The Relationship Between Migraines and The Gut-Brain Axis from the Physical Therapy Scope: A Scoping Review

This scoping review sought to answer two major questions: what role does the gut-brain axis play in migraines, and what is the scope of physical therapy in addressing these issues. The methodological process of this scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. Databases utilized in this review include PubMed, Physical Therapy and Rehabilitation Journal, EBSCO, Google Scholar, and EBSCO Cinahl Complete, Elsevier, Cumulative Index of Nursing and Allied Health, American Psychological Association, SPORTDiscus, ProQuest: Dissertation Abstracts International, Cochran Collaboration, PEDro, OT Seeker, American Speech-Language-Hearing Association, American Physical Therapy Association, The Web of Science, and Stanford University: Highwire Press. There were a total of 61 articles included in the final analysis using the inclusion criteria of peer reviewed, academic journals, published within the last 10 years, and English only, and all subjects within the studies to be 18 years or older. The results showed migraines are closely tied to overall systemic health, reflecting a complex connection between the nervous system and other bodily systems, particularly the gut-brain axis. To support patients in managing their migraines, clinicians should focus on personalized care that involves collaboration, shared decision-making, and practical problem-solving. This approach can help improve self-management skills and enhance quality of life. ¹⁸ Diet and nutrition has been seen to affect the relationship between the gut-brain axis and migraine intensity, frequency, and duration meaning that it can be used as a variable in the treatment of migraine. Along with diet, the relationship between exercise and migraine is multifaceted, with evidence supporting both its prophylactic potential and its role as a possible trigger. Regular physical activity, particularly aerobic exercise, appears to reduce migraine frequency, intensity, and duration while improving quality of life and addressing comorbid conditions such as obesity, hypertension, and psychiatric disorders. ⁴³,⁴⁹. Diet and exercise can play a vital role in the development of migraine and therefore since there is a scope of nutrition under physical therapy practice guidelines, physical therapists should be implementing nutrition screening and generalized advice along with looking for opportunities to refer to collogues within the diet and nutrition realm to encourage interprofessional care and truly model a multimodal experience for all patients.