Mechanism-Based Cervical Rehabilitation for Chronic Migraine

To investigate the effectiveness of mechanism-based cervical sensorimotor rehabilitation on cervical muscle activation, cervical proprioception, and migraine burden.

Inclusion Criteria: * Male or female adults aged 18-55 years. Diagnosed with chronic migraine according to the International Classification of Headache Disorders, Third Edition (ICHD-3), defined as headache occurring on ≥15 days per month for more than 3 months, with migraine features present on at least 8 days per month. History of migraine for at least 12 months prior to enrolment. Experiencing chronic migraine during the previous three months, confirmed through clinical history and/or headache diary. Presence of cervical sensorimotor impairment, demonstrated by at least one of the following: Increased cervical joint position error. Reduced cervical range of motion. Impaired cervical motor control. Neck pain or cervical dysfunction associated with migraine. Exclusion Criteria: * • Diagnosis of headache disorders other than chronic migraine (e.g., cervicogenic headache, cluster headache, or medication-overuse headache). Previous cervical spine surgery, fracture, or significant cervical trauma. Cervical radiculopathy, myelopathy, or severe cervical spine pathology. Neurological disorders other than migraine (e.g., stroke, multiple sclerosis, Parkinson's disease). Vestibular disorders affecting balance or proprioception. Inflammatory or systemic musculoskeletal diseases (e.g., rheumatoid arthritis, ankylosing spondylitis). Pregnancy or breastfeeding. Physiotherapy, chiropractic treatment, acupuncture, or cervical rehabilitation within the previous 3 months. Botulinum toxin injections or cervical pain interventions within the previous 3-4 months. Changes in migraine preventive medication within the previous 4 weeks. Skin conditions preventing surface EMG electrode placement. Inability to comply with the study protocol or provide informed consent.