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Vol. 23. Issue 5.
Pages 387-394 (01 September 2019)
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Vol. 23. Issue 5.
Pages 387-394 (01 September 2019)
Original Research
DOI: 10.1016/j.bjpt.2019.01.001
Reduced flexion rotation test in women with chronic and episodic migraine
NOTICE Undefined index: totales (includes_ws_v2/modulos/cuerpo/info-item.php[202])
Ana Izabela S. Oliveira-Souzaa,
Corresponding author

Corresponding author at: Rua Francisco da Cunha, 1325, ap 403, CEP: 51020-041, Recife, Pernambuco, Brazil.
, Lidiane L. Florenciob, Gabriela F. Carvalhoa, César Fernández-De-Las-Peñasb, Fabiola Dachc, Debora Bevilaqua-Grossia
a Department of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
b Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
c Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil

  • C1/C2 hypomobility is an important finding in women with migraine and is related to migraine chronicity.

  • Mobility of the C1/C2 segment is influenced by neck pain related-disability.

  • Chronic migraine patients have a reduced global cervical range of motion.

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Figures (2)
Tables (3)
Table 1. Characteristics of participants.
Table 2. Scores (degrees) obtained for the flexion rotation test (FRT) and the global active cervical range of motion for individuals with chronic migraine, episodic migraine, and headache-free women.
Table 3. Prevalence ratio (PR) of the flexion rotation test (FRT) between women with chronic or episodic migraine and headache-free women.
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To compare flexion rotation test and global active cervical mobility in women with chronic migraine, episodic migraine, and headache-free controls. The influence of neck pain-related disability on the flexion rotation test was also analyzed.


Women with chronic migraine (n=25), episodic migraine (n=30), and those who were headache-free (n=30) were evaluated. Upper cervical mobility was measured using the flexion rotation test and global active mobility was assessed using the cervical range of motion device. Neck pain related-disability was assessed using the Neck Disability Index. Statistical analyses were performed using a MANOVA test, prevalence ratios, and linear regression.


Chronic (right, MD: −15°; 95%CI: −21° to −11°; left, MD: −13°; 95%CI: −20° to −12°) and episodic (right, MD: −8°; 95%CI: −13° to −4°; left, MD: −8°; 95%CI: −12° to −5°) migraine groups achieved lower flexion rotation test mobility bilaterally than headache-free women. Only chronic migraine was associated with a lower global cervical range of motion compared to that of headache-free women during flexion, (MD: −8°; 95%CI: −15° to −1°), extension (MD: −13°; 95%CI: −20° to −4°), right lateral flexion (MD: −4°; 95%CI: −9° to −0.2°), left lateral flexion (MD: −6°; 95%CI: −10° to −2°), right rotation (MD: −9°; 95%CI: −15° to −4°), and left rotation (MD: −8°; 95%CI: −13° to −2°). Migraine was associated with a 2.85-fold increase in the risk of a positive flexion rotation test. Flexion Rotation Test was influenced by disability-related neck pain (R2=19.1; p=0.001).


Women with migraine have a lower upper cervical range of motion than headache-free women. Women with chronic migraine demonstrated reduced global cervical range of motion when compared to headache-free women. Migraine was associated with in increased likelihood of a positive Flexion Rotation Test. Reduction in mobility was influenced by migraine frequency and disability-related neck pain.

Migraine disorders
Joint range of motion


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