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Ten per cent of people worldwide suffer from migraines
MAKING HEADWAY
A Swedish study shows that regular exercise is just as effective as drugs or relaxation therapy in treating migraines
‘‘T
his non-pharmacolog- ical approach [physical activity] may be an option for the prophylactic [preventative] treat-
ment of migraine in patients who do not benefi t from or do not want daily medica- tion,” wrote Dr Emma Varkey, lead author of a Swedish study published in the journal Cephalalgia in October.* T e aim of the research was to evaluate the eff ect of exercise in warding off migraine
– a chronic neurological disorder charac- terised by moderate to severe headaches and nausea, which aff ects 10 per cent of peo- ple around the world. Doctors use a variety of methods to pre-
vent migraines, including topiramate – an anti-epilepsy drug – and relaxation exer- cises. While exercise is also prescribed, there has not previously been suffi cient evidence to demonstrate that it works.
THREE-MONTH STUDY
Conducted by scientists at the University of Gothenburg, the randomised, controlled trial comprised 91 migraine patients aged 18-65 attending a headache clinic. All were women – the disorder is known to be more
prominent in females – suff ering from head- aches two to eight times a month. T e women were split into three groups.
One-third were prescribed a daily dose of topiramate – slowly increased to the individ- ual’s highest tolerable level (with a maximum of 200mg a day). Another third carried out common forms of relaxation, breathing and stress-management techniques according to a recorded programme. T e fi nal group exercised on a static bike for 40 minutes, for three times a week, under the supervi- sion of a physiotherapist. Throughout the three-month study,
the patients’ migraine status, quality of life, aerobic capacity and level of physical activ- ity were evaluated before, during and aſt er their respective treatment.
SURPRISING RESULTS
The results show that migraine attacks decreased by approximately 75 per cent across all three groups and that there was no signifi cant diff erence between them. Commenting to Reuters Health, Dr Var-
key said: “Topiramate is a drug of fi rst choice that’s shown great eff ects in studies. It was a bit surprising and very interesting that the change in the number of migraine attacks
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was similar in all three groups. T e only parameter where topiramate was better than exercise and relaxation was the reduction of pain intensity. “On the other hand, the non-pharmaco-
logical options were free from adverse events and the exercise group increased oxygen uptake, which is very positive.” While women in the exercise and relax-
ation groups had no issues, eight women taking topiramate had side-eff ects – tingling, fatigue, depression, vertigo and constipation – and consequently three leſt the study. Varkey told Reuters Health: “From a
wider health-based perspective, it should be stressed that patients with migraine are less physically active than the general popu- lation, and that exercise has positive eff ects in terms of general wellbeing and the pre- vention of disease. “Additional and larger studies are, of
course, needed to verify our results and to gain evidence for exercise as migraine treat- ment, but our results are hopeful.” ●
*Varkey, E et al. Exercise as migraine prophy- laxis: A randomized study using relaxation and topiramate as controls. Cephalalgia. Vol 31, no 14, 1428–1438, Oct 2011.
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