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Abstract

Background: Migraines are a common neurological disorder characterized by recurrent episodes of moderate-to-severe headaches, often accompanied by nausea, sensitivity to light and sound, and reduced cervical mobility. While pharmacological treatments are widely used, non-pharmacological approaches such as Mulligan Manual Therapy (MMT) and Mind-Body Therapy (MBT) have shown promise in managing migraine symptoms. However, limited research has explored the combined effects of these interventions. Objective: This study aimed to evaluate the effectiveness of combining MMT and MBT in migraine patients by assessing pain intensity, cervical range of motion (ROM), perceived stress levels, and migraine-specific quality of life (MSQ). Methods: A randomized clinical trial was conducted with 70 migraine patients, divided into two groups. Group A received only MMT, while Group B received a combination of MMT and MBT. The intervention lasted four weeks, with outcome measures including the Visual Analog Scale (VAS) for pain intensity, goniometric assessment of cervical ROM, the Perceived Stress Scale (PSS), and the Migraine-Specific Quality of Life Questionnaire (MSQ). Results: Both groups showed significant improvements post-treatment. Pain intensity (VAS scores) reduced in both groups, with Group A decreasing from 6.94 to 3.88 and Group B from 7.02 to 3.97. Cervical ROM improved more in Group B, with flexion increasing from 35.77° to 45.85°, compared to 36.91° to 41.45° in Group A. Stress levels (PSS scores) decreased more significantly in Group B (28.14 to 12.22) compared to Group A (33.71 to 21.91). MSQ scores also improved more in Group B (60.37 to 80.48) than in Group A (54.57 to 66.65). Conclusion: The combination of MMT and MBT demonstrated superior benefits in reducing stress, improving cervical ROM, and enhancing quality of life in migraine patients compared to MMT alone. These findings highlight the potential of an integrated approach for migraine management. Future research should explore long-term effects and larger sample sizes to validate these results.