The putative neuromodulatory effect on motor control may support the application of such ankle-foot orthoses in, for example, drop foot. Furthermore, the objective assessment of a neurophysiological mode of action of orthoses by Hoffmann reflex recordings might be an appropriate primary outcome parameter in clinical trials.

Background/aims Data on mechanical sensitivity and cutaneous allodynia in different types and phases of migraine headaches are limited. Existence and pattern of such symptoms may advance the understanding of neurophysiological mechanisms, assist clinical evaluation of the patients, and further improve management. Hence, in a large controlled study on migraine patients, mechanical sensitivity and cutaneous allodynia were assessed together with clinical markers. Methods Sensitivity to mechanical stimuli was measured in migraine patients during attack (within 2 h of headache onset), within remission phase (48–72 h after headache onset), and in pain-free periods (>5 days pain-free) in comparison with sex-and age-matched healthy controls. Pin-prick stimulation was performed in the temple region in the pain-referred side using weight-calibrated pins (8, 16, 32, 64, 128, 256 mN) in a randomized order (3 stimuli lasting 2 s), with the patient rating the sensation on a 10-point numerical scale. Pressure Pain Threshold (PPT) was assessed using a handheld algometer (1 cm2 rubber probe) over the anterior aspect of the temporal muscle (30 kPa/s, 3 times). Results Preliminary analysis revealed increased mechanical sensitivity to Pin-prick during all phases in migraine patients (n = 4) compared to healthy controls (n = 5), and likewise increased during attack and remission phases compared to pain-free periods within patients. PPT, assessing mainly muscle nociception, showed a tendency to decline during attack and remission phases (89 ± 13% and 82 ± 6%, respectively) compared to pain-free periods, with even higher sensitivity during attack and remission phases (80 ± 12% and 75 ± 11.1%, respectively) compared to healthy controls. Conclusions The current preliminary observed tendencies imply the presence of mechanical hypersensitivity in migraine patients with a notable change during attack and remission phases. This study is ongoing and no firm conclusion can be stated. In addition, alteration of mechanical sensitivity in different phases will be correlated to objective assessments of biological markers in serum specimens of the study population.