BackgroundThe aim of the proposed study is to analyze the effect of a six-week osteopathic visceral manipulation (OVM) program on the flexion-relaxation phenomenon in individuals with non-specific chronic low back pain (LBP) and functional constipation.Methods/DesignAn assessor-blinded, two-arm, randomized, placebo-controlled trial will be conducted. The sample will comprise 76 individuals with non-specific chronic LBP who have functional intestinal constipation, aged 18–65 years. The participants will be randomly allocated to two groups: (1) OVM and (2) sham OVM (SOVM). Evaluations will involve an interview, the Oswestry Disability Index, Fear-Avoidance Beliefs Questionnaire, functional constipation according to Rome III criteria, Biering-Sorensen test to normalize electromyographic (EMG) data, T12–L1 paraspinal level of the EMG signal during the flexion-relaxation phenomenon, 11-point numeric pain rating scale and fingertip-to-floor test. OVM and SOVM will be performed once per week for six weeks. Group 1 will receive OVM for 15 min and Group 2 will receive a sham visceral technique. Evaluations will be performed before and after the first session, after six weeks of treatment, and three months after randomization (follow-up). The findings will be analyzed statistically considering a 5% significance level (p ≤ 0.05). The limitation of the study is that the therapist will not be blinded.DiscussionThis will be the first trial to analyze the clinical response and electromyographic signals during the flexion-relaxation phenomenon after OVM.Trial registrationBrazilian Clinical Trial Registry, RBR-7sx8j3. Registered on 26 October 2017. Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2532-8) contains supplementary material, which is available to authorized users.
RESUMO O objetivo desta pesquisa foi avaliar os efeitos de uma intervenção manipulativa sobre a atividade eletromiográfica dos músculos paraverterbais e a intensidade da dor na coluna lombar imediatamente e 30 minutos após sua realização em indivíduos com dor lombar crônica mecânica. Foram avaliados 38 indivíduos, distribuídos aleatoriamente em dois grupos: o que recebeu a técnica de manipulação vertebral global (n=20) e o controle (n=18), que permanecia em decúbito lateral por dez segundos sobre cada lado do corpo. O sinal eletromiográfico dos paravertebrais ao nível L4-L5 direito e esquerdo foi coletado durante três ciclos do movimento de flexão-relaxamento-extensão do tronco. Nos intervalos entre os ciclos, os participantes relataram a intensidade de dor através da Escala Visual Analógica (EVA 100 mm). Foi observada redução significativa na intensidade da dor no grupo que recebeu a manipulação, ao contrário do grupo controle, em que a pontuação na EVA aumentou. O tamanho do efeito na intensidade da dor foi de 1,0 e 0,9 logo após a manipulação e 30 minutos depois. A razão de flexão/relaxamento (RFR) aumentou no grupo que foi submetido à manipulação, mas permaneceu inalterada no grupo controle. A RFR exibiu tamanhos de 0,6 e 0,5 entre os grupos nas duas avaliações. Foi possível constatar efeitos da manipulação nessas duas variáveis e sua continuidade no intervalo observado, concluindo-se que eles perduram pelo menos durante esse tempo.
The aim of this study was to analyze the immediate effects of a manipulative intervention in chronic nonspecific low back pain and in the increase of global joint mobility. This cross-sectional, randomized and single-blind study, was composed by 19 women with 18 to 55 years, divided into two groups: experimental group (EG = 10) and control group (CG = 9). The evaluation consisted of a physical examination, Rolland Morris’s questionnaire, "distance fingers-floor" test, Visual Analogue Scale and algometry (spinous process L5) before and after the manipulative intervention. The EG volunteers underwent five vertebral manipulations: two in the pelvis (bilateral), one on the middle thoracic (T5-T7) and two in the neck (C3 bilateral). The volunteers of the CG were submitted to two placebos manipulative techniques. They lying in the right and left lateral decubitus for 10 seconds each, the same position of global manipulation in the pelvis, but without performing the manipulative impulse (thrust). The results were statistically significant to reduce pain (p <0.001) and increase global joint mobility (p <0.05) when comparing the pre and post intragroups. However, no statistic difference was observed in the pain threshold. We conclude that a manipulative intervention can reduce pain and increase global joint mobility immediately after the spinal manipulation.
DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n3p332 Physiological effects of thermal changes in tissues might influence some physical properties of muscle fibers, such as strength. The aim of this study was to compare the effects of cryotherapy and microwave diathermy application on the strength production capacity of the elbow flexor muscles. Thirty male, healthy and sedentary subjects, with average age of 22.40 (±3.42) years, participated in this prospective study. Participants were submitted to assessment of isometric strength production capability by an adapted load cell. Half of volunteers received cryotherapy on the first day of application and microwave diathermy (MD) 48 hours later, whereas the other half was treated the other way around. Cryotherapy was applied up to the temperature of the biceps region reached 25ºC, and MD was applied up to 42ºC. Six peak strength reevaluations were made over 2 hours. There was significant increase in peak strength (PS) up to 15 minutes after cryotherapy, then there was a decrease in maximum isometric strength, however, statistically significant difference remained up to 1 hour and 30 minutes after cryotherapy. In MD, PS decreased significantly after application until 15 min. From this moment, PS returned close to the initial value, and in the last assessment, PS reduced again. Cryotherapy and MD differently interfered in isometric muscle strength production capacity of elbow flexors, while cooling generated increment, heating caused decline.
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