O papel do exercício físico no tratamento da enxaqueca: qual a evidência?

Objetivo: Determinar a evidência do efeito do exercício aeróbico no controlo das crises de enxaqueca. Fontes de dados: PubMed, National Institute of Health and Care Excellence (NICE), The Cochrane Library, British Medical Journal (BMJ), Canadian Medical Association Infobase e Centre for Reviews and Dissemination. Métodos: Foram pesquisados artigos de revisão sistemática (RS)‌, ‌meta-análise‌s (MA) e normas de orientação clínica (NOC), ‌em‌ ‌português‌‌, inglês e espanhol,‌ ‌sem‌ ‌limite‌ ‌de‌ ‌data‌ ‌de‌ ‌publicação,‌ ‌utilizando‌ ‌os termos MeSH ‌migraine disorders e exercise.‌ ‌Foram‌ ‌também‌ ‌pesquisados‌ ‌estudos originais (EO) ‌publicados‌ ‌nos‌ ‌últimos‌ ‌cinco‌ ‌anos.‌ ‌Incluíram-se‌ ‌os‌ ‌artigos‌ ‌que‌ ‌avaliavam‌ o efeito do exercício aeróbico na frequência, duração e intensidade das crises de enxaqueca. A‌ ‌atribuição‌ ‌do‌ ‌nível‌ ‌de‌ ‌evidência‌ ‌(NE)‌ ‌e‌ ‌força‌ ‌de‌ ‌recomendação‌ ‌(FR)‌ ‌foi‌ ‌realizada‌ ‌com‌ ‌base‌ ‌na‌ ‌escala‌ ‌Strength of Recommendation‌ ‌Taxonomy‌ ‌(SORT),‌ ‌da‌ ‌American‌ ‌Academy of Family‌ ‌Physicians.‌ Resultados: Da pesquisa efetuada obtiveram-se 69 artigos, tendo sido selecionados seis que cumpriam os critérios de inclusão: três RS com MA, uma RS e dois EO. Todos os artigos apresentaram NE 2. A maioria dos estudos incluídos favorece a prática de exercício físico como medida profilática das crises de enxaqueca; contudo, apresentam amostras pequenas, curtos períodos de intervenção e de follow-up e intervenções heterogéneas. Conclusão: Apesar de se considerar necessária a realização de mais ensaios clínicos para definir concretamente os efeitos a curto e longo prazo do exercício aeróbico na enxaqueca conclui-se que é possível recomendar a sua inclusão na abordagem profilática destes doentes (FR B).

Resistance Training Reduces Pain Indices and Improves Quality of Life and Body Strength in Women with Migraine Disorders

Purpose The benefits of resistance training (RT) for migraineurs appears to be lacking although beneficial of aerobic training have been shown in previous studies. The aim of current study, therefore, is to investigate the influence of RT on migraine headache indices, upper and lower-body strength, and quality of life (QOL) in women with migraine disorders. Methods Twenty female migraine patients who were referred by a neurologist were randomly assigned in two groups including RT group (n = 10) and control (CON) group (n = 10). The RT protocol consisted of 8 weeks, 3 sessions per week, 45–60 min per session. Visual Analog Scale (VAS) and pain diary were utilized to measure the subjects' migraine indices including duration, pain severity, and frequency within 48 h pre- and post-training protocol. Patients in Control group (CON) has been refrained from regular exercise during this study. The quality of life (QOL) and muscular strength were measured by the Headache Impact Tests (HIT) and one-repetition maximum (1RM) test, respectively, for 48 h pre- and post-training protocol. Results The RT resulted in a significant decrease in the migraine indices (headache intensity, frequency, and duration) (p = 0.02, p = 0.001, p = 0.04, respectivetly). Increased quality of life and chest and leg muscular strength significantly (p = 0.001 for all) were also showed after 8-week RT protocol. However, there was not any significant differences between groups considering, BMI and waist-hip ratio (WHR) after executing RT protocol (p > 0.05). Conclusion Based on results of current study that mainly had a positive trend, it could state that RT protocol with special considering for migraine patients is probably an alternative therapy or augmentative complement to established interventions for migraine treatment.

The management of migraine through Acupuncture: a literature review

Background: Migraine is one of the most disabling conditions worldwide, and acupuncture can be used as prophylaxis. This practice is indicated to relieve tension, stress, induce analgesia, and has been gaining space due to its A level evidence. Objectives: Investigate the impact of acupuncture on the management of migraine disorders. Design and Settings: literature review. Methods: After searching the MEDLINE database for “migraine disorders OR headache”, “acupuncture” and “integrative medicine OR alternative medicine”, 271 articles were found and 6 used. Only those with full text available and published between 2011-2021 were included. Those that addressed a specific type of migraine were excluded. Results: Acupuncture was analyzed in 4 studies as prophylaxis for migraine, in which there was a general reduction in symptoms and 50% reduction in frequency of episodes (p <0.05), with its effects comparable to drugs such as Depakene, Topamax, Metoprolol and Flunarizine. A meta-analysis involving 39 clinical trials showed that the acupuncture group obtained better results than the control group (p <0.001), these results were sustained when analyzing pain after randomization, in agreement with another study that demonstrated pain reduction in the group that used simulated acupuncture (p=0.002). It should be noted that, although some patients report adverse effects, it’s safe and as effective than drugs used in the treatment of migraine. Conclusions: Acupuncture is a good prophylactic method for migraine. It reduces pain episodes and has less adverse effects when compared to conventional methods. However, further studies on this therapy are needed.