[8] In 2008, Busch and Gaul[9] summarized the status of research on the role of exercise on migraine outcomes, and concluded that exercise generally was associated with decreases in pain intensity, but not with changes in headache frequency or duration. However, they suggested that it is difficult to draw conclusions based on the studies they examined, owing to methodological limitations. Aerobic exercise is of particular interest, as it is associated with improved cardiovascular fitness,[10, 11] which is hypothesized to be a mechanism of change in the improvement of headache

symptoms.[4, 11] The exact mechanism of this relationship is unclear, Selleckchem Ensartinib although various hypotheses have been suggested, including sustained increased serotonin levels,[4] and moderation of the sympathetic and parasympathetic responses to stress.[11, 12] Since 2008, 3 additional publications have conducted systematic investigations of aerobic exercises as a treatment option for headache. Varkey et al administered a 40-minute aerobic exercise cycling intervention 3 times a week for 12 weeks.[13] Most of the exercise sessions were supervised, but patients had the option of completing 1 session per selleck products week at home. Among the 26 patients who completed

the program, significant improvements at post-treatment were found in the quality of life, migraine frequency and intensity, and medication use, as well as in maximum oxygen intake (VO2 max), an indicator of physical fitness. Building on these findings, Varkey et al conducted a larger randomized controlled trial (RCT) in which participants received this exercise prescription, a relaxation treatment, or a course of daily topiramate treatment.[14] Those in the exercise group had higher VO2 max levels at post-treatments than those who received topiramate or a relaxation MCE公司 treatment. Participants in the topiramate group received a significantly greater improvement in headache intensity compared with the other groups. Otherwise, there were no differences between groups in terms of headache frequency or quality of life, prompting

the authors to argue that exercise is just as effective at controlling migraines as relaxation training and topiramate – 2 well-established treatments. Another recent pilot study utilizing a similar exercise prescription (30 minutes of aerobic exercise, 3 times per week for 10 weeks) reported significant improvements in the number of migraine days per month, migraine intensity, fitness level, and stress level.[15] Collectively, these findings provide evidence regarding the utility of aerobic exercise in the treatment of chronic headaches. The Busch and Gaul[9] report and the studies discussed above assess the effectiveness of exercise as a monotherapy for the management of chronic headache, and suggest that it may be a useful treatment option.