Impacts of cervical exercise and Mulligan manual therapy on headache frequency, intensity, and disability for people with episodic migraine - a randomized clinical trial.

This study aimed to compare Mulligan manual therapy (MMT) with sham MMT. Researchers involved 99 adults with episodic migraine, averaging 41.5 years old. Participants received either neck exercises alone, exercises plus MMT, or exercises plus sham MMT. The primary outcome was migraine frequency. Secondary outcomes included headache intensity, duration, medication use, and disability. Evaluations occurred at baseline, and at 4, 13, and 26 weeks. Results showed no significant difference in headache frequency among the groups. At the 4-week mark, exercise plus MMT significantly reduced disability compared to exercises alone and exercise plus sham MMT. However, this improvement did not persist at later follow-ups. Improvements in upper cervical range of motion were observed at 13 and 26 weeks. The lack of significant headache frequency reduction may relate to not subgrouping migraine patients based on articular impairments. Clinical relevance: This research indicates that while disability may improve, headache frequency does not significantly change with MMT.