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Bewegen tegen migraine*
Uit een kleine Zweedse studie blijkt dat regelmatig bewegen net zo effectief werkt in het voorkomen van een migraine-aanval als medicatie. In de studie deed 1/3 van de deelnemers drie keer per week 40 minuten oefeningen o.l.v. een fysiotherapeut, 1/3 van hen deed ontspanningsoefeningen en de andere 1/3 kreeg Topiramaat als medicatie (in een dosering oplopend tot max. 200 mg/dag). Voor, tijdens en tot zes maanden na de studie van drie maanden werden regelmatig de migraine status, de levenskwaliteit en het uithoudingsvermogen vastgelegd. Na afloop van de studie bleek er geen verschil te zijn in het aantal migraine-aanvallen in alle groepen. Regelmatig bewegen blijkt dus net zo effectief te zijn dan medicatie in het voorkomen van migraine.
Exercise Just as Good as Drugs at Preventing Migraines, Swedish Study Suggests
Although exercise is often prescribed as a treatment for migraine, there has not previously been sufficient scientific evidence that it really works. However, research from the Sahlgrenska Academy at the University of Gothenburg, Sweden, has now shown that exercise is just as good as drugs at preventing migraines.
Doctors use a variety of different methods to prevent migraines these days: on the pharmaceutical side a drug based on the substance topiramate has proved effective, while non-medical treatments with well-documented effects include relaxation exercises.
No previous evidence
Exercise is also frequently recommended as a treatment, though there has not been sufficient scientific evidence that it really has any effect on migraine patients.
In a randomized controlled study researchers from the University of Gothenburg's Sahlgrenska Academy have now analysed how well exercise works as a preventative treatment for migraines relative to relaxation exercises and topiramate.
40 minutes of exercise
Published in the journal Cephalalgia, the study involved 91 migraine patients, a third of whom were asked to exercise for 40 minutes three times a week under the supervision of a physiotherapist, with another third doing relaxation exercises, and the final third given topiramate. The study lasted for a total of three months, during which the patients' migraine status, quality of life, aerobic capacity and level of phyical activity were evaluated before, during and after their treatment. Follow-ups were then carried out after three and six months.
Exercise just as effective
The results show that the number of migraines fell in all three groups. Interestingly, there was no difference in the preventative effect between the three treatments.
"Our conclusion is that exercise can act as an alternative to relaxations and topiramate when it comes to preventing migraines, and is particularly appropriate for patients who are unwilling or unable to take preventative medicines," says Emma Varkey, the physiotherapist and doctoral student at the Sahlgrenska Academy who carried out the study.
Abstract
Aim: Scientific evidence regarding exercise in migraine prophylaxis is required. Therefore this study aimed to evaluate the effects of exercise in migraine prevention. 
Methods: In a randomized, controlled trial of adults with migraine, exercising for 40 minutes three times a week was compared to relaxation according to a recorded programme or daily topiramate use, which was slowly increased to the individual’s highest tolerable dose (maximum 200 mg/day). The treatment period lasted for 3 months, and migraine status, quality of life, level of physical activity, and oxygen uptake were evaluated. The primary efficacy variable was the mean reduction of the frequency of migraine attacks during the final month of treatment compared with the baseline. 
Results: Ninety-one patients were randomized and included in the intention-to-treat analysis. The primary efficacy variable showed a mean reduction of 0.93 (95% confidence interval (CI) 0.31–1.54) attacks in the exercise group, 0.83 (95% CI 0.22–1.45) attacks in the relaxation group, and 0.97 (95% CI 0.36–1.58) attacks in the topiramate group. No significant difference was observed between the groups (p = 0.95). 
Conclusion: Exercise may be an option for the prophylactic treatment of migraine in patients who do not benefit from or do not want to take daily medication. (November 2011)
 

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