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°; 95%CI: -21° to -11°; left, MD: -13°; 95%CI: -20° to -12°) and episodic (right, MD: -8°; 95%CI: -13° to -4°; left, MD: -8°; 95%CI: -12° to -5°) 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°; 95%CI: -15° to -1°), extension (MD: -13°; 95%CI: -20° to -4°), right lateral flexion (MD: -4°; 95%CI: -9° to -0.2°), left lateral flexion (MD: -6°; 95%CI: -10° to -2°), right rotation (MD: -9°; 95%CI: -15° to -4°), and left rotation (MD: -8°; 95%CI: -13° to -2°). 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 (R2=19.1; p=0.001).
Conclusions: 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.