The Effects of Aerobic Exercise on Pediatric Headache-Related Disability and Quality of Life: A Pilot Randomized Controlled Trial.

This pilot randomized-controlled trial aimed to evaluate the impact of aerobic exercise on (1) headache-related disability, via the Pediatric Migraine Disability Assessment Scale, and (2) quality of life, via the Pediatric Quality of Life Inventory and KIDSCREEN-27. Participants (8-17 years of age) were randomized at an initial 1:1 ratio revised to 2:1 to a 4-week at-home program of daily aerobic exercise or stretching. Nineteen participants (89% female, mean age = 14.3 ± 2.2 years) completed the study. There were clinically meaningful differences in headache-related disability in both groups from baseline to post-study (standardized mean change, Hedges' g, in aerobic exercise group: 0.53 [95% CI: -0.29, 1.35]; stretching group: 0.71 [95% CI: -0.27, 1.66]), but no differences in quality of life (P values ranging from 0.06 to 1.00 across all domains). When considered alongside the broader health benefits of exercise documented elsewhere, our findings represent a preliminary signal warranting further investigation of exercise training as a potential care pathway for pediatric headache. Given our limited sample size, these findings should be interpreted with caution, and alone are insufficient to inform clinical recommendations. This study was limited by poor enrollment over 5 years and higher rates of drop-out in the aerobic exercise group. Future studies should seek to define and overcome feasibility barriers associated with exercise-based interventions.