"Personalized Physiotherapy for Migraine: Effects on Pain, Fatigue, and Physical Function"

N/ANot Yet RecruitingNCT07261384

Hacettepe University50 enrolled

Overview

Migraine is a prevalent neurological disorder associated with pain, fatigue, and reduced physical function. The aim of this randomized controlled trial is to examine the effects of a personalized and structured physiotherapy program-including cervical spine stabilization exercises, vestibular rehabilitation, and pain neuroscience education-on pain intensity, fatigue, and functional outcomes in individuals with migraine. Participants will be randomly allocated to an intervention group receiving personalized physiotherapy or a control group receiving standard physiotherapy care. Outcomes will be assessed at baseline, post-intervention, and follow-up.

Migraine is a disabling primary headache disorder characterized by recurrent attacks and frequently accompanied by cervical musculoskeletal dysfunction, vestibular symptoms, and altered pain processing mechanisms. Current evidence suggests that physiotherapy interventions targeting manual therapy, cervical stabilization, vestibular function, and pain neuroscience education may positively influence migration-related outcomes; However, studies combining these components in a personalized treatment model are limited. This randomized controlled trial aims to investigate the effectiveness of a personalized structured physiotherapy program designed specifically for individuals with migraine. The interventions will include manual therapy, cervical spine stabilization exercises, vestibular rehabilitation strategies, and pain neuroscience education delivered by a physiotherapist. The control group will receive only pain neuroscience education. Primary outcomes will include pain intensity and frequency. Secondary outcomes will include fatigue, disability level, cervical function, physical performance, and patient-reported functional limitations. Assessments will be conducted at baseline, immediately post-intervention, and during a follow-up period. The findings are expected to contribute to evidence-based physiotherapy approaches for migraine management.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

Interventions

Personalized Structured Physiotherapy InterventionOTHER

The manual therapy will include component, applied according to individual patient needs to reduce pain, improve mobility, and modulate neuromuscular control. The cervical spine stabilization exercises will target deep neck flexors and cervical postural muscles to improve neuromuscular control, endurance, and motor coordination. The vestibular rehabilitation component will include gaze stabilization, habituation, and balance exercises tailored to migraine-related vestibular symptoms. The PNE program will consist of structured individual education sessions focusing on pain neurobiology, central sensitization, and self-management strategies. Participants will attend supervised physiotherapy sessions twice weekly for 8 weeks, complemented by a personalized home exercise program. All components will be delivered by a licensed physiotherapist.

Standard TreatmentOTHER

Participants continue routine care including medications prescribed by their physician. Only two 40-minute Pain Neuroscience Education sessions over 8 weeks. No physiotherapy or exercise intervention provided.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 55 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged between 18 and 55 years * Diagnosed with migraine according to the International Classification of Headache Disorders - 3rd edition (ICHD-3) criteria * Experiencing 2-8 migraine attacks per month in the last 3 months * Able to participate in an 8-week physiotherapy intervention program * Able to understand instructions and provide written informed consent * Stable medication use for migraine for at least 1 month prior to participation (no changes planned during study period) Exclusion Criteria: * • Presence of other primary headache disorders (cluster headache, tension-type headache as primary diagnosis, etc.) * Neurological diseases (epilepsy, stroke, multiple sclerosis) * Vestibular disorders unrelated to migraine * Cervical radiculopathy, myelopathy, or severe cervical spine pathology * History of neck surgery or significant cervical trauma * Severe musculoskeletal conditions affecting posture or cervical function * Pregnancy or breastfeeding * Participation in another clinical trial within the last 3 months * Inability to attend intervention sessions or complete outcome assessments

Outcomes

Primary Outcomes

Pain Intensity (VAS)

Pain intensity will be assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain). Measurements will be taken at baseline, and at the completion of the 8-week intervention.

Time frame: Baseline, Week 8

Secondary Outcomes

Pain Frequency (MIDAS A Question)

Pain frequency will be assessed using Question A of the Migraine Disability Assessment Questionnaire (MIDAS), which evaluates the number of headache days over the previous 3 months.