Kopfschmerz und Sport

Zusammenfassung

Aerober Ausdauersport ist Bestandteil von multidisziplinären Kopfschmerzbehandlungsprogrammen. Die aktuelle Datenlage spricht am ehesten für eine Wirksamkeit von regelmäßigem Ausdauersport mittlerer Intensität mit Aufwärmtraining zu Therapiebeginn. Ob bestimmte Sportarten zu bevorzugen sind, ist nicht bekannt. Sinnvoll ist die Anleitung durch einen ausgebildeten Trainer. Die Wirkmechanismen, die Sport in der Migränepropylaxe effektiv machen könnten sind letztlich unbekannt. Leistungssport ist – gerade bei untrainierten – mit dem Risiko von Kopfschmerzen verbunden. Der Anstrengungskopfschmerz kann durch langsam ansteigende Trainingsintensität, Betablocker und akut mit Indometacin oder Triptanen behandelt werden.

Abstract

Aerobic endurance training is an important element in multidisciplinary headache treatment programmes. Current available data recommend aerobic endurance training after a warm-up. It is not known which type of sport should be favoured. Instruction by a qualified trainer is recommended. The exact mechanisms of action of sports in migraine prophylaxis are not well understood. Competitive sports – especially in untrained persons – may cause headache. Primary exertional headache can be avoided by slowly increasing activity, prophylactic intake of beta-blockers or indomethacine.

Schlüsselwörter

Ausdauersport - Kopfschmerz - Migräne

Keywords

aerobic endurance training - headache - migraine

• Literatur

• 1 Evers S, Afra J, Frese A et al. European Federation of Neurological Societies. EFNS guideline on the drug treatment of migraine-revised report of an EFNS task force. Eur J Neurol 2009; 16: 968
• 2 Evers S, May A, Fritsche G et al. Akuttherapie und Prophylaxe der Migräne. Leitlinie der Deutschen Migräne- und Kopfschmerzgesellschaft und der Deutschen Gesellschaft für Neurologie. Nervenheilkunde 2008; 27: 933-949
• 3 Berger A, Bloudek LM, Varon SF et al. Adherence with Migraine Prophylaxis in Clinical Practice. Pain Pract Feb 2 2012; [Epub ahead of print]
• 4 Gaul C, van DC, Webering N et al. Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study. J Headache Pain 2011; 12: 475-483
• 5 Kinart CM, Cuppett MM, Berg K. Prevalence of migraines in NCAA division I male and female basketball players. National Collegiate Athletic Association. Headache 2002; 42: 620-629
• 6 Linde K, Witt CM, Streng A et al. The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain 2007; 128: 264-271
• 7 The International Classification of Headache Disorders: 2^nd edition. Cephalalgia 2004; 24 (Suppl. 01) 9-160
• 8 Dishman RK, Ickes W. Self-motivation and adherence to therapeutic exercise. J Behav Med 1981; 4: 421-438
• 9 Martin JE, Dubbert PM. Adherence to exercise. Exerc Sport Sci Rev 1985; 13: 137-167
• 10 Tfelt-Hansen P, Block G, Dahlof C et al. Guidelines for controlled trials of drugs in migraine: second edition. Cephalalgia 2000; 20: 765-786
• 11 Busch V, Gaul C. Exercise in migraine therapy – is there any evidence for efficacy? A critical review. Headache 2008; 48: 890-899
• 12 Koseoglu E, Akboyraz A, Soyuer A et al. Aerobic exercise and plasma beta endorphin levels in patients with migrainous headache without aura. Cephalalgia 2003; 23: 972-976
• 13 Narin SO, Pinar L, Erbas D et al. The effects of exercise and exercise-related changes in blood nitric oxide level on migraine headache. Clin Rehabil 2003; 17: 624-630
• 14 Fischer H, Heller R, Giesler A et al. Ausdauertraining bei Migräne: eine Pilotstudie. In: Regulations- und Repairmechanismen. 33. Deutscher Sportärztekongress. Edited by Liesen H, Weiß M, Baum H. Paderborn Köln: Deutscher Ärzteverlag; 1994: 807-808
• 15 Fitterling JM, Martin JE, Gramling S et al. Behavioral management of exercise training in vascular headache patients: an investigation of exercise adherence and headache activity. J Appl Behav Anal 1988; 21: 9-19
• 16 Gerber W, Miltner W, Gabler H et al. Bewegungs- und Sporttherapie bei chronischen Kopfschmerzen. In: Vorgebnisse und Perspektiven interdisziplinärer Forschung. Edited by Gerber W, Miltner W, Mayer K. edition medizin; 1987: 55-66
• 17 Grimm L, Douglas D, Hanson P. Aerobic training in the prophylaxis of migraine. Med Sci Sports Exerc 2012; 13
• 18 Lockett DM, Campbell JF. The effects of aerobic exercise on migraine. Headache 1992; 32: 50-54
• 19 Varkey E, Cider A, Carlsson J et al. A study to evaluate the feasibility of an aerobic exercise program in patients with migraine. Headache 2009; 49: 563-570
• 20 Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 1970; 2: 92-98
• 21 Ekblom B, Engstrom LM, Ekblom O. Secular trends of physical fitness in Swedish adults. Scand J Med Sci Sports 2007; 17: 267-273
• 22 Macsween A. The reliability and validity of the Astrand nomogram and linear extrapolation for deriving VO2max from submaximal exercise data. J Sports Med Phys Fitness 2001; 41: 312-317
• 23 Strand PO, Ryhming I. A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during sub-maximal work. J Appl Physiol 1954; 7: 218-221
• 24 Wilmore JH, Costill DL, Kenney WL. Physiology of Sport and Exercise. Human Kinetics 2008;
• 25 Darabaneanu S, Overath CH, Rubin D et al. erobic exercise as a therapy option for migraine: a pilot study. Int J Sports Med 2011; 32: 455-460
• 26 Varkey E, Cider A, Carlsson J et al. Exercise as migraine prophylaxis: A randomized study using relaxation and topiramate as controls. Cephalalgia 2011; 31: 1428-1438
• 27 Boecker H, Sprenger T, Spilker ME et al. The runner’s high: opioidergic mechanisms in the human brain. Cereb Cortex 2008; 18: 2523-252331
• 28 Boecker H, Henriksen G, Sprenger T et al. Positron emission tomography ligand activation studies in the sports sciences: measuring neurochemistry in vivo. Methods 2008; 45: 307-318
• 29 Wedekind D, Broocks A, Weiss N et al. A randomized, controlled trial of aerobic exercise in combination with paroxetine in the treatment of panic disorder. World J Biol Psychiatry 2010; 11: 904-913
• 30 Craft LL, Perna FM. The Benefits of Exercise for the Clinically Depressed. Prim Care Companion J Clin Psychiatry 2004; 6: 104-111
• 31 Fisher JP, Fadel PJ. Therapeutic strategies for targeting excessive central sympathetic activation in human hypertension. Exp Physiol 2010; 95: 572-580
• 32 Chodorowski Z, Sein Anand J. Acute poisoning with clenbuterol – a case report. Przegl Lek 1997; 54: 763-764
• 33 Pestronk A, Pestronk S. Goggle migraine. N Engl J Med 1983; 308: 226-227
• 34 Swain R, Rosencrance G. Headache occurrence and classification among distance runners. W V Med J 1999; 95: 76-79
• 35 Williams SJ, Nukada H. Sport and exercise headache: Part 1. Prevalence among university students. Br J Sp Med 1994; 28: 90-95
• 36 McCrory P. Headaches and exercise. Sports Med 2000; 30: 221-229
• 37 Matthews WB. Footballerʼs migraine. Br Med J 1972; 2: 326-327
• 38 Indo T, Takahashi A. Swimmer’s migraine. Headache 1990; 30: 485-487
• 39 Sallis RE, Jones K. Prevalence of headaches in football players. Med Sci Sports Exerc 2000; 32: 1820-1824
• 40 Keidel M, Diener H-C. Der posttraumatische Kopfschmerz. Nervenarzt 1997; 68: 769-777
• 41 McCrory P, Heywood J, Ugoni A. Open label study of intranasal sumatriptan (Imigran) for footballer’s headache. Br J Sports Med 2005; 39: 552-554
• 42 Haas DC, Pineda GS, Lourie H. Juvenile head trauma syndromes and their relationship to migraine. Arch Neurol 1975; 32: 727-730
• 43 Plager DA, Purvin V. Migraine precipitated by head trauma in athletes. Am J Ophthalmol 1996; 122: 277-278
• 44 Rooke ED. Benign exertional headache. Med Clinics North Am 1968; 52: 801-808
• 45 Powell B. Weight lifterʼs cephalgia. Ann Emerg Med 1982; 11: 449-451
• 46 Lambert RW, Burnet DL. Prevention of exercise induced migraine by quantitative warm-up. Headache 1985; 25: 317-331
• 47 Richalet JP, Larmignat P, Poitrine E et al. Physiological risk factors for severe high-altitude illness: a prospective cohort study. Am J Respir Crit Care Med 2012; 185: 192-198
• 48 Burtscher M, Likar R, Nachbauer W et al. Aspirin for prophylaxis against headache at high altitudes: randomised, double blind, placebo controlled trial. Br Med J 1998; 316: 1057-1058
• 49 Yarnell PR, Heit J, Hackett PH. High-altidude cerebral edema (HACE): the Denver/Front Range experience. Semin Neurol 2000; 20: 209-217
• 50 Mairer K, Wille M, Burtscher M. The prevalence of and risk factors for acute mountain sickness in the Eastern and Western Alps. High Alt Med Biol 2010; 11: 343-348
• 51 Burtscher M, Mairer K, Wille M et al. Risk factors for high-altitude headache in mountaineers. Cephalalgia 2011; 31: 706-711
• 52 Diamond S, Solomon GD, Freitag FG. Headache in Sports. In: Jordan BD, Tsairis P, Warren RF. (eds.). Sports neurology. Rockville: Aspen Pub.; 1989: 127-132
• 53 Massey EW. Effort headache in runners. Headache 1982; 22: 99-100
• 54 Evans RW, Wilmshurst P, Nightingale S. Is cardiac evaluation for a possible right-to-left shunt indicated in a scuba diver with migraine with aura?. Headache 2003; 43: 294-295
• 55 Eichner ER. Treatment of suspected heat illness. Int J Sports Med 1998; 19 (Suppl. 02) 150-153
• 56 Wei JH, Wang HF. Cardiac cephalalgia: case reports and review. Cephalalgia 2008; 28: 892-896