Abstract
Thirty-six million individuals in the U.S. are affected by migraines. Pharmacological treatments are most used, but adverse side effects cause most (~70%) to delay or avoid taking medication. Exercise is a non-pharmacological treatment that is effective, but the effect of environment in reducing overall migraine burden is unknown. PURPOSE: to determine if exercise in a natural environment affects the monthly migraine load. METHODS: Six sedentary females who experienced migraines 8+ times per month (age = 36 ± 8 yrs, 165 ± 4 cm, 77 ± 26 kg) participated. Participants completed one month of exercise (3 x week, 30-min, 60-70% estimated HRmax) indoors as well as in a natural outdoor environment in a randomized counterbalanced order, with a two-week washout period. Migraine load was determined using the Headache Impact Test (HIT-6) and Migraine Disability Assessment (MIDAS) at the beginning and end of each month. The MIDAS questionnaire also includes number of migraine days, and pain intensity. Data were analyzed using a 2 (location: inside, natural environment) x 2 (test: pre, post) repeated measures ANOVA. RESULTS: No location x test interaction was evident for HIT-6 questionnaire responses (p = 0.82, effect size [ES] = 0.01), nor main effect for test observed (p = 0.33, ES = 0.16). The main effect for location was not different, but approached significance (p = 0.06, ES = 0.48; Inside = 58 ± 7, Outside = 54 ± 10). No interaction was noted for MIDAS questionnaire responses (p = 0.48, ES = 0.11), main effect for test (p = 0.73, ES = 0.26), or location (p = 0.27, ES = 0.24). No interaction was observed for migraine days (p = 0.40, ES = 0.14), nor main effect for test (p = 0.79, ES = 0.02), nor location (p = 0.38, ES = 0.15). No interaction was noted for pain intensity (p = 0.67, ES = 0.04), main effect for test (p = 0.61, ES = 0.06), or location (p = 0.61, ES = 0.06). CONCLUSION: Exercise environment did not appear to have an impact on MIDAS questionnaire results, number of migraine days, or pain intensity. A trend was noted with respect to the HIT-6 questionnaire responses, such that exercise in a natural environment tended to reduce overall score when compared to indoors. While this trend may be promising, insufficient evidence exists to conclude that exercise environment has an effect on monthly migraine load in individuals who suffer from chronic migraines.
Published Version
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