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Effectiveness of a manual therapy protocol based on articulatory techniques in migraine patients. A randomized controlled trial [with consumer summary]
Munoz-Gomez E, Ingles M, Serra-Ano P, Espi-Lopez GV
Musculoskeletal Science & Practice 2021 Apr;54:102386
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Physiotherapy is used as a non-pharmacological treatment for migraine. However, controversy exists over whether articulatory manual techniques are effective in some aspects related to migraine. OBJECTIVES: To assess the effectiveness of a manual therapy protocol based on articulatory techniques in pain intensity, frequency of episodes, migraine disability, quality of life, medication intake and self-reported perceived change after treatment in migraine patients. DESIGN: Randomized controlled trial. METHODS: Fifty individuals with migraine were randomized into the experimental group, which received manual therapy based on articulatory techniques (n = 25), or the placebo group (n = 25). The intervention lasted 4 weeks and included 4 sessions. Patients were assessed before (T1), after (T2) and at a one-month follow-up following the intervention (T3). The instruments used were the Migraine Disability Assessment (MIDAS) questionnaire, the Short Form-36 Health Survey (SF-36), the medication intake and The Patients' Global Impression of Change scale. RESULTS: In comparison with placebo group, manual therapy patients reported significant effects on pain intensity at T2 (p < 0.001; d = 1.15) and at T3 (p < 0.001; d = 1.13), migraine disability at T3 (p < 0.05; d = 0.69), physical quality of life at T2 (p < 0.05; d = 0.72), overall quality of life at T2 (p < 0.05; d = 0.60), decrease in medication intake at T2 (p < 0.001; d = 1.11) and at T3 (p < 0.05; d = 0.77) and self-reported perceived change after treatment at T2 and T3 (p < 0.001). No serious adverse events were reported. CONCLUSIONS: The application of a manual therapy protocol based on articulatory techniques reduced pain intensity, migraine disability, and medication intake, while improving quality of life in patients with migraine.

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