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Effects of Suboccipital Release on Sensorial and Functional Parameters

B

Bezmialem Vakif University

Status

Completed

Conditions

Suboccipital Muscles

Treatments

Other: Suboccipital manual therapy
Diagnostic Test: Cervical Joint Position Sense
Diagnostic Test: Cervical Range of Motion
Diagnostic Test: Balance Error Scoring
Diagnostic Test: Pain Pressure Threshold

Study type

Interventional

Funder types

Other

Identifiers

NCT06761391
Bvu1903

Details and patient eligibility

About

Suboccipital release is a straightforward technique beneficial for addressing musculoskeletal complaints like neck pain and headaches. This versatile method aids the autonomic system by manipulating the occipital-atlanto region, specifically regulating the parasympathetic system rather than the sympathetic system targeted by most osteopathic treatments. Studies indicate this technique enhances range of motion and balance in the lower extremities of both healthy and pre-existing patients due to fascia connections throughout the body. Suboccipital muscle release increases cervical spine range of motion, facilitating physical therapy. Myofascial release significantly boosts joint flexibility and range of motion (ROM) without reducing strength or performance. The rectus capitus posterior minor (RCPM) muscle, dense with spindles, is crucial in the suboccipital region for balance and pain proprioception. Trauma-induced atrophy in this muscle is strongly linked to chronic neck pain and reduced standing balance. A case report showed that a patient undergoing a personalized balance program exhibited significant balance improvement, suggesting that balance training should be considered for cervicogenic pain intervention strategies. Neck muscle spasms or fatigue can impair proprioception and postural control, with prolonged unilateral cervical muscle contraction increasing neck proprioceptor sensitivity. Muscle fatigue-related interstitial inflammatory mediators can sensitize muscle spindles. This study will explore suboccipital relaxation's acute effects on pressure pain threshold, range of motion, balance, and joint position sense in healthy individuals based on existing literature.

Full description

Suboccipital release is a relatively easy technique that a person can use to help with musculoskeletal complaints such as neck pain and headaches. This technique is also very versatile and can help regulate the autonomic system in the body due to the manipulation of the occipital-atlanto region. This technique has been noted to regulate the parasympathetic system rather than the sympathetic system that most osteopathic treatments target. Studies have shown that this technique improves range of motion and balance in the lower extremities of healthy and pre-existing patients due to the connection of the fascia throughout the body. The release of the suboccipital muscles increases the range of motion of the cervical spine, which makes it easier for the physical therapist. Myofascial release has been shown to significantly increase joint flexibility and range of motion (ROM) without causing any loss of strength or decreased performance . Studies on the rectus capitus posterior minor (RCPM) muscle indicate that it is one of the most important muscles in the suboccipital region. Because of the high density of muscle spindles, it is presumed that this muscle plays a role as a proprioceptive monitor important for balance and pain. Trauma has been shown to cause atrophy in this muscle, and this atrophy is strongly associated with chronic neck pain and decreased standing balance (4). A case report has shown that a patient who underwent a personalized balance program showed significant improvement in balance as measured by sensory organization testing; this improved balance control suggests that balance training should be considered when determining appropriate intervention strategies for patients with cervicogenic pain. Neck muscle spasms or fatigue can alter proprioception and postural control, and prolonged contraction of unilateral cervical muscles can significantly increase the sensitivity of neck proprioceptors. Interstitial inflammatory mediators produced by muscle fatigue can sensitize muscle spindles. The acute effects of suboccipital relaxation on pressure pain threshold, range of motion, balance, and joint position sense in healthy individuals have been examined in the literature.

Enrollment

30 patients

Sex

All

Ages

18 to 55 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Volunteers willing to participate in the study.

Exclusion criteria

Diagnosed with an upper extremity musculoskeletal system disease. Experiencing chronic headaches or migraine complaints. Presence of any pathology causing sensory or balance impairments. Diagnosed with a pathology in the cervical regio

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

30 participants in 2 patient groups

Suboccipital Myofascial Release
Experimental group
Description:
The application will be done in the supine position. The therapist will sit on the stool at the head of the stretcher with his/her forearm in contact with the stretcher. After palpating the occiput condyles with his/her fingers, the therapist will place his/her fingers in the slightly concave area between the occiput and the spinous process of the second cervical vertebra. The therapist will lift the participant's head a little by bending the metacarpophalangeal joints. While the base of the participant's skull is in the therapist's palm, the therapist will apply pressure equal to the weight of the participant's head with his/her second, third and fourth fingers on the participant's rectus capitis posterior and obliqus capitis superior muscles for 5 minutes. In order for eye movements not to affect the suboccipital muscle tone, the participants will be asked to close their eyes during the application.
Treatment:
Diagnostic Test: Pain Pressure Threshold
Diagnostic Test: Balance Error Scoring
Diagnostic Test: Cervical Joint Position Sense
Diagnostic Test: Cervical Range of Motion
Other: Suboccipital manual therapy
Suboccipital Hold
Sham Comparator group
Description:
No suboccipital relaxation will be applied to the control group, and the experimental group will be kept in contact with the suboccipital region for the same period of time, namely 5 minutes, and the measurements will be recorded before and after the application.
Treatment:
Diagnostic Test: Pain Pressure Threshold
Diagnostic Test: Balance Error Scoring
Diagnostic Test: Cervical Joint Position Sense
Diagnostic Test: Cervical Range of Motion
Other: Suboccipital manual therapy

Trial contacts and locations

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Data sourced from clinicaltrials.gov

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