Department of Psychology, University of Mississippi, Oxford, MS, USA.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA.
Headache. 2020 Oct;60(9):1930-1938. doi: 10.1111/head.13921. Epub 2020 Aug 2.
This study sought to compare ambulatory physical activity (PA) between young adults with migraine, tension-type headache (TTH), and non-headache controls and determine if differences in PA were attributable to headache activity or other relevant covariates.
PA has been implicated in the development, manifestation, and treatment of various headache disorders. However, objective quantification of PA across headache types is lacking, and no study has quantified both prospective PA and the influence of headache occurrence on PA.
A prospective cohort study followed university participants with migraine, with TTH, or without headache for 7 days using an Omron HJ-112 pedometer and daily headache diaries. Daily free-living PA was compared between groups, and differences in PA as a function of headache day vs non-headache day were compared among those with migraine and TTH.
The final sample consisted of 516 observations from 100 young adults (81/100 female, mean age = 19.0 ± 1.7) comprised of 28 individuals with migraine, 37 individuals with TTH, and 35 non-headache controls. On average, individuals with migraine engaged in less total PA than non-headache controls (6847 vs 8573 steps/day; mean difference = -1726 [95% CI: -3135 to -318], P = .017) across the 7-day monitoring period. After adjusting for relevant covariates (psychological symptoms, body mass index, weekend vs weekday), this difference was evident on both non-headache days (adjusted mean = 5987 vs 8610, P = .002) and headache days (adjusted mean = 6986 vs 9958, P = .017). In contrast, PA of individuals with TTH (mean = 7691 steps/day) did not significantly differ from those with migraine. PA within groups as a function of headache day (vs non-headache day) did not significantly differ for individuals with migraine (mean = 7357 vs 6191, P = .061) or individuals with TTH (mean = 7814 vs 7641, P = .736).
Consistent with other studies, individuals with migraine reported lower levels of PA compared to non-headache controls. Notably, relative reductions in PA occurred even on days in which headache was not experienced and were not attributable to the examined covariates, instead supporting a more global pattern of reduced PA. Further research is needed to isolate the mechanisms underlying interictal reductions in PA among those with migraine.
本研究旨在比较偏头痛、紧张型头痛（TTH）和无头痛对照组年轻成年人的日常体力活动（PA），并确定 PA 差异是否归因于头痛活动或其他相关协变量。
PA 与各种头痛障碍的发生、表现和治疗有关。然而，目前缺乏对不同头痛类型 PA 的客观量化，并且尚无研究对前瞻性 PA 以及头痛发作对 PA 的影响进行量化。
采用前瞻性队列研究，使用 Omron HJ-112 计步器和每日头痛日记对 100 名偏头痛、TTH 或无头痛的大学生进行为期 7 天的监测。比较组间日常体力活动差异，并比较偏头痛和 TTH 患者中头痛日与非头痛日之间 PA 的差异。
最终纳入了 100 名年轻成年人（81/100 名女性，平均年龄=19.0±1.7 岁）的 516 个观测值，其中 28 名偏头痛患者、37 名 TTH 患者和 35 名无头痛对照组。平均而言，偏头痛患者的总 PA 少于无头痛对照组（6847 步/天与 8573 步/天；平均差异=-1726 [95% CI：-3135 至-318]，P=0.017）。在调整相关协变量（心理症状、体重指数、周末与工作日）后，这一差异在非头痛日（调整后的平均=5987 步/天与 8610 步/天，P=0.002）和头痛日（调整后的平均=6986 步/天与 9958 步/天，P=0.017）均明显存在。相比之下，TTH 患者的 PA（平均 7691 步/天）与偏头痛患者无显著差异。偏头痛患者（平均 7357 步/天与 6191 步/天，P=0.061）和 TTH 患者（平均 7814 步/天与 7641 步/天，P=0.736）的组内 PA 差异也不受头痛日（与非头痛日）的影响。
与其他研究一致，偏头痛患者报告的 PA 水平低于无头痛对照组。值得注意的是，即使在没有经历头痛的日子里，PA 也会相对减少，并且这种减少与所检查的协变量无关，这反而支持了更普遍的 PA 减少模式。需要进一步研究来分离偏头痛患者间歇性 PA 减少的机制。
