Impacts of cervical exercise and Mulligan manual therapy on headache frequency, intensity, and disability for people with episodic migraine - a randomized clinical trial
Abstract
OBJECTIVE
To compare the addition of Mulligan manual therapy (MMT) or sham MMT to neck exercise for the management of people with episodic migraine.
METHODS
Ninety-nine adult patients (mean 41.5 years, SD 13.3) with episodic migraine were allocated to six sessions of neck exercise alone, exercise + MMT, or exercise + sham MMT. Migraine frequency was the primary outcome measure. Headache intensity and duration, medication, disability, upper cervical range of motion (CROM), pressure-pain thresholds of cervical and tibialis anterior muscle areas, as well as patient satisfaction score were secondary outcome measures evaluated at baseline, 4, 13, and 26 weeks.
RESULTS
Headache frequency was not significantly improved when comparing exercise + MMT to exercise alone (4-week MD: 0.57, 95%CI: -0.30 to 1.43; 13-week MD: 0.90, 95%CI: 0.01 to 1.79; 26-week MD: 0.66, 95%CI: -0.31 to 1.62) and to exercise + sham MMT (4-week MD: -2.28, 95%CI: -1.35 to 0.79; 13-week MD: -0.88, 95%CI: -1.81 to 0.06; 26-week MD: -0.81, 95%CI: -1.77 to 0.15). For secondary outcome of disability, a statistically significant improvement was observed for exercise + MMT only at 4-week over exercise alone (MD: 5.59, 95%CI: 3.06 to 8.11) and over exercise + sham MMT (MD: -3.57, 95%CI: -6.12 to -1.03) but not at 13 and 26 weeks. Statistically significant improvement in CROM was observed at 13‑ and 26-week follow-up over the other two groups.
CONCLUSION
MMT combined with exercise did not result in a significant…
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.
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.