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The effects of aerobic exercise and the impact of migraine and co-existing tension-type headache and neck pain

Krøll, Lotte Skytte LU (2018) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2018(60).
Abstract
The overall aims of this thesis were to investigate the effects of an aerobic exercise program and the impact of migraine and co-existing TTH and NP in persons with these combined conditions. This thesis is based on four studies.
In study I, a new questionnaire, Impact of Migraine, TTH and NP (Impact M-TTH-NP), was developed. This questionnaire covered pain, triggers, psychosocial,
socioeconomic and work related aspects. Face and content validity were
investigated together with five additional questionnaires; the International Physical Activity Questionnaire (IPAQ short form), Migraine-Specific Quality of Life
Questionnaire (MSQ v. 2.1), The World Health Organization five-item
Psychological Well-Being Index (WHO-5),... (More)
The overall aims of this thesis were to investigate the effects of an aerobic exercise program and the impact of migraine and co-existing TTH and NP in persons with these combined conditions. This thesis is based on four studies.
In study I, a new questionnaire, Impact of Migraine, TTH and NP (Impact M-TTH-NP), was developed. This questionnaire covered pain, triggers, psychosocial,
socioeconomic and work related aspects. Face and content validity were
investigated together with five additional questionnaires; the International Physical Activity Questionnaire (IPAQ short form), Migraine-Specific Quality of Life
Questionnaire (MSQ v. 2.1), The World Health Organization five-item
Psychological Well-Being Index (WHO-5), Major Depression Inventory (MDI) and
Neck Disability Index (NDI). Face validity was assessed by group interviews of
nine persons with migraine and co-existing TTH and NP. Content validity was
assessed by the degree of relevance by 13 headache experts. Impact M-TTH-NP
showed acceptable face validity and excellent content validity. MSQ, WHO-5, MDI
and NDI showed acceptable face validity, and WHO-5, MDI and NDI showed excellent content validity.
In study II, the prevalence of co-existing TTH and NP in a clinical sample of persons with migraine was investigated. Also, we investigated level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing TTH and NP, their perceived ability to engage in physical activity and which among the three conditions (migraine, TTH or NP) was rated as the most burdensome condition. A survey of 148 persons with migraine and 100 healthy controls was conducted. The prevalence of co-existing TTH and NP in persons with migraine was 67%; this group had a low level of physical activity, low psychological well-being, high level of perceived stress and poor self-rated health compared to healthy controls. They reported reduced ability to engage in physical activity owing to migraine (high degree), TTH (moderate degree) and NP (low degree). The most burdensome condition was migraine, followed by TTH and NP.
In studies III and IV, the effect of a 12-week aerobic exercise program, with follow-up six months from baseline, in persons with migraine and co-existing TTH and NP was investigated in a prospective, open-label, randomized, clinical trial. Fifty-two persons (26 in exercise group and 26 in control group) completed the six-month study period. The exercise group showed a significant improvement in the ability to engage in daily activities because of reduced impact of migraine compared to controls. Migraine frequency, pain intensity and duration were significantly reduced in the exercise group compared to baseline, although not significant compared to the control group (Study III). The effect of the aerobic exercise program on pain perception was measured in Study IV. We did not identify any significant effect on muscle tenderness and pain thresholds. We concluded that aerobic exercise had positive effects on migraine severity and migraine burden, but these results could not be explained by the applied tests of muscle tenderness and pain thresholds. Thus, the positive effect on migraine burden may rather be explained by positive alteration of avoidance behaviour. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • professor Bjørn Russel, Michael , Oslo, Oslo
organization
publishing date
type
Thesis
publication status
published
subject
keywords
migraine, tension-type headache, neck pain, aerobic exercise, impact, pain perception, validation
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2018
issue
60
pages
100 pages
publisher
Lund University: Faculty of Medicine
defense location
Health Sciences Centre, Baravägen 3, Lecture Hall H01, Lund, Sweden
defense date
2018-05-23 13:00:00
ISSN
1652-8220
ISBN
978-91-7619-626-7
language
English
LU publication?
yes
additional info
ISSN: 1652-8220 Lund University, Faculty of Medicine Doctoral Dissertation Series 2018:60
id
25fdc014-edd5-48ef-aa3d-4eb0d26efb4f
date added to LUP
2018-04-19 11:35:01
date last changed
2020-03-13 10:29:06
@phdthesis{25fdc014-edd5-48ef-aa3d-4eb0d26efb4f,
  abstract     = {{The overall aims of this thesis were to investigate the effects of an aerobic exercise program and the impact of migraine and co-existing TTH and NP in persons with these combined conditions. This thesis is based on four studies.<br/>In study I, a new questionnaire, Impact of Migraine, TTH and NP (Impact M-TTH-NP), was developed. This questionnaire covered pain, triggers, psychosocial,<br/>socioeconomic and work related aspects. Face and content validity were<br/>investigated together with five additional questionnaires; the International Physical Activity Questionnaire (IPAQ short form), Migraine-Specific Quality of Life<br/>Questionnaire (MSQ v. 2.1), The World Health Organization five-item<br/>Psychological Well-Being Index (WHO-5), Major Depression Inventory (MDI) and<br/>Neck Disability Index (NDI). Face validity was assessed by group interviews of<br/>nine persons with migraine and co-existing TTH and NP. Content validity was<br/>assessed by the degree of relevance by 13 headache experts. Impact M-TTH-NP<br/>showed acceptable face validity and excellent content validity. MSQ, WHO-5, MDI<br/>and NDI showed acceptable face validity, and WHO-5, MDI and NDI showed excellent content validity.<br/>In study II, the prevalence of co-existing TTH and NP in a clinical sample of persons with migraine was investigated. Also, we investigated level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing TTH and NP, their perceived ability to engage in physical activity and which among the three conditions (migraine, TTH or NP) was rated as the most burdensome condition. A survey of 148 persons with migraine and 100 healthy controls was conducted. The prevalence of co-existing TTH and NP in persons with migraine was 67%; this group had a low level of physical activity, low psychological well-being, high level of perceived stress and poor self-rated health compared to healthy controls. They reported reduced ability to engage in physical activity owing to migraine (high degree), TTH (moderate degree) and NP (low degree). The most burdensome condition was migraine, followed by TTH and NP.<br/>In studies III and IV, the effect of a 12-week aerobic exercise program, with follow-up six months from baseline, in persons with migraine and co-existing TTH and NP was investigated in a prospective, open-label, randomized, clinical trial. Fifty-two persons (26 in exercise group and 26 in control group) completed the six-month study period. The exercise group showed a significant improvement in the ability to engage in daily activities because of reduced impact of migraine compared to controls. Migraine frequency, pain intensity and duration were significantly reduced in the exercise group compared to baseline, although not significant compared to the control group (Study III). The effect of the aerobic exercise program on pain perception was measured in Study IV. We did not identify any significant effect on muscle tenderness and pain thresholds. We concluded that aerobic exercise had positive effects on migraine severity and migraine burden, but these results could not be explained by the applied tests of muscle tenderness and pain thresholds. Thus, the positive effect on migraine burden may rather be explained by positive alteration of avoidance behaviour.}},
  author       = {{Krøll, Lotte Skytte}},
  isbn         = {{978-91-7619-626-7}},
  issn         = {{1652-8220}},
  keywords     = {{migraine, tension-type headache, neck pain, aerobic exercise, impact, pain perception, validation}},
  language     = {{eng}},
  number       = {{60}},
  publisher    = {{Lund University: Faculty of Medicine}},
  school       = {{Lund University}},
  series       = {{Lund University, Faculty of Medicine Doctoral Dissertation Series}},
  title        = {{The effects of aerobic exercise and the impact of migraine and co-existing tension-type headache and neck pain}},
  url          = {{https://lup.lub.lu.se/search/files/42544535/Lotte_Avhandling.pdf}},
  volume       = {{2018}},
  year         = {{2018}},
}