TY - JOUR
T1 - Therapeutic Exercise Parameters, Considerations, and Recommendations for Migraine Treatment
T2 - An International Delphi Study
AU - Reina-Varona, Álvaro
AU - Madroñero-Miguel, Beatriz
AU - Gaul, Charly
AU - Hall, Toby
AU - Oliveira, Arão Belitardo
AU - Bond, Dale S
AU - Fernández-de Las Peñas, César
AU - Florencio, Lidiane Lima
AU - Carvalho, Gabriela Ferreira
AU - Luedtke, Kerstin
AU - Varkey, Emma
AU - Krøll, Lotte Skytte
AU - Bevilaqua-Grossi, Debora
AU - Kisan, Ravikiran
AU - La Touche, Roy
AU - Paris-Alemany, Alba
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: [email protected].
PY - 2023/10/3
Y1 - 2023/10/3
N2 - OBJECTIVE: The goal of this study was to reach consensus about the best exercise prescription parameters, the most relevant considerations, and other recommendations that could be useful for prescribing exercise to patients with migraine.METHODS: This was an international study conducted between April 9, 2022 and June 30, 2022. An expert panel of health care and exercise professionals was assembled, and a 3-round Delphi survey was performed. Consensus was reached for each item if an Aiken V Validity Index ≥ 0.7 was obtained.RESULTS: The study included 14 experts who reached consensus on 42 items by the third round. The most approved prescription parameters were 30 to 60 minutes of exercise per session, 3 days per week of moderate-intensity continuous aerobic exercise, and relaxation and breathing exercises for 5 to 20 minutes every day. When considering an exercise prescription, initial exercise supervision should progress to patient self-regulation; catastrophizing, fear-avoidance beliefs, headache-related disability, anxiety, depression, physical activity baseline level, and self-efficacy could influence the patients' exercise participation and efficacy; and gradual exposure to exercise could help improve these psychological variables and increase exercise efficacy. Yoga and concurrent exercise were also included as recommended interventions.CONCLUSION: From the experts in the study, exercise prescriptions should be adapted to patients with migraine considering different exercise modalities, such as moderate-intensity aerobic exercise, relaxation, yoga, and concurrent exercise, based on the patients' preferences and psychological considerations, level of physical activity, and possible adverse effects.IMPACT: The consensus reached by the experts can help prescribe exercise accurately to patients with migraine. Offering various exercise modalities can improve exercise participation in this population. The evaluation of the patients' psychological and physical status can also facilitate the adaptation of the exercise prescription to their abilities and diminish the risk of adverse events.
AB - OBJECTIVE: The goal of this study was to reach consensus about the best exercise prescription parameters, the most relevant considerations, and other recommendations that could be useful for prescribing exercise to patients with migraine.METHODS: This was an international study conducted between April 9, 2022 and June 30, 2022. An expert panel of health care and exercise professionals was assembled, and a 3-round Delphi survey was performed. Consensus was reached for each item if an Aiken V Validity Index ≥ 0.7 was obtained.RESULTS: The study included 14 experts who reached consensus on 42 items by the third round. The most approved prescription parameters were 30 to 60 minutes of exercise per session, 3 days per week of moderate-intensity continuous aerobic exercise, and relaxation and breathing exercises for 5 to 20 minutes every day. When considering an exercise prescription, initial exercise supervision should progress to patient self-regulation; catastrophizing, fear-avoidance beliefs, headache-related disability, anxiety, depression, physical activity baseline level, and self-efficacy could influence the patients' exercise participation and efficacy; and gradual exposure to exercise could help improve these psychological variables and increase exercise efficacy. Yoga and concurrent exercise were also included as recommended interventions.CONCLUSION: From the experts in the study, exercise prescriptions should be adapted to patients with migraine considering different exercise modalities, such as moderate-intensity aerobic exercise, relaxation, yoga, and concurrent exercise, based on the patients' preferences and psychological considerations, level of physical activity, and possible adverse effects.IMPACT: The consensus reached by the experts can help prescribe exercise accurately to patients with migraine. Offering various exercise modalities can improve exercise participation in this population. The evaluation of the patients' psychological and physical status can also facilitate the adaptation of the exercise prescription to their abilities and diminish the risk of adverse events.
KW - Delphi Technique
KW - Exercise
KW - Exercise Therapy
KW - Humans
KW - Migraine Disorders
KW - Yoga
UR - http://www.scopus.com/inward/record.url?scp=85176494898&partnerID=8YFLogxK
U2 - 10.1093/ptj/pzad080
DO - 10.1093/ptj/pzad080
M3 - Journal article
C2 - 37410390
SN - 0031-9023
VL - 103
JO - Physical Therapy
JF - Physical Therapy
IS - 10
M1 - pzad080
ER -