Estrategias de fisioterapia cognitivo conductual aplicadas al ejercicio en pacientes con migraña crónica

Resumen

In this doctoral thesis, chronic migraine is studied from different perspectives. The objective is to be able to have an alternative treatment to the pharmacological, in order to be able to study a treatment according to its neurophysiology and based on conservative techniques from the exercise under the bio-behavioral perspective. For this, five studies have been carried out, with different methodological designs to not only study the hypothesis of the treatment of the disease but also to be able to study scientifically that the neurophysiological theories on which we support are based on a greater evidence. In the first and second studies, a review of the scientific literature on biobehavioral techniques of education and therapeutic exercise is done. In the third and fourth studies, cross-sectional studies are intended to study the pathophysiology of chronic migraine by studying somatosensory and psychosocial variables associated with the disease to study the relationship between them. In the last one , a randomized clinical trial evaluates the combination of biopsychosocial techniques which are most effective for the treatment of chronic migraine. In the last study, these techniques are compared with a control group that only receives medication. The results show that the pathophysiology of migraine is based on the central sensitization theory through the trigeminal-cervical nucleus also that biobehavioral treatments based on therapeutic education and exercise and the combination between them or with manual therapy or with medication are effective and safe approaches for the treatment of chronic migraine at least in the short term.