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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