Reduced flexion rotation test in women with chronic and episodic migraine

Objective: To compare flexion rotation test and global active cervical mobility in women with chronic migraine, episodic migraine, and headache-free controls. The influence of neck pain related disability on the flexion rotation test was also analyzed. Methods: Women with chronic migraine (n = 25), episodic migraine (n = 30), and those who were headache-free (n = 30) were evaluated. Upper cervical mobility was measured using the flexion rotation test and global active mobility was assessed using the cervical range of motion device. Neck pain related-disability was assessed using the Neck Disability Index. Statistical analyses were performed using a MANOVA test, prevalence ratios, and linear regression. Results: Chronic (right, MD: -15 degrees; 95%CI: -21 degrees to -11 degrees; left, MD: -13 degrees; 95%CI: -20 degrees to -12 degrees) and episodic (right, MD: -8 degrees; 95%CI: -13 degrees to -4 degrees; left, MD: -8 degrees; 95%CI: -12 degrees to -5 degrees) migraine groups achieved lower flexion rotation test mobility bilaterally than headache-free women. Only chronic migraine was associated with a lower global cervical range of motion compared to that of headache-free women during flexion, (MD: -8 degrees; 95%Cl: -15 degrees to -1 degrees), extension (MD: -13 degrees; 95%CI: -20 degrees to -4 degrees), right lateral flexion (MD: -4 degrees; 95%CI: -9 degrees to -0.2 degrees), left lateral flexion (MD: -6 degrees; 95%CI: -10 degrees to -2 degrees), right rotation (MD: -9 degrees; 95%CI: -15 degrees to -4 degrees), and left rotation (MD: -8 degrees; 95%Cl: -13 degrees to -2 degrees). Migraine was associated with a 2.85-fold increase in the risk of a positive flexion rotation test. Flexion Rotation Test was influenced by disability-related neck pain (R-2 = 19.1; p = 0.001). Conclusion: Women with migraine have a lower upper cervical range of motion than headache free women. Women with chronic migraine demonstrated reduced global cervical range of motion when compared to headache-free women. Migraine was associated with in increased likelihood of a positive Flexion Rotation Test. Reduction in mobility was influenced by migraine frequency and disability-related neck pain. (C) 2019 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved.