Therapeutic exercise recommendations for primary headaches treatment: A qualitative approach on the headache units in Catalonia
e202507041
Keywords:
primary headache disorders, Exercise Therapy, migraine, tension-type headache, chronic headache, Physiotherapy, therapeutic adherence, comorbidities, Clinical practice guideline, tertiary healthcare, patient care teamAbstract
BACKGROUND // Therapeutic exercise (TE) is a fundamental component of preventive treatment for chronic primary headaches, as outlined in clinical practice guidelines. Its implementation requires human, structural, and material resources. Currently, headache units and monographic consultations (HUM) are multidisciplinary teams focused on managing chronic headaches, high-frequency episodic headaches, and the most complex cases. The aim of this paper was to assess the status of TE recommendations in HUM, identifying modalities, resources, adherence, barriers, facilitators, and opportunities for improvement in its implementation.
METHODS // Qualitative data were collected through semi-structured interviews with twenty-seven healthcare professionals from ten HUM in Catalonia (Spain) between March and November 2024, using chain sampling. Data were analyzed through inductive thematic analysis.
RESULTS // All participants (100%) recommended TE, highlighting moderate-intensity aerobic exercise as the preferred modality, particularly for chronic migraine. Currently, implementation is limited to verbal recommendations and informational leaflets. The main barriers identified were headache frequency, painful comorbidities, and a lack of tailored programs. Facilitators included prior positive exercise experience and professional supervision, highlighting the role of physiotherapist in this field.
CONCLUSIONS // TE is considered essential in headache management; however, there are significant shortcomings in resources for its implementation and monitoring. Incorporating physiotherapists and technological support could enhance the application of these recommendations.
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