Intentional avoidance of physical activity in women with migraine

Abstract

Given the benefits of habitual physical activity for migraine management and overall health, it is important to understand the reasons for low physical activity levels in those with migraine. Beliefs that physical activity can trigger and/or worsen migraine pain may contribute to low physical activity levels via intentional avoidance of physical activity, particularly of higher intensities. This study evaluated intentional avoidance of physical activity at varying intensity levels and its association with (a) leisure-time physical activity levels, (b) beliefs that physical activity will trigger and/or worsen migraine, and (c) migraine characteristics. Participants were women ( n = 100) who screened positive for migraine on the IDMigraine and completed an online survey on physical activity and migraine. The majority of the sample (78%) reported avoiding physical activity to manage migraine attacks at least once in the past month, and most reported avoidance of both moderate- and vigorous-intensity activity. Among those who reported avoidance, moderate- and vigorous-intensity physical activity was avoided on an average of 4.0 ± 2.0 and 4.1 ± 2.2 days/week, respectively. More frequent avoidance of vigorous-intensity physical activity (but not moderate-intensity) was significantly correlated with lower vigorous-intensity physical activity indicated by fewer days/week ( r = −0.28, p = 0.016) and fewer minutes/day ( r = −0.29, p = 0.011). The frequency of physical activity avoidance was significantly correlated with stronger expected likelihood that physical activity, at both intensity levels, will both trigger ( r = 0.39–0.43, p < 0.01) and worsen ( r = 0.24–0.25, p < 0.05) migraine attacks. Individuals who avoided physical activity reported a significantly higher number of migraine attacks in the past month and were more likely to have chronic migraine, compared to those who did not report avoidance. Intentional avoidance of moderate- and vigorous-intensity physical activity is a common migraine management strategy that is associated with lower levels of vigorous-intensity physical activity, stronger beliefs that physical activity will trigger or worsen migraine, and more frequent migraine attacks. Individuals with migraine who avoid physical activity may benefit from targeted intervention to address beliefs about physical activity and migraine, which has the strong potential to improve both migraine and health outcomes.