The effect of whole-body resistance exercise versus non-exercise on primary headaches: A scoping review and exploratory meta-analysis

Abstract

Background: Whole-body resistance exercise is a popular training method that enhances strength and muscle hypertrophy. Little is known about the effect of this type of exercise on primary headaches. This scoping review and exploratory meta-analysis aim to elucidate the existing state of knowledge of whole-body resistance exercise as a non-pharmacological treatment of primary headaches compared to non-exercise. Methods: Following the PRISMA Extension for Scoping Reviews guidelines and the Cochrane handbook, we conducted a literature search in Embase, Medline, Amed, PEDro, and Web of Science. Methodological quality was assessed using the Cochrane 2.0 tool to characterize the evidence base. An exploratory meta-analysis was conducted using a random-effect model. Results: We identified notable gaps in the evidence base, with only two studies on migraine (18 participants) and vestibular migraine (286 participants), respectively, meeting the inclusion criteria. No studies were found for cluster headache or tension-type headache. The interventions consisted of 8 to 12 weeks of whole-body resistance exercise with two to three sessions per week, utilizing 45% to 80% of 1-repetition-maximum. The exploratory meta-analyses showed a standardized mean difference of −1.69 [95% CI −2.26, −1.13] for headache/vertigo intensity and −1,31 [95% CI −2.05, −0.56] for headache/vertigo frequency between exercise and no exercise. Quality assessments revealed major methodological limitations in both studies. Conclusion: This scoping review identified substantial evidence gaps regarding whole-body resistance for primary headaches. While exploratory analyses suggest benefits for people with migraine, the limited and low-quality evidence base indicates a need for well-designed studies—particularly for tension-type headaches and cluster headaches. Trial registration: The registration can be found under CRD42022343692 in PROSPERO. Registration details. Amendments from this protocol are explained in detail in the supplemental materials (Appendix 1).