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Relationship Between Active Trigger Points and Head/Neck Posture in Patients with Migraine

Ferracini, Gabriela Natália MD; Chaves, Thaís Cristina PhD; Dach, Fabíola PhD; Bevilaqua-Grossi, Débora PhD; Fernández-de-las-Peñas, César PhD; Speciali, José Geraldo PhD

American Journal of Physical Medicine & Rehabilitation: November 2016 - Volume 95 - Issue 11 - p 831–839
doi: 10.1097/PHM.0000000000000510
Original Research Articles
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Objective To investigate the relationship between the presence of active trigger points (TrPs), craniocervical posture, and clinical features (frequency, intensity, and duration) in patients with migraine.

Design A cross-sectional study.

Methods Fifty patients with migraine (90% women; age, 34.1 years) participated. Clinical data regarding migraine (frequency, intensity, and duration) were obtained. Trigger points were bilaterally explored in the following muscles: masseter, suboccipital, temporalis (anterior, medium, and posterior fibers), sternocleidomastoid, upper trapezius, and splenius capitis. Eight measures of head and neck posture were obtained from radiographs using the K-Pacs software.

Results Individuals with migraine showed active and latent TrPs in all the muscles, the suboccipital, upper trapezius, sternocleidomastoid, and temporalis muscles being the most affected. The results showed a relationship between the number of active TrPs and several x-ray outcomes, suggesting that the higher number of active TrPs was positively associated with a reduction in cervical lordosis and head extension of the head on the neck. No association between the number of active TrPs and clinical features of migraine was seen.

Conclusion Our study supports the hypothesis that active TrPs are associated with reduced cervical lordosis and head extension in individuals with migraine.

Supplemental digital content is available in the text.

From the Department of Neurosciences and Behavioral Sciences/Faculty of Medicine of Ribeirão Preto, University of São Paulo—FMRP-USP, Ribeirão Preto, São Paulo, Brazil (GNF, JGS); Department of Neurosciences and Behavioral Sciences/Faculty of Medicine of Ribeirão Preto, University of São Paulo—FMRP-USP/Postgraduate Program of Rehabilitation and Functional Performance, Ribeirão Preto, São Paulo, Brazil (TCC); Postgraduate Program of Rehabilitation and Functional Performance, Ribeirão Preto, São Paulo, Brazil (DB-G); Department of Neurosciences and Behavioral Sciences/Faculty of Medicine of Ribeirão Preto, University of São Paulo—FMRP-USP/Headache and Craniofacial Pain Outpatient Clinic, University Hospital, Faculty of Medicine of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil (FD); and Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Alcorcón, Spain (CF-P).

All correspondence and requests for reprints should be addressed to: Gabriela Natália Ferracini, MD, Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes 3900, Ribeirão Preto, 14048–900, SP, Brazil.

This study was funded by Fundação de Amparo à pesquisa do estado de São Paulo (FAPESP).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ajpmr.com).

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