Débora Bevilaqua-Grossi

• Associated Professor
• University of São Paulo

Background The aims of this study were to analyze the profile of childhood headache complaints in a tertiary headache center, verify the differences between children and adolescents, and provide the clinical characteristics that are related to the headaches.MethodsA review of 384 medical records of children aged between 4-12 years old (n=206) and a...

Background Neck pain is common among individuals with migraine, but there is a lack of information of how this comorbidity can be associated with cervical muscle function. This controlled cross‐sectional study aimed to compare cervical muscle function, activity, and sensitization in women with migraine, neck pain, both, and neither. Methods This s...

Abstract: Knowledge of reference values for cervical muscle strength is a key tool for clinicians to use as a clinical reference measure and to establish goals during rehabilitation. The objective was to establish reference values for the maximal strength of cervical muscles in healthy women using a handheld dynamometer and verify the association o...

Objective: The goal of this study was to reach consensus about the best exercise prescription parameters, the most relevant considerations, and other recommendations that could be useful for prescribing exercise to patients with migraine. Methods: This was an international study conducted between April 9, 2022 and June 30, 2022. An expert panel...

Introduction: Migraine is a neurological and disabling disease whose peripheral manifestations can be addressed with physiotherapy. These manifestations can include pain and hypersensitivity to muscular and articular palpation in the neck and face region, a higher prevalence of myofascial trigger points, limitation in global cervical motion, espec...

Background: Migraine patients may present with both cervical and balance dysfunctions. The neck plays an important role in balance by providing substantial proprioceptive input, which is integrated in the central nervous system and influences the balance control systems. Whether balance and neck dysfunctions are associated in patients with migrain...

Background: Migraine has been associated with balance dysfunction, more pronounced in patients with aura and chronic migraine. Also, it has been suggested that balance deficits are progressive through the migraineurs lifetime. Objective: To analyze the one-year progression of balance parameters and clinical parameters associated with balance in...

Background: Although patients with migraine show cervical muscle impairments previous studies investigating motor performance have not characterized the sample of patients with migraine according to the presence/absence of neck pain complaints. Objective: To verify if there are differences in the clinical and muscular performance of the superfic...

Background: Migraine is associated with motion sensitivity symptoms such as kinetosis, vestibular symptoms and balance alterations. While focus is given to headache management, addressing these symptoms is often neglected, although they are related to additional migraine burden and increased disability. Purpose: Our aim is to disseminate the cur...

Background: Repeated migraine attacks and aura could independently cause structural changes in the central nervous system. Our research aims to study the correlation of migraine type, attack frequency, and other clinical variables with the presence, volume and localization of white matter lesions (WML), in a controlled study. Methods: Sixty volunte...

Autonomic dysfunction, such as reduced vagally mediated heart rate variability, has been suggested in headache patients but is still uncertain when considering primary headache disorders. This study aims to compare the heart rate and blood pressure variability and baroreflex sensitivity between women with migraine and controls. A migraine (n = 20)...

Objective: The purpose of this study was to assess the correlation, concurrent validity, and agreement between the isometric cervical force measurements obtained with fixed and portable dynamometers in asymptomatic individuals. Methods: Fifty asymptomatic individuals performed 3 maximal isometric contractions for flexion, extension, and lateral...

IntroductionIndividuals with migraine have a high prevalence of vestibular symptoms, such as dizziness and balance deficits. The presence of aura and high frequency of attacks are associated with an increased risk of these symptoms. Vestibular migraine is a subtype of migraine described in the appendix of the International Classification of Headach...

Introduction Individuals with migraine may have associated cervical musculoskeletal dysfunctions that may influence muscle function ¹,², but we still do not know if the alteration in muscle strength can predict the magnitude of this relationship or if the presence of pain during the tests can influence these results. Therefore, evaluating the muscl...

Background Migraine was previously interpreted as “benign” disease since the major part of patients were asymptomatic between attacks and brain lesions are absent in primary headaches. Advances in structural neuroimaging have changed this point of view. Voxel-based-morphometry is an accurate technique to evaluate objectively structural brain damage...

IntroductionMigraine is a primary headache disorder with generalized neuronal hyperexcitability. Migraine individuals have a high prevalence of cutaneous allodynia, neck pain, and reduced cervical isometric strength. Lower isometric strength is also known to correlate with greater severity of cutaneous allodynia. However, the correlation between ce...

IntroductionMusculoskeletal disorders in the cervical spine have been increasingly investigated and observed in patients with migraine. One of them is a poorer cervical muscle performance as assessed by the cranio-cervical flexion test (CCFT). In addition, patients with migraine have alterations in the recruitment of muscle motor units observed by...

IntroductionChildhood headache is one of the most common neurological symptoms that affects about 60% of children (CR) and adolescents (AD) and its prevalence increases with age. Primary and secondary childhood headache have different characteristics and prevalence, but also have similarities, such as the diagnostic and treatment method. However, t...

IntroductionMigraine affects 7.7% of children and adolescents and presents with short duration, bilateral and generally frontotemporal localization, however, the relationship of pain and sensitivity symptoms and their correlations with physical tests as well as range of motion are not well understood in these groups. Objective Correlate sensitizati...

Introduction Migraine sufferers frequently complain of cervical pain during and in-between migraine attacks and studies suggest that chronic neck pain is a risk factor for high-frequency migraine, including chronic migraine. Increased headache frequency and chronic neck pain are, in turn, independently associated with cephalic cutaneous allodynia,...

IntroductionMigraine is a highly disabling primary headache that can be accompanied by pain and musculoskeletal dysfunction in the cervical region. These individuals with cervical musculoskeletal dysfunction present a greater tendency toward fear and catastrophic thoughts and a greater risk of migraine chronification, developing behaviors such as h...

Objective: To compare the vestibular function and clinical aspects (vestibular and migraine symptoms) of patients divided into three groups-migraine without aura, migraine with aura, and chronic migraine-and a control group by using electronystagmography and a design questionnaire. Study design: Case-control study. Setting: Tertiary referral c...

This cross-sectional study aimed to describe and compare kinetic and kinematic variables of the knee joint during stair descent, single-leg step down, and single-leg squat tasks. It also aimed to investigate potential sex difference during the tasks. Thirty young asymptomatic individuals (15 males, 15 females) were assessed during the performance o...

Objective: To assess the balance sensory organization among patients with migraine, considering the influence of migraine subdiagnosis, otoneurological function, falls, and psychosocial factors. Background: Migraine has been associated with vestibular symptoms and balance dysfunction; however, neither comprehensive balance assessment nor associa...

Background Migraine patients have musculoskeletal disorders and pain in the cervical. And, despite the pathophysiology demonstrating the relationship between migraine and the cervical spine, the effectiveness of craniocervical exercises in these patients has not been verified. So, the aimed of this study was verify the effectiveness of craniocervic...

OBJECTIVE: The objective of this study was to measure the intra- and inter-rater reliability of the quantitative sensory testing for measuring the thermal pain threshold on myofascial trigger points in the upper trapezius muscle of individuals with chronic neck pain. METHODS: Thirty female participants were included, aged between 18 and 45 years an...

This cross-sectional study aimed to compare the waveform morphology through noninvasive intracranial pressure (ICP-NI) measurement between patients with migraine and controls, and to analyze the association with clinical variables. Twenty-nine women with migraine, age 32.4 (11.2) years and headache frequency of 12.6 (7.5) days per month and twenty-...

Recent studies have demonstrated the presence of brain alterations in patients with migraine. Functional and vascular changes in the brain are related to the presence and severity of cutaneous allodynia. However, the association between brain structural changes and cutaneous allodynia has not been yet investigated in patients with migraine. Thus, t...

Objective: The objective of the study was to correlate the thermal pain threshold (heat and cold) on myofascial trigger points with measurements of pain and skin temperature in patients with chronic neck pain. Methods: This is a cross-sectional study. We included participants of both genders, aged between 18-45 years, with chronic neck pain (>90...

Introdução A cinesiofobia é caracterizada pelo medo irracional do movimento e está presente em aproximadamente metade dos pacientes com migrânea. Sabe-se que esses pacientes, quando apresentam a forma crônica da migrânea, com mais de 15 dias de cefaleia por mês, apresentam maior prevalência de alodinia, níveis mais severos de incapacidade cervical,...

Introdução Alterações de equilíbrio durante atividades funcionais tem sido observadas em pacientes com migrânea. A literatura sugere que as alterações de equilíbrio estático estão relacionadas com alterações vestibulares, presença de aura e migrânea crônica, porém não se sabe ainda se estes ou outros fatores estão associados à alterações no desempe...

Introdução A literatura sugere que os déficits de equilíbrio observados em pacientes com migrânea estão relacionados à presença de aura e alta frequência de crises. Além disso, sintomas vestibulares também são altamente prevalentes nesses pacientes. Do ponto de vista neurofisiológico, a contribuição de cada um dos sistemas que controlam o equilíbri...

Introdução A cervicalgia é altamente prevalente em migranosos, e um potencial contribuinte para a incapacidade relacionada à cefaleia. Além disso, indivíduos com migrânea crônica apresentam maior incapacidade cervical, entretanto não é conhecido se esta relação também se manifesta em indivíduos com aura. Objetivo Avaliar as características da cervi...

Introdução As cefaleias primárias e secundárias atingem em torno de 60% das crianças e adolescentes, e cerca de 80% deles possuem comorbidades. Objetivo Avaliar a prevalência de diagnóstico e comorbidades de crianças e adolescentes com cefaleias atendidos em um hospital terciário nos últimos cinco anos. Material E Métodos Estudo retrospectivo, base...

Background: It is evidenced that migraineurs present balance deficits. However, the balance recovery following unexpected ground perturbations, which reflect conditions of everyday activities, has not been investigated in this population. Aim: We aimed to assess the reactive postural responses among patients with migraine with and without aura, chr...

Introdução A migrânea é comumente associada a déficits de equilíbrio, que progridem mais rapidamente do que em indivíduos sem cefaleia. Porém, ainda não está definido se a progressão é mais evidente na presença de aura ou em pacientes com migrânea crônica. Objetivo Analisar as alterações no equilíbrio de pacientes com migrânea com e sem aura, e mig...

Introdução O relato da dor cervical nos pacientes com migrânea pode contribuir negativamente para o aumento das crises de cefaleia e severidade da alodínia cutânea, com impacto nas atividades de vida diária. Objetivo Verificar se o desempenho de mulheres com migrânea durante o teste de resistência muscular cervical é afetado pelo diagnóstico clínic...

Introdução Mudanças estruturais do Sistema Nervoso Central estão comumente associadas com alterações funcionais. Apesar de estar estabelecida a presença de alterações morfológicas cerebrais e a redução da performance de tarefas funcionais em pacientes com migrânea, a relação entre esses dois fatores ainda não foi verificada nessa população. Objetiv...

Introdução Pacientes com migrânea apresentam alterações musculoesqueléticas e dor cervical. Por meio da fisiopatologia da doença, é possível entender a relação entre a migrânea e a coluna cervical. Entretanto, a eficácia de exercícios craniocervicais em pacientes com migrânea ainda não foi verificada. Objetivo Verificar a eficácia de um protocolo d...

Introdução Dor cervical e disfunções musculoesqueléticas parecem estar associadas à migrânea. No entanto, os estudos que investigaram essas associações foram realizados majoritariamente em mulheres. Objetivo Verificar se migranosos apresentam diferenças entre os gêneros em relação à dor e incapacidade no pescoço, no desempenho dos músculos flexores...

Introdução As alterações cerebrais presentes nos pacientes com migrânea tem sido muito estudadas nos últimos anos. A presença e a severidade da alodinia cutânea (AC) estão relacionadas a alterações funcionais e vasculares do cérebro. Todavia, a associação entre alterações estruturais do cérebro e a AC ainda não estão bem esclarecidas em pacientes c...

Introduction: Kinesiophobia is a common symptom associated with high disability, and has been observed in patients with migraine. However, the association between kinesiophobia and clinical factors in this population is unknown. Objective: To assess the fear of falling, dizziness disability, and migraine disability in patients with migraine, con...

This study aims to validate the Brazilian version of World Health Organization Disability Assessment Schedule (WHODAS 2.0) for individuals with temporomandibular disorders (TMD), assessing its psychometric properties, including internal consistency, construct validity, and discriminant validity. In total, 100 female and male patients with TMD were...

We aimed to compare movement parameters and muscle activity during active cervical spine movements between women with episodic or chronic migraine and asymptomatic control. We also assessed the correlations between cervical movement measures with neck-related disability and kinesiophobia. Women with episodic (n = 27; EM) or chronic (n = 27; CM) mig...

This study aimed to verify if migraine frequency or migraine-associated neck pain were associated with a reduction of normalized force and altered electromyographic activity during maximal cervical muscle isometric contractions. Additionally, it aimed to assess the correlation of normalized isometric force with years with migraine, headache frequen...

We aimed to determine the association of cervical range of motion (ROM) with the clinical features of headache and neck pain and psychosocial factors in patients with migraine. Seventy women diagnosed with migraine were questioned regarding migraine onset and frequency, and the presence, frequency, and intensity of self-reported neck pain. These in...

Background Non-pharmacological approaches for the management of migraine exhibit low to moderate effectiveness due to a lack of high-quality randomized clinical trials. In fact, previous studies applied isolated techniques, which were not representative of common clinical practice. A multimodal approach for migraine may benefit these patients more...

Objectives: To evaluate the discriminative validity and provide a clinical cut-off of the craniocervical flexion test (CCFT) in migraineurs stratified by the report of neck pain, headache-related disability, and neck disability. Methods: Fifty women without headache and 102 women with migraine were recruited by convenience from a local tertiary...

Background Under a typical light and sound environment context, individuals with migraine showed balance control deficits on a series of functional activities, which helps to explain why migraineurs report more falls. it isn't established, the effects of intensity light and sound in migraineurs during functional tasks. Research question Based on t...

Objective: To evaluate gender differences in clinical characteristics of migraine by examining presence and severity of cutaneous allodynia, migraine-related disability, neck pain and its associated disability, passive mobility of the upper cervical spine, and performance of the deep neck flexor muscles. Design: cross-sectional study. Subjects:...

Background: Despite that photophobia and phonophobia are well-known symptoms related to migraine, it is unclear whether they affect daily life activities during the headache-free period. Objective: To evaluate the interictal photophobia/phonophobia intensity during daily activities in migraineurs and non-headache individuals. Methods: Women with mi...

Background: Despite previous reports supporting cervical muscle weakness and altered motor control in migraine, the endurance under standardized submaximal loads has not been investigated. Therefore, this study aimed to assess the endurance and muscle activity of the cervical musculature during submaximal isometric contractions in women with migra...

Background: The Headache Impact Test-6™ is a widely recommended questionnaire to evaluate the impact of headaches. However, its measurement properties were never evaluated in both primary and secondary headaches, and the Brazilian Portuguese version of the questionnaire was never assessed at all. Objective: To assess the reliability, and structu...

A migrânea é uma condição clínica referida como uma perturbação cefalálgica primária, comum e incapacitante, de alta prevalência e que produz impactos socioeconômicos e pessoais elevados. Ela possui manifestações episódicas, com crises recorrentes de cefaleia, apresentando-se com quadro de dor unilateral, pulsátil, de intensidade moderada ou severa...

Background: Migraine is a highly disabling condition and pharmacological treatment is the gold standard. However, several patients have also positive responses to the application of different manual techniques and therapeutic exercises in terms of reducing the intensity and frequency of migraine attacks. Nevertheless, the effects of a neck-specifi...

IntroduçãoA migrânea afeta 9,1% de crianças e adolescentes, e grande parte deles apresentam outras condições associadas à doença. Algumas das comorbidades estudadas nesta população são as síndromes epiléticas, distúrbios psicológicos, como ansiedade e depressão, e obesidade. Entretanto, outras condições também são frequentemente observadas, especia...

IntroduçãoDéficits no controle do equilíbrio tem sido observado em pacientes com migrânea, bem como maior prevalência e medo de quedas. No entanto, ainda não são conhecidas as alterações do equilíbrio relacionadas com a recorrência de quedas nestes pacientes. O objetivo deste estudo foi comparar a preocupação com quedas e o controle postural de ind...

IntroduçãoA migrânea é uma disfunção neurovascular incapacitante cujos pacientes apresentam alterações no equilíbrio, dentre outros fatores. Ademais, a cinesiofobia também pode ser frequentemente percebida por esses pacientes e por se tratar de um comportamento de evitação de movimento, pode afetar o controle de equilíbrio. No entanto, essa relação...

IntroductionUnder a typical sound environment context, individuals with migraine showed balance control deficits on a series of functional activities as compared to healthy controls, which helps to explain why migraineurs report more falls than controls. However, it is not stablished, the effects of intensity sound in migraine patients during funct...

IntroduçãoA migrânea é uma cefaleia primária, crônica e incapacitante frequentemente associada ao relato de dor cervical. Além disso, pacientes com migrânea apresentam déficits no desempenho dos músculos cervicais avaliado pelo Craniocervical Flexion Test (CCFT) que podem piorar na presença de relato de dor cervical. Porém, ainda não é conhecido se...

IntroduçãoA disfunção cervical é uma condição frequentemente observada em pacientes com migrânea, e está associada com o risco para a cronificação. A força muscular cervical reduzida é um dos fatores dessa disfunção, e pode estar relacionada com a apresentação clínica da migrânea. O objetivo deste estudo foi verificar a correlação entre as caracter...

IntroduçãoA presença de dor cervical é bem conhecida no quadro de migrânea, bem como a associação entre e a alta frequência de crises e maior incapacidade cervical. No entanto, pacientes com aura apresentam alguns fatores que não são observados em indivíduos sem aura, e a incapacidade cervical ainda não foi investigada neste grupo de pacientes. O o...

Background Most migraine patients report neck pain as part of their migraine symptomatology, but it is unknown whether triggering neck pain would induce migraine attacks. Our aim was to assess the occurrence of headache and/or neck pain after an endurance test of the neck muscles among migraineurs and controls. Methods Sixty-five patients with mig...

Background Migraine may be associated with neck impairment and migraine chronicity is related to greater disability. However, whether other subclassifications of migraine, such as migraine with aura, are related to neck impairment is currently unknown. The aim of this study was to assess the musculoskeletal aspects of the neck in patients with migr...

Background Different closed kinematic tasks may present different magnitudes of knee abduction, foot pronation, and foot plantar pressure and area. Although there are plenty of studies comparing knee abduction between different tasks, the literature lacks information regarding differences in foot pronation and foot plantar pressure and area. We com...

Background The Headache Disability Inventory assesses the dimensions of headache disability, but it is not available in Brazilian Portuguese yet. We aimed to translate the Headache Disability Inventory into Brazilian Portuguese and analyze its measurement properties. Methods Consecutive patients with headaches diagnosed by expert neurologists as p...

Background: People with migraine exhibit postural control impairments. These patients also have an increased light sensitivity due to the disease, and it remains during the headache-free period. It is currently unknown if increased lighting levels can alter the balance control, especially in individuals with visual hypersensitivity, such as migrai...

Objective This study aimed to verify a possible relationship between shoulder disability and shoulder pain intensity and the variables related to cervical-spine dysfunction, and determine which of these can differentiate moderate to severe shoulder pain (>4 on a numerical rating scale [NRS]) from mild shoulder pain (≤4 on the NRS) in individuals wi...

Objective The aim of this study was to determine the reliability, standard error of measurement (SEM), and smallest detectable change (SDC) of the flexion rotation test (FRT) and cervical range of motion (CROM) assessed with the CROM device in individuals with and without migraine. Methods Twenty-five women with migraine (mean age, 35 years; stand...

Background: Migraine is related to musculoskeletal impairment of the neck and the chronicity of migraine is related to greater disability levels. However, it is not known if other forms of migraine, such as migraine with aura, is related to a different pattern of neck impairment. Objective: To assess the musculoskeletal and clinical aspects of the...

Background: Vestibular symptoms and balance changes are common in patients with migraine, especially in the ones with aura and chronic migraine. However, it is not known if the balance changes are determined by the presence of vestibular symptoms or migraine subdiagnosis. Therefore, the aim of this study was to verify if the migraine subdiagnosis...

Objective: To identify assessment tools used to evaluate patients with temporomandibular disorders (TMD) considered to be clinically most useful by a panel of international experts in TMD physical therapy (PT). Methods: A Delphi survey method administered to a panel of international experts in TMD PT was conducted over three rounds from October...

Background: Migraine is a primary headache with high levels of associated disability that can be related to a variety of symptoms and comorbidities. The role of physical therapy in the management of migraine is largely unknown. Therefore, the aim of this review is to highlight and critically discuss the current literature and evidence for physical...

Football players frequently face the occurrence of non-contact injuries. Although there are likely multiple factors that contribute to increased risk of non-contact injury, it remains a challenge to correlate all these factors. However, it is not clear how much of individual training abilities may interfere in these events. As such, the primary aim...

Purpose Neck pain is considered a common characteristic of migraine attacks. The relationship between neck pain and migraine can be explained by central sensitization of the trigeminocervical complex, where superior cervical afferents and the trigeminal nerve converge. However, few studies have evaluated motor control of cervical muscles in individ...

Objective: 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. Methods: Women with chronic migraine (n=25), episodic migraine (n=30), and those who were head...

Study design: Cross-sectional study. Objective: We explored the differences between chronic low back pain (CLBP) patients suited for the functional optimization approach and healthy controls in isometric hip-strength and lumbar-endurance tests and determined classificatory cutoff values for strength and endurance tests and ratios. Summary of ba...

Background: Cervical spine disorders are frequently associated with temporomandibular disorders (TMDs). Although headache is common in TMD, few studies have considered headache regarding the functional performance of the cervical spine in TMD. Objectives: To evaluate TMD subjects with and without self-reported headache, assess the active and pas...

Objective: To investigate the association between the presence of self-reported neck pain in patients with migraine and clinical features, upper cervical mobility, and neck muscle performance. Methods: A total of 142 patients with migraine were recruited and stratified by the presence (n = 99) or absence of self-reported neck pain (n = 43). The...

Link for open acess: https://doi.org/10.1016/j.ptsp.2019.04.011 Objectives To verify the intrasession reliability and the agreement between strength measurement of hip and knee muscles using hand-held dynamometer stabilized by a belt or by an examiner. Design Test-retest design. Setting Knee and hip muscles strength were measured bilaterally usi...

Study design: Cross-sectional, controlled laboratory study. Background: Despite previous evidence, the association between migraines and cervical muscular performance is unclear. Objective: To compare the differences in neck flexor and extensor muscle endurance between women with and without migraine. Methods: Twenty-six women with migraine...

Objective: The purpose of this study was to assess the correlations between neck muscle strength and pain features, such as neck-related disability, neck pain frequency and intensity, and headache frequency in women with headache. Methods: Seventy women with migraine between 18 and 55 years of age diagnosed according to International Headache So...

Objective: The aim of this study was to assess kinesiophobia in patients with migraine and to determine its association and correlation with cutaneous allodynia and clinical manifestations of migraine. Design: A cross-sectional study. Setting: A headache clinic of a university-based hospital. Subjects: Eighty-nine patients diagnosed with mig...