, 10 second editio n, 9,[34][35][36][37][44][45][46]48,50,52 or third edition 5,[38][39][40][41][42][43]47,49,51 of the ICHD, to the Neuhauser criteria 35,36,46,50 or to the guidelines by the Cervicogenic International Study Group. 5 Five studies subdivided patients with migraine into groups with chronic migraine, migraine with aura, and without aura.…”

“…5 Five studies subdivided patients with migraine into groups with chronic migraine, migraine with aura, and without aura. [37][38][39][40]43 Eight studies assessed patients with vestibular migraine. 35,36,[44][45][46][47]49,50 One study assessed patients with migraine during the ictal period.…”

“…Eighteen studies evaluated the static balance test through the posturography method, and in most of the studies it was performed over a firm, foam surface, with opened and closed eyes. The main outcomes comprised the displacement of the CoP area, 5,9,10,37,38,40,[42][43][44][45][47][48][49]51 velocity, 9,10,34,40,44,45,47,49,50,52 length, 5,9,10,40,44,48,51 and stability index and weight distribution index, 46 which were derived from sway measures. Dynamic balance tests were assessed by 9 studies and included gait, 36,37,39 tandem walk, 34,39,52 LOS, 34,38,49,52 sit-to-stand test, 39 step-up-and-over test, 39 transpose an obstacle, 41 step-up task, 41 step-down task, 41 and balance evaluation systems test (...…”