Effects of Cervical Spine Mobilization on Respiratory Function and Cervical Angles of Stroke Patients: A Pilot Study

Abstract

The forward head posture (FHP) of stroke patients has a negative impact on respiratory function. Cervical spine mobilization is a manual therapy technique that used to prevent and treat FHP and respiratory function. This pilot study investigated whether cervical spine mobilization can effectively improve outcomes following FHP and respiratory function of stroke patients. Twenty-four patients participated in our assessor-blinded randomized controlled trial. All the participants received neurodevelopmental treatments (gait training and trunk rehabilitation). The experimental group additionally received 15-min sessions of cervical spine mobilization three times per week for 4 weeks. The control group received cervical spine sham mobilization during the same period. For the cervical angles, the cranial vertebral angle (CVA) and cranial rotation angle (CRA) were measured. A respiratory function test was performed to measure the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and chest circumferences (upper and lower chest sizes). Except for MIP, there was no significant difference between the experimental group and the control group. The CVA and CRA were significantly increased in the experimental group only. Cervical spine mobilization improved cervical angles and inspiratory function of the stroke patients in this study. However, a comparative study with a larger number of patients is needed to confirm this finding from our pilot study, which had a small sample size.

Effects of Cervical Mobilization on Balance and Gait Parameters in Individuals With Stroke: A Randomized Controlled Trial

“…In our study, we achieved greater improvement in FHP scores in the SG using CM. A limited number of past studies have shown that CM may improve FHP, cervical position sense, swallowing function, and respiratory function in SI (An et al, 2021; An & Park, 2021; Jeon et al, 2020). These results are consistent with ours.…”

The Effect of Sling-Based Manual Therapy and Stabilization Exercise for Improving Cervical Alignment and Mobility in Individual With Forward Head Posture

“…Spinal mobilization techniques used in manual spinal treatment activate the descending pathway from the peritubular gray region (PAG) of the midbrain, reduce superficial neck flexion, and increase deep flexor activity. It has a neurophysiological effect on the strength of the neck muscles 21 .…”

“…This intervention approach stepped forward tissue elasticity and range of motion around the neck, alleviated it, relaxation, impaired muscle function, and reduced soft tissue swelling and inflammation 16 . Pain alleviation may additionaly reduce motor system depression and partially enhance function 21 . Some research confimed that a combination of manual therapy and stabilizing exercise become extra powerful in treating FHP than stabilizing exercise alone 14,23,19 .…”

Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model

“…To assist the paralysis of the principal respiratory muscle and compensate for the decreased respiratory function of stroke patients, overuse of the respiratory accessory muscles, such as the sternocleidomastoid and scalenus muscles, may occur and may move the head forward [9]. This postural change affects the anteroposterior diameter of the chest cage as well as the volume of the lungs, thereby affecting the respiratory system [10].…”