Towards an objective quantitative assessment of daily functioning in migraine: a feasibility study

Migraine is a chronic disabling disorder, with migraine episodes significan tly reducing quality of life and leading to impaired functioning (physicall y, socially, emotionally) bath at home and at work. We explored whether amb ulatory accelerometry can be used as an objective method to quantify the be havioral aspects of migraine-related disability. Four body mounted uni-axia l piezo-resistive accelerometers were used to quantify the time spent in di fferent body postures (lying, sitting, standing), physical activities (walk ing, cycling) and a general index of body motility during eight migraine at tacks and subsequent recovery periods of six patients in their habitual env ironment. The migraine attacks and recovery periods could be monitored afte r about 1 h, which was the time required for the investigator to travel to the patient and for the sensors to be attached. Ln order to quantify the in fluence of a migraine episode on daily activities, we also performed measur ements during a headache-free baseline period of the same patients. Overall , the procedures functioned well, indicating that ambulatory accelerometry measurements before, during and after a migraine attack are feasible to per form. Furthermore, our quantitative data revealed that migraine always infl uenced behavior by reducing overall body motility and that, dependent upon the severity of the attack, the effectiveness of acute treatment and the ti me of day, the time spent in various body positions, dynamic activities, an d the number of postural transitions were affected. This feasibility study showed that ambulatory accelerometry can provide the objective behavioral e ffect parameters for the evaluation of migraine and its treatment on daily functioning in the habitual environment of migraine patients. (C) 2000 Inte rnational Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.