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偏头痛患者的跌倒发生率和跌倒恐惧增加了吗?一项横断面研究。

Do patients with migraine experience an increased prevalence of falls and fear of falling? A cross-sectional study.

机构信息

Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.

Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.

出版信息

Physiotherapy. 2018 Dec;104(4):424-429. doi: 10.1016/j.physio.2018.02.001. Epub 2018 Feb 15.

Abstract

OBJECTIVE

To assess the prevalence of falls and fear of falling in patients with migraine compared with controls.

DESIGN

Cross-sectional.

SETTING

Tertiary headache clinic.

PARTICIPANTS

This study consisted of 105 controls and 105 consecutive patients diagnosed with migraine with aura (MA, n=35), migraine without aura (MO, n=35) and chronic migraine (CM, n=35).

MAIN OUTCOME MEASURES

Patients were interviewed using a questionnaire containing questions about the history of falls and impairment in balance, and completed the International Falls Efficacy Scale (FES-I). Groups were contrasted using Student's t-test and analysis of variance, and prevalence ratios were estimated.

RESULTS

Falls and self-reported impairment in balance are more prevalent in patients with migraine (54% and 69%, respectively) than in controls (2% and 2%, respectively). In particular, patients with CM and MA reported a greater mean number of falls during the previous year {CM 1.4 [standard deviation (SD) 2.2]; MA 2.2 (SD 2.3)} compared with patients with MO [0.5 (SD 1.0); P <0.04] and controls [0.05 (SD 0.2); P <0.002]. The prevalence ratio of falls was greater in patients with MA (7.2; P <0.002) and CM (4.5; P <0.002) compared with controls. Patients with migraine experienced a high level of concern about falls during their daily activities compared with controls (29.8 vs 20.1 points in the FES-I questionnaire; P<0.0001).

CONCLUSIONS

The balance impairment of patients with migraine may have a functional impact. Migraine is associated with risk of falling, and patients exhibit a higher prevalence of impairment in balance, falls and fear of falling.

摘要

目的

评估偏头痛患者与对照组相比跌倒和跌倒恐惧的发生率。

设计

横断面研究。

地点

三级头痛诊所。

参与者

本研究包括 105 名对照者和 105 名连续确诊的偏头痛伴先兆(MA,n=35)、偏头痛无先兆(MO,n=35)和慢性偏头痛(CM,n=35)患者。

主要观察指标

患者通过包含跌倒史和平衡障碍的问卷接受访谈,并完成国际跌倒效能量表(FES-I)。采用学生 t 检验和方差分析对比各组,估计患病率比。

结果

跌倒和自我报告的平衡障碍在偏头痛患者中更为常见(分别为 54%和 69%),而在对照组中分别为 2%和 2%。特别是,CM 和 MA 患者在过去一年中报告的平均跌倒次数更多[CM 1.4(标准差 2.2);MA 2.2(标准差 2.3)],与 MO 患者[0.5(标准差 1.0);P<0.04]和对照组[0.05(标准差 0.2);P<0.002]相比。与对照组相比,MA(7.2;P<0.002)和 CM(4.5;P<0.002)患者的跌倒患病率更高。与对照组相比,偏头痛患者在日常活动中对跌倒的担忧程度更高(FES-I 问卷中分别为 29.8 分和 20.1 分;P<0.0001)。

结论

偏头痛患者的平衡障碍可能具有功能性影响。偏头痛与跌倒风险相关,且患者表现出更高的平衡障碍、跌倒和跌倒恐惧患病率。

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