Impaired Standing Balance in Individuals with Cervicogenic Headache and Migraine

Sremakaew, Munlika; Sungkarat, Somporn; Treleaven, Julia; Uthaikhup, Sureeporn

doi:10.11607/ofph.2029

Cited by 14 publications

(23 citation statements)

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“…In addition to vestibular symptoms, migraineurs often present balance disorders [5,7,9,[14][15][16][17][18], which is also augmented by the presence of aura and chronicity in the interictal [5][6][7] and ictal period [19]. Without considering the migraine subdiagnosis, some studies suggest that migraineurs with vestibular symptoms present more balance instability [15,20] in association with [20] or without otoneurologic alterations [15].…”

Section: Introductionmentioning

confidence: 99%

Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

et al. 2020

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Background: Vestibular symptoms and balance changes are common in patients with migraine, especially in the ones with aura and chronic migraine. However, it is not known if the balance changes are determined by the presence of vestibular symptoms or migraine subdiagnosis. Therefore, the aim of this study was to verify if the migraine subdiagnosis and/or the presence of vestibular symptoms can predict balance dysfunction in migraineurs. Methods: The study included 49 women diagnosed with migraine with aura, 53 without aura, 51 with chronic migraine, and 54 headache-free women. All participants answered a structured questionnaire regarding migraine features and presence of vestibular symptoms, such as dizziness/vertigo. The participants performed the Modified Sensory Organization Test on an AMTI© force plate. The data were analysed using a linear mixed-effect regression model. Results: The presence of vestibular symptoms did not predict postural sway, but the subdiagnosis was a significant predictor of postural sway. Migraine with aura patients exhibited more sway than migraine patients without aura when the surface was unstable. Additionally, we found high effect sizes (ES > 0.79) for postural sway differences between patients with chronic migraine or with aura compared to controls or migraine without aura, suggesting that these results are clinically relevant. Conclusions: The subdiagnosis of migraine, instead of the presence of vestibular symptoms, can predict postural control impairments observed in migraineurs. This lends support to the notion that balance instability is related to the presence of aura and migraine chronicity, and that it should be considered even in patients without vestibular symptoms.

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Section: Introductionmentioning

confidence: 99%

Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

et al. 2020

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“…30,36 The divergent information regarding the head position in relation to the body received by the CNS is often related to postural instability, vestibular symptoms and nystagmus. 30,31,36,45 In fact, recent studies have demonstrated balance impairment also in patients with idiopathic neck pain 31 and in patients with headaches related to the neck, such as cervicogenic 46 and tension-type headache. [47][48][49] In this way, we would suppose that the balance impairment demonstrated in patients with aura could be related to a greater neck dysfunction, since neck pain is very prevalent in migraine population 1,4,50 and the aura is related to an altered neuromuscular transmission.…”

Section: Discussionmentioning

confidence: 99%

“…48,49,[53][54][55][56] On the other hand, patients with cervicogenic and tension type headache would present balance alterations due the altered cervical afferent input, in a similar pro le of patients with idiopathic neck pain. 46,47,49 The presence of neck pain in migraineurs is also related to worse clinical presentation, including greater severity of cutaneous allodynia, reduced upper cervical mobility, and worse performance in the Craniocervical Flexion Test. 44 Despite allodynia is more prevalent in patients with aura, 24 no differences regarding the remaining outcomes were found.…”

Section: Discussionmentioning

confidence: 99%

The presence of aura is not related to changes in the cervical performance and mobility of patients with migraine

Carvalho

Lodovichi

Pinheiro

et al. 2021

Musculoskeletal Science and Practice

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Background: Migraine is related to musculoskeletal impairment of the neck and the chronicity of migraine is related to greater disability levels. However, it is not known if other forms of migraine, such as migraine with aura, is related to a different pattern of neck impairment. Objective: To assess the musculoskeletal and clinical aspects of the neck in patients with migraine with and without aura. Methods: Up to 125 consecutive patients diagnosed with migraine according to the ICHD-III were recruited from a tertiary headache clinic. Patients were classi ed by the presence of aura into two groups: migraine with aura (MA, n=37) and migraine without aura (MoA, n=88). The self-report of neck pain was assessed and patients completed the Neck Disability Index (NDI) questionnaire. Furthermore, patients performed the Flexion Rotation Test (FRT) and the Cranio-Cervical Flexion Test (CCFT). Results of all outcomes were contrasted between groups through Mann-Whitney and Qui-square tests. Results: There was no association between the presence of aura and self-report of neck pain (x²: 1.32, p=0.25). No differences were veri ed between groups regarding presence of neck disability (

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“…Abgesehen von Patienten mit Schwindelbeschwerden, bei denen Probleme der posturalen Kontrolle im Vergleich zu Gesunden sehr offensichtlich vorliegen, gibt es diese zum Beispiel auch bei Patienten mit Kopfschmerzen [5]. Speziell in Verbindung mit zervikogenen Kopfschmerzen oder Migräne zeigen sich auffällige Defizite der Haltungskontrolle [6]. Deshalb lohnt es sich in vielen Fällen, Patienten mit Kopf-oder Nackenschmerzen oder auch mit Kieferbeschwerden mit entsprechenden Tests zu überprüfen und mit sensomotorischen Übungen zu versorgen.…”

Section: Introductionunclassified

Testsequenzen für den Praktiker

Schulze¹,

Kubat²

2020

manuelletherapie

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ZusammenfassungBei kraniozervikalen Beschwerden gibt es sowohl im Stehen als auch beim Gehen Hinweise für Defizite in der Haltungskontrolle. Stand- und Gangproben stellen hierfür adäquate Testverfahren dar. Für den Tandemstand, den Einbeinstand und den geschlossenen Stand auf einem 10 Zentimeter dicken Schaumstoff unter standardisierten Bedingungen existieren altersspezifische Standzeitwerte. Sie können in der Untersuchung im Vergleich zu Patienten herangezogen werden und decken Dysfunktionen des sensomotorischen Systems auf. Bezüglich der Gangproben hat sich ein standardisierter Tandemgang bewährt.

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Impaired Standing Balance in Individuals with Cervicogenic Headache and Migraine

Cited by 14 publications

References 0 publications

Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

The presence of aura is not related to changes in the cervical performance and mobility of patients with migraine

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