The Association of Headache and Physical Activity in Times of the COVID‐19 Pandemic: A Prospective Cohort Study

BACKGROUND: Prospective studies of the risk of headache with low levels of physical activity are limited. Pandemic-related lifestyle changes and the potential headache risk associated with Coronavirus Disease (COVID-19) and SARS-CoV-2 vaccination may complicate this association. Our study aims to investigate the potential risk of new bothersome headache in relation to physical activity and explore the impact of COVID-19 and SARS-CoV-2 vaccines on this association. METHODS: This prospective cohort study utilized questionnaires from the Norwegian Mother, Father, and Child Cohort Study (MoBa). Logistic regression analyses were conducted to estimate the adjusted odds ratio (aOR) for new-onset headache according to physical activity levels. Models were adjusted for gender, age, body mass index, education level, smoking, alcohol intake, anxiety/depression, and COVID-19 and SARS-CoV-2 vaccination prior to February 2022. The potential impact of COVID-19 disease was investigated in a stratified analysis. RESULTS: Both low level of physical activity and inactivity were significantly associated with new bothersome headache when compared to moderate to high activity levels (low activity: aOR 1.22, 95% CI 1.13 to 1.30; inactive: aOR 1.26, 95% CI 1.05 to 1.51). The corresponding adjusted absolute risk differences were 1.9% (95% CI 1.2 to 2.6) and 2.3% (95% CI 0.4 to 4.3), respectively. Findings persisted across COVID-19 status strata, without significant interactions. CONCLUSION: Our findings underscore the potential role of physical activity in mitigating new bothersome headache also for headache associated with COVID-19. Encouraging regular physical activity may serve as a preventive measure for headache in a pandemic setting.