{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:22:28Z","timestamp":1791933748145,"version":"4.3.4"},"reference-count":66,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>Aim To assess the efficacy of pain neuroscience education combined with physiotherapy for the management of migraine.<\/jats:p>\n                  <jats:p>Background Physiotherapy can significantly reduce the frequency of migraine, but the evidence is based only on a few studies. Pain neuroscience education might pose a promising treatment, as it addresses migraine as a chronic pain disease.<\/jats:p>\n                  <jats:p>Methods In this non-blinded randomized controlled trial, migraine patients received physiotherapy\u2009+\u2009pain neuroscience education or physiotherapy alone, preceded by a three-month waiting period. Primary outcomes were frequency of headache (with and without migraine features), frequency of migraine and associated disability.<\/jats:p>\n                  <jats:p>Results Eighty-two participants were randomized and analyzed. Both groups showed a decrease of headache frequency (p\u2009=\u20090.02, d\u2009=\u20090.46) at post-treatment (physiotherapy: 0.77 days, 95%CI: \u22120.75 to 2.29 and physiotherapy\u2009+\u2009pain neuroscience education: 1.25 days, 95%CI: \u22120.05 to 2.55) and at follow-up (physiotherapy: 1.93, 95%CI: 0.07 to 3.78 and physiotherapy\u2009+\u2009pain neuroscience education: 3.48 days, 95%CI: 1.89 to 5.06), with no difference between groups (p\u2009=\u20090.26, d\u2009=\u20090.26). Migraine frequency was reduced significantly in the physiotherapy\u2009+\u2009pain neuroscience education group, and not in the physiotherapy group, at post-treatment (1.28 days, 95%CI: 0.34 to 2.22, p\u2009=\u20090.004) and follow-up (3.05 days, 95%CI: 1.98 to 5.06, p\u2009&lt;\u20090.0001), with a difference between groups at follow-up (2.06 days, p\u2009=\u20090.003). Migraine-related disability decreased significantly in both groups (physiotherapy: 19.8, physiotherapy\u2009+\u2009pain neuroscience education: 24.0 points, p\u2009&lt;\u20090.001, d\u2009=\u20091.15) at follow-up, with no difference between groups (p\u2009=\u20090.583). Secondary outcomes demonstrated a significant effect of time with no interaction between time and group. No harm or adverse events were observed during the study.<\/jats:p>\n                  <jats:p>Conclusion In comparison to physiotherapy alone, pain neuroscience education combined with physiotherapy can further reduce the frequency of migraine, but had no additional effect on general headache frequency or migraine-related disability.<\/jats:p>\n                  <jats:p>Trial Registration The study was pre-registered at the German Clinical Trials Register (DRKS00020804).<\/jats:p>","DOI":"10.1177\/03331024221144781","type":"journal-article","created":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T03:17:27Z","timestamp":1675567047000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Additional effects of pain neuroscience education combined with physiotherapy on the headache frequency of adult patients with migraine: A randomized controlled trial"],"prefix":"10.1177","volume":"43","author":[{"given":"Ruth","family":"Meise","sequence":"first","affiliation":[{"name":"Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck, Universitaet zu Luebeck, Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4442-2040","authenticated-orcid":false,"given":"Gabriela Ferreira","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck, Universitaet zu Luebeck, Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Thiel","sequence":"additional","affiliation":[{"name":"Department of Applied Health Sciences, Hochschule fuer Gesundheit (University of Applied Sciences), Bochum, Germany"},{"name":"Faculty of Sports Science, Ruhr-University Bochum, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5429-5770","authenticated-orcid":false,"given":"Kerstin","family":"Luedtke","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck, Universitaet zu Luebeck, Luebeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"key":"bibr1-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2019.07.008"},{"key":"bibr2-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-017-2866-0"},{"key":"bibr3-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1177\/0333102414535110"},{"key":"bibr4-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2009.01608.x"},{"key":"bibr5-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04595-w"},{"key":"bibr6-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2019.11.001"},{"key":"bibr7-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1007\/s00482-019-0369-z"},{"key":"bibr8-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2019.01.001"},{"key":"bibr9-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1080\/10669817.2018.1480912"},{"key":"bibr10-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1177\/0333102419854061"},{"key":"bibr11-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-018-1030-9"},{"key":"bibr12-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417716934"},{"key":"bibr13-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-017-0808-0"},{"key":"bibr14-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2012.02169.x"},{"key":"bibr15-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1111\/head.12336"},{"key":"bibr16-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-003-0036-y"},{"key":"bibr17-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002417"},{"key":"bibr18-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-019-0815-8"},{"key":"bibr19-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1177\/2515816320930681"},{"key":"bibr20-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-019-1066-0"},{"key":"bibr21-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1177\/1744806918767697"},{"key":"bibr22-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"bibr23-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001384"},{"key":"bibr24-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1111\/head.14261"},{"key":"bibr25-03331024221144781","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2021.705276"},{"key":"bibr26-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-018-0873-z"},{"key":"bibr27-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001231"},{"key":"bibr28-03331024221144781","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001739"},{"key":"bibr29-03331024221144781","first-page":"262","volume":"55","author":"Pancheri 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