Carvalho GF1, Pinheiro CF1, Zorzin L1, Maciel NM1, Dach F2, Bevilaqua-Grossi D1
1Ribeirão Preto Medical School – University of São Paulo, Department of Health Sciences, Ribeirão Preto, Brazil, 2Ribeirão Preto Medical School – University of São Paulo, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto, Brazil
Background: Migraine may be associated to postural balance impairment. These alterations have been verified especially in patients with chronic migraine and migraine with aura. However it is unknown the contribution of the visual, vestibular and somatosensory systems to the balance of migraineurs, neither the influence of kinesiophobia on balance.
Purpose: To assess the postural balance of patients with migraine through the Computerized Dynamic Posturography (Neurocom Equitest®) and to verify the influence of kinesiophobia on balance.
Methods: Women aging between 18 to 55 years old were recruited from a tertiary headache clinic and were diagnosed with migraine by neurologists according to the ICHD-III. The included subjects had migraine without aura (n=30), with aura (n=18), chronic migraine (n=30) and headache-free controls were also recruited (n=29). They performed the Sensory Organization Test in the Equitest®System and answered the TAMPA scale of Kinesiophobia, guided by a blinded examinator. The balance score ranging from 0 to 100 was assessed in six conditions: stable with eyes open (SEO), stable with closed eyes (SEC), stable with moveable visual surround (SMS), instable with eyes open (IEO), instable with closed eyes (IEC) and instable with moveable visual surround (IMS), and the total score was calculated (TS). Groups were compared through One-way Anova with Bonferroni post-hoc test, and t-Student test in the SPSS 21.0 software, with significance level of 5%.
Results: For all conditions and in the TS, patients with migraine with aura presented lower balance scores than headache-free subjects (p 0.006). In the SEC, SMS, IEO, IEC, IMS and TS conditions, patients with chronic migraine presented lower scores than controls (p 0.008). In the IEO, IEC, IMS and TS conditions, migraineurs without aura exhibited lower scores than controls (p 0.001). Migraineurs with aura also presented lower scores when compared to patients without aura in the conditions SEO, SEC, IEO and TS (p 0.006). Up to 53% of the patients with migraine had kinesiophobia and their TS was lower compared to migraineurs without kinesiophobia (p=0.002). Our results demonstrated the presence of balance alterations in patients with migraine with substantial impairment in the visual and vestibular systems, due the greater differences between groups in the IEO, IEC and IMS conditions.
Conclusion(s): Patients with migraine, especially with aura and chronic migraine, exhibited balance changes due to impairment mainly of the vestibular and visual systems. Furthermore, the presence of kinesiophobia affects negatively the balance scores of migraineurs.
Implications: The postural balance impairment may have functional impact in migraineurs daily life. Rehabilitaton strategies should be considered in this population considering the migraine subtype, the presence of kinesiophobia and the sensorial system affected.
Keywords: Migraine, postural control, kinesiophobia
Funding acknowledgements: FAPESP Foundation, process number 2017/07482-1.
Purpose: To assess the postural balance of patients with migraine through the Computerized Dynamic Posturography (Neurocom Equitest®) and to verify the influence of kinesiophobia on balance.
Methods: Women aging between 18 to 55 years old were recruited from a tertiary headache clinic and were diagnosed with migraine by neurologists according to the ICHD-III. The included subjects had migraine without aura (n=30), with aura (n=18), chronic migraine (n=30) and headache-free controls were also recruited (n=29). They performed the Sensory Organization Test in the Equitest®System and answered the TAMPA scale of Kinesiophobia, guided by a blinded examinator. The balance score ranging from 0 to 100 was assessed in six conditions: stable with eyes open (SEO), stable with closed eyes (SEC), stable with moveable visual surround (SMS), instable with eyes open (IEO), instable with closed eyes (IEC) and instable with moveable visual surround (IMS), and the total score was calculated (TS). Groups were compared through One-way Anova with Bonferroni post-hoc test, and t-Student test in the SPSS 21.0 software, with significance level of 5%.
Results: For all conditions and in the TS, patients with migraine with aura presented lower balance scores than headache-free subjects (p 0.006). In the SEC, SMS, IEO, IEC, IMS and TS conditions, patients with chronic migraine presented lower scores than controls (p 0.008). In the IEO, IEC, IMS and TS conditions, migraineurs without aura exhibited lower scores than controls (p 0.001). Migraineurs with aura also presented lower scores when compared to patients without aura in the conditions SEO, SEC, IEO and TS (p 0.006). Up to 53% of the patients with migraine had kinesiophobia and their TS was lower compared to migraineurs without kinesiophobia (p=0.002). Our results demonstrated the presence of balance alterations in patients with migraine with substantial impairment in the visual and vestibular systems, due the greater differences between groups in the IEO, IEC and IMS conditions.
Conclusion(s): Patients with migraine, especially with aura and chronic migraine, exhibited balance changes due to impairment mainly of the vestibular and visual systems. Furthermore, the presence of kinesiophobia affects negatively the balance scores of migraineurs.
Implications: The postural balance impairment may have functional impact in migraineurs daily life. Rehabilitaton strategies should be considered in this population considering the migraine subtype, the presence of kinesiophobia and the sensorial system affected.
Keywords: Migraine, postural control, kinesiophobia
Funding acknowledgements: FAPESP Foundation, process number 2017/07482-1.
Topic: Neurology; Pain & pain management; Disability & rehabilitation
Ethics approval required: Yes
Institution: Ribeirão Preto Medical School
Ethics committee: Ethics Committee of the Clinics Hospital FMRP/USP
Ethics number: Process Number: 15572/2016
All authors, affiliations and abstracts have been published as submitted.
