POSTER AWARD 2018 – Visceral Manipulation decreases cervical pain and influence electromyographic activity of the upper trapezius muscle in patients with chronic nonspecific neck pain and functional dyspepsia – A randomized blind placebo-controlled pilot study

Authors: Andréia Cristina de Oliveira Silva (PT, DO, MSc), Daniela Aparecida Biasotto-Gonzalez (PT, PhD), Marco Antônio Fumagalli (Eng., PhD), Fabiano Politti (PT, PhD)

Introduction

Nonspecific neck pain (NS-NP) is a musculosceletal disorder often provided by multifactorial causes (1). Thereby, the ongoing afferent stimulation produced from a restriction of the mobility of tissues innervated by the phrenic nerve (2) and the anatomical relationship between the accessory nerve and the vagus nerve could promote facilitation of cerviacl levels (3). A pilot randomized placebo-controlled study was designed to evaluate the effect of visceral manipulation (stomach and liver) on pain, cervical mobility and electromyographic activity of upper trapezius (UT) muscle in individuals with NS-NP and dyspepsia.

 

Material and Methods

Participants: 28 individuals with NS-NP and symptoms related to functional dyspepsia were divided into two groups, visceral manipulation and placebo.

Primary outcome was Numeric Pain Rating Scale (NPRS), and secondary’s were pain area, cervical ROM, amplitude and muscle fiber conduction velocity (MFCV) obtained by surface electromyography (EMG) of the upper trapezius muscle.

 

Conclusion

The results show that a single visceral manipulation session for the stomach and liver reduces cervical pain and increases the amplitude of the upper trapezius muscle EMG signal immediately and seven days after treatment in patients with nonspecific neck pain anf functional dyspepsia. Patients treated with placebo manipulation demonstrated a significant decrease in pain after immediate treatment. The effect of this intervention on the cervical range of motion was inconclusive.

These results suggest that further investigation is necessary.

 

Literature

  • Binder A. The diagnosis and treatment of nonspecific neck pain and whiplash. Eura. Medicophys. 43, 79-89 (2007).
  • Standring S. Gray’s Anatomy: the Anatomical Basis of Clinical Practice. (Elsevier Health Sciences UK, 2008).
  • Shoja MM. et al. A comprehensive review with potential significance during skull base and neck operations, Part II: Glossopharyngeal, vagus, accessory, and hypoglossal nerves and cervical spinal nerves 1-4. Clin. Anat. 27, 131-144(2014).

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