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Integrating Nutrition and Physical Activity into the EXEMIG/01 Interdisciplinary Model for Chronic and High-Frequency Migraine

Pippi R, Prete D, Pagano S, Valenti C, Simonetti S, Prati S, Alabiso M, Settembrini G et al.

Nutrients, 2026

200 participants

Abstract

Background: Migraine (MIG) management guidelines support a comprehensive approach combining medication, therapeutic patient education (TPE), behavioral strategies, lifestyle changes, diet, and physical activity (PA). Objective: To present an innovative interdisciplinary outpatient model for individuals with MIG, focusing on PA, sedentary behavior, eating habits (EH), metabolic health, temporomandibular disorders, and postural dysfunctions. Design: A randomized controlled trial will enroll 200 adults with MIG over two years. Inclusion criteria are chronic MIG (≥15 attacks/month for ≥3 months) or high-frequency episodic MIG (8-14 attacks/month), physical inactivity, and independent walking ability. Exclusion criteria include contraindications to PA and lack of informed consent. Participants will be randomized to standard care (SC) or an intervention group receiving TPE plus three months of supervised exercise (EXE). All participants will receive an informational brochure with nutritional tips (included in SC) and undergo: (1) neurological examination, (2) validated questionnaires, (3) kinesiological and postural assessment, and (4) gnathological evaluation. The primary outcome is change in monthly MIG frequency at 6 and 12 months; additional outcomes include disability, quality of life, and intensity of MIG, PA levels, sedentary behavior, medication use, EH, functional capabilities, postural parameters, and temporomandibular disorder-related variables. Results: Hypothetically,…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 200 participants or records.

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