Exercise interventions in migraine patients: a YouTube content analysis study based on grades of recommendation

BACKGROUND: Migraine is the second leading cause of disability worldwide, engendering a high economic cost in developed countries. The adverse events related to pharmacological treatment use have increased interest in non-pharmacological interventions such as exercise. YouTube offers a public source of information for migraine patients regarding exercise interventions for migraine improvement. However, this information has not been validated to ensure the quality and validity of its content. OBJECTIVE: This qualitative content analysis study aims to review and evaluate YouTube videos regarding exercise for migraine. METHODS: A systematic review of the current evidence regarding exercise for migraine was performed to establish evidence classification and grades of recommendation with the Scottish Intercollegiate Guidelines Network tool. The data sources were PubMed, PEDro, Cochrane, EBSCO, Google Scholar and Web of Science. The quality of YouTube videos on exercise in migraine was reviewed using the Global Quality Scale and DISCERN scale. Finally, the classification in grades of recommendation was used to evaluate the included videos in terms of the various exercise modalities. RESULTS: The classification into recommendation grades showed a grade B for aerobic exercise, yoga and changes in lifestyle behavior regarding exercise. A total of 129 videos were included. The healthcare and exercise professional authors produced higher quality videos with a significant statistical difference, although the alternative therapists and patients’ videos had a greater impact and a higher viewership based on correlation analysis. The evaluation of the videos based on the recommendation grades could only include 90 videos. 71% of these videos showed a B grade of recommendation, which corresponded to fewer than half of the total included videos. CONCLUSIONS: YouTube needs higher quality videos on exercise for migraine, and healthcare and exercise professional authors need to improve their scoping strategies to acquire more views. The authors of YouTube videos should have better access to the best current evidence regarding exercise interventions in migraine.