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Table 2 Meta-analysis and post-hoc sensitivity analysis of physical testing in patients with migraine compared to asymptomatic individuals

From: Differentiating migraine, cervicogenic headache and asymptomatic individuals based on physical examination findings: a systematic review and meta-analysis

Test Procedure or location Analysis No. of studies Patients with migraine Asympto
matic indivi
duals
Mean difference (95% CI) Heterogeneity (I2) P for overall effect
Cervical ROM Flexion Meta-analysis 7 258 210 −2.85 [−5.12, − 0.58] 12% P = 0.01*
  Sensitivity analysis (QI> 75%) 5 216 133 −3.57 [−6.28,-0.86] 9% P = 0.01*
Extension Meta-analysis 7 258 210 −2.30 [−5.33, 0.73] 44% P = 0.14
  Sensitivity analysis (QI> 75%) 5 216 133 −3.45 [−7.40,0.50] 50% P = 0.09
Rotation Meta-analysis 7 258 210 −0.21 [−9.13, 8.71] 96% P = 0.96
  Sensitivity analysis (QI> 75%) 5 216 133 −4.42 [−6.51,-2.33] 0% P < 0.0001*
Lateral flexion Meta-analysis 7 258 210 −2.17 [−3.75, −0.59] 0% P = 0.007*
  Sensitivity analysis (QI> 75%) 5 216 133 −1.78 [−3.87,0.32] 13% P = 0.10
Rotation (sum of both sides) Meta-analysis 3 69 93 3.54 [−2.23, 9.31] 0% P = 0.23
  Sensitivity analysis (QI> 75%) 0 N/A N/A N/A N/A N/A
Lateral flexion (sum of both sides) Meta-analysis 3 69 93 −0.63 [−6.04, 4.77] 0% P = 0.82
  Sensitivity analysis (QI> 75%) 0 N/A N/A N/A N/A N/A
FRT (both sides) Meta-analysis 2 67 53 −5.86 [−17.12, 5.41] 93% P = 0.31
  Sensitivity analysis (QI> 75%) 2 67 53 −5.86 [− 17.12, 5.41] 93% P = 0.31
FRT (sum of both sides) Meta-analysis 2 163 98 −8.96 [−13.22, −4.69] 0% P < 0.0001*
  Sensitivity analysis (QI> 75%) 1 N/A N/A N/A N/A N/A
Flexion + extension Meta-analysis 3 69 93 2.46 [−3.84,8.77] 0% P = 0.44
  Sensitivity analysis (QI> 75%) 0 N/A N/A N/A N/A N/A
JPE Extension Meta-analysis 3 118 104 0.20 [−0.48,0.88] 0% P = 0.57
  Sensitivity analysis (QI> 75%) 0 N/A N/A N/A N/A N/A
Rotation (both sides) Meta-analysis 3 118 104 −0.07 [−0.84,0.7] 25% P = 0.86
  Sensitivity analysis (QI> 75%) 0 N/A N/A N/A N/A N/A
Posture CVA Standing Meta-analysis 5 217 123 −1.11 [−4.10,1.89] 83% P = 0.47
  Sensitivity analysis (QI> 75%) 3 172 78 −0.75 [−3.06,1.57] 62% P = 0.53
Sitting Meta-analysis 5 195 102 −2.94 [−5.98,0.09] 75% P = 0.06
  Sensitivity analysis (QI> 75%) 3 175 82 −1.62 [−3.11,-0.13] 62% P = 0.02*
Posture CLA Standing Meta-analysis 2 139 45 −0.89 [−1.72,-0.07] 0% P = 0.03*
  Sensitivity analysis (QI> 75%) 2 139 45 −0.89 [−1.72,-0.07] 0% P = 0.03*
Sitting Meta-analysis 2 139 45 −0.81 [−1.74, 0.12] 0% P = 0.09
  Sensitivity analysis (QI> 75%) 2 139 45 −0.81 [−1.74, 0.12] 0% P = 0.09
PPT Upper trapezius Meta-analysis 5 124 110 −0.61 [−0.92,-0.29] 89% P = 0.0002*
  Sensitivity analysis (QI> 75%) 4 99 85 −0.61 [− 0.99,-0.23] 92% P = 0.002*
Sternocleidomastoid muscle Meta-analysis 3 79 65 −0.69 [− 0.98,-0.39 79% P < 0.00001*
  Sensitivity analysis (QI> 75%) 3 79 65 −0.69 [− 0.98,-0.39 79% P < 0.00001*
Temporalis muscle anterior part Meta-analysis 4 89 75 −0.67[−0.88,-0.45] 47% P < 0.00001*
  Sensitivity analysis (QI> 75%) 2 49 35 −0.65 [−1.03,-0.27] 63% P = 0.0008*
Temporalis muscle central part Meta-analysis 3 64 50 −0.70 [−0.93,-0.47] 37% P < 0.00001*
  Sensitivity analysis (QI> 75%) 2 49 35 −0.64 [−1.02,-0.25] 67% P = 0.001*
Temporalis muscle posterior part Meta-analysis 3 64 50 −0.95 [−1.15,-0.75] 0% P < 0.00001*
  Sensitivity analysis (QI> 75%) 2 49 35 −1.02 [−1.25,-0.79] 0% P < 0.00001*
Average over multiple sites including the splenius capitis and trapezius Meta-analysis 3 136 102 −0.87 [−1.44,-0.31] 0% P = 0.002*
  Sensitivity analysis (QI> 75%) 3 136 102 −0.87 [−1.44,0.31] 0% P = 0.002*
GON Meta-analysis 2 40 40 −3.46 [−9.43,2.52] 99% P = 0.26
  Sensitivity analysis (QI> 75%) 1 N/A N/A N/A N/A N/A
Suboccipital Meta-analysis 2 50 50 −0.80 [−0.85,-0.75] 0% P < 0.00001*
  Sensitivity analysis (QI> 75%) 2 50 50 −0.80 [− 0.85,-0.75] 0% P < 0.00001*
Strength Extensors Meta-analysis 6 207 228 −11.13 [−16.66,-5.6] 26% P < 0.0001*
  Sensitivity analysis (QI> 75%) 4 169 154 −10.89 [− 17.64, −4.15] 53% P = 0.002*
Flexors Meta-analysis 6 207 228 −4.72 [−8.98,-0.45] 47% P = 0.01*
  Sensitivity analysis (QI> 75%) 4 169 154 −5.00 [−9.25, −0.75] 64% P = 0.03*
Lateral flexors Meta-analysis 3 95 101 −12.82 [−24.96,-0.68] 91% P = 0.04*
  Sensitivity analysis (QI> 75%) 3 95 101 −12.82 [−24.96,-0.68] 91% P = 0.04*
LOS Average reaction time Meta-analysis 2 130 60 0.00 [−0.58,0.59] 96% P = 0.99
  Sensitivity analysis (QI> 75%) 1 N/A N/A N/A N/A N/A
EMG CCFT 22 mmHg Upper trapezius Meta-analysis 2 120 54 6.18 [2.65,9.71] 0% P = 0.0006**
  Sensitivity analysis (QI> 75%) 2 120 54 6.18 [2.65,9.71] 0% P = 0.0006**
Splenius Meta-analysis 2 120 54 3.38 [−0.82,7.58] 79% P = 0.12
  Sensitivity analysis (QI> 75%) 2 120 54 3.38 [−0.82,7.58] 79% P = 0.12
Sternocleidomastoid muscle Meta-analysis 2 120 54 0.95 [−2.49,4.40] 22% P = 0.59
  Sensitivity analysis (QI> 75%) 2 120 54 0.95 [−2.49,4.40] 22% P = 0.59
Anterior scalene Meta-analysis 2 120 54 2.87 [0.81,4.94] 0% P = 0.006**
  Sensitivity analysis (QI> 75%) 2 120 54 2.87 [0.81,4.94] 0% P = 0.006**
EMG CCFT 30 mmHg Upper trapezius Meta-analysis 2 120 54 8.12 [4.33,11.91] 1% P < 0.0001**
  Sensitivity analysis (QI> 75%) 2 120 54 8.12 [4.33,11.91] 1% P < 0.0001**
Splenius Meta-analysis 2 120 54 6.11 [−1.52,13.75] 90% P = 0.12
  Sensitivity analysis (QI> 75%) 2 120 54 6.11 [−1.52,13.75] 90% P = 0.12
Sternocleidomastoid muscle Meta-analysis 2 120 54 1.12 [−8.92,11.15] 72% P = 0.83
  Sensitivity analysis (QI> 75%) 2 120 54 1.12 [−8.92,11.15] 72% P = 0.83
Anterior scalene Meta-analysis 2 120 54 5.99 [0.03,11.94] 75% P = 0.05
  Sensitivity analysis (QI> 75%) 2 120 54 5.99 [0.03,11.94] 75% P = 0.05
Trigeminocervical reflex Latency, ms Meta-analysis 2 45 47 0.29 [−2.75,3.34] 56% P = 0.85
  Sensitivity analysis (QI> 75%) 0 N/A N/A N/A N/A N/A
Amplitude, mV Meta-analysis 2 45 47 −0.34 [−0.83,0.15] 94% P = 0.17
  Sensitivity analysis (QI> 75%) 0 N/A N/A N/A N/A N/A
  1. ROM Range Of Motion, FRT Flexion Rotation Test, JPE Joint Position Error, PPT Pressure Pain Threshold, LOS Limits Of Stability, CCFT craniocervical flexion test, QI Quality Index
  2. *Direction of effect found for migraine
  3. **Direction of effect found for asymptomatic individuals