• Lidiane Lima Florencio, Anamaria Siriani de Oliveira, Gabriela Ferreira Carvalho, Tolentino Gabriella de Almeida Gde A Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation - Faculty of Medicine of Ribeirão Preto, University of Sã, Fabiola Dach, Marcelo Eduardo Bigal, César Fernández-de-las-Peñas, and Bevilaqua Grossi Débora D Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation - Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ri.
• Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation - Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto-SP, Brazil.
• Headache. 2015 Nov 1; 55 (10): 1312-22.

ObjectivesThis cross-sectional study investigated potential differences in cervical musculature in groups of migraine headaches vs. non-headache controls. Differences in cervical muscle strength and antagonist coactivation during maximal isometric voluntary contraction (MIVC) were analyzed between individuals with migraine and non-headache subjects and relationships between force with migraine and neck pain clinical aspects.MethodA customized hand-held dynamometer was used to assess cervical flexion, extension, and bilateral lateral flexion strength in subjects with episodic migraine (n=31), chronic migraine (n = 21) and healthy controls (n = 31). Surface electromyography (EMG) from sternocleidomastoid, anterior scalene, and splenius capitis muscles were recorded during MIVC to evaluate antagonist coactivation. Comparison of main outcomes among groups was conducted with one-way analysis of covariance with the presence of neck pain as covariable. Correlations between peak force and clinical variables were demonstrated by Spearman's coefficient.ResultsChronic migraine subjects exhibited lower cervical extension force (mean diff. from controls: 4.4 N/kg; mean diff from episodic migraine: 3.7 N/kg; P = .006) and spent significantly more time to generate peak force during cervical flexion (mean diff. from controls: 0.5 seconds; P = .025) and left lateral-flexion (mean diff. from controls: 0.4 seconds; mean diff. from episodic migraine: 0.5 seconds; P = .007). Both migraine groups showed significantly higher antagonist muscle coactivity of the splenius capitis muscle (mean diff. from controls: 20%MIVC, P = .03) during cervical flexion relative to healthy controls. Cervical extension peak force was moderately associated with the migraine frequency (rs: -0.30, P = .034), neck pain frequency (rs: -0.26, P = .020), and neck pain intensity (rs: -0.27, P = .012).ConclusionPatients with chronic migraine exhibit altered muscle performance, took longer to reach peak of force during some cervical movements, and had higher coactivation of the splenius capitis during maximal isometric cervical flexion contraction. Finally, patients with migraine reported the presence of neck and head pain complaints during maximal isometric voluntary cervical contractions.© 2015 American Headache Society.

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