Bilateral Cervical Manipulation (C3/C4) on Thoracoabdominal Kinematics

Escola Superior de Tecnologia da Saúde do Porto

Status: Not yet enrolling

Conditions: Healthy

Treatments: Other: Sham technique; Other: HVLA C3/C4 manipulation

Study type: Interventional

Funder types: Other

Identifiers

NCT04398160

OST1-003

Details and patient eligibility

About

There is evidence of the interdependence between the diaphragm and the C4 vertebral level with regard to nerve, fascial and muscular connections. The purpose of this study is to evaluate the influence of cervical bilateral manipulation (C3/C4) on the thoracoabdominal kinematics in healthy young adults.

Full description

Due to respiration the thoracoabdominal kinematics is considered a complex mechanism that evolves the movement of the ribs and fascia, the diaphragmatic function, the respiratory muscles and the mechanical properties of the airways that includes a coordinated reflex neural activity. The phrenic nerve (C3 to C5) is responsable for the motor and sensory innervation of the diaphragm.

The High Velocity Low Amplitude (HVLA) vertebral manipulation stimulates the corresponding spinal nerves. It is well known that when this manipulation is applied to cervical region induces vasomotor cutaneous and cardiorespiratory modifications in autonomic nervous system.

The sample composed of healthy young adults (aged 18-40 years) will be assigned randomly in three groups: experimental group (bilateral C3/C4 HVLA manipulation), sham manipulation group (passive cervical mobilization) and control group (no intervention). The thoracoabdominal kinematics measures will be assessed at baseline, right after the intervention and five minutes after the second measure using the Qualisys Motion Capture System.

Enrollment: 90 estimated patients

Sex: All

Ages: 18 to 40 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Volunteers between 18 and 40 years of age.

Exclusion criteria

• Attending a degree in Osteopathy or being a health professional in this area;
• Apprehension to cervical manipulation;
• Be pregnant;
• Presenting cervical pain on the day of the study;
• Does not comply with the Australian Vertebral Artery Protocol guidelines;
• Having a clinical history of cervical and/or thoracoabdominal surgery;
• Having a clinical history of cervical trauma during the prior 12 months;
• Recurrent use of anti-coagulant and/or analgesic, muscle relaxant or anti-inflammatory therapeutics during the week before the study;
• Have been submitted to any manual intervention at cervical region during the week before the study;
• Having cardio-respiratory, neurological, rheumatic, oncologic and/or systemic diagnosed pathologies.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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90 participants in 3 patient groups

HVLA manipulation

Experimental group

Description:

In the intervention of the experimental group, the investigator will be primarily on the right side of the volunteer and identify C3 through the cervical reference of jaw angle, which is at the disc level between C2/C3 and then contact with the phalanges of third metacarpal in the left transverse of this vertebra. The volunteer will be seated with 110º of hip and knee flexion using a digital goniometer and will be asked to breath normally.

Treatment:

Other: HVLA C3/C4 manipulation

Sham technique

Sham Comparator group

Description:

The investigator will be primarily on the right side of the volunteer and identify the C3 vertebra, having as anatomical reference the angle of the jaw, which is at the disc level between C2/C3 and then contact, with the phalanges of the third metacarpal, the left transverse apophysis of this vertebra. The volunteer will be seated with 110º of hip and knee flexion using a digital goniometer and will be asked to breath normally.

Treatment:

Other: Sham technique

No intervention group

No Intervention group

Description:

The volunteer will be seated with 110º of hip and knee flexion using a digital goniometer and will be asked to breath normally.