Bilateral Cervical Manipulation (C3/C4) on Thoracoabdominal Kinematics

NCT ID: NCT04398160

Last Updated: 2024-04-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-30

Study Completion Date

2024-12-31

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Healthy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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HVLA manipulation

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.

Group Type EXPERIMENTAL

HVLA C3/C4 manipulation

Intervention Type OTHER

The investigator will apply an anterior and lateral translation associated with extension, homolateral inclination and contralateral rotation of the cervical. This procedure will increase the tension of the soft tissues to reduce the remaining slack and, finally, the thrust will be applied in pure rotation. Subsequently the head of the volunteer will be repositioned in the neutral position without applying any pressure and will wait 10 seconds in this position. Finally, the previous procedure will be repeated to the opposite side.

Sham technique

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.

Group Type SHAM_COMPARATOR

Sham technique

Intervention Type OTHER

The investigator will apply an anterior and lateral translation associated with extension, homolateral inclination and contralateral rotation of the cervical until the perception of tissue tension at the point of contact, holding this position for 10 seconds. The investigator then repositions the head of the volunteer in the neutral position without applying pressure, holding again this position for 10 seconds. Finally, the previous procedure will be repeated for the opposite side.

No intervention group

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

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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HVLA C3/C4 manipulation

The investigator will apply an anterior and lateral translation associated with extension, homolateral inclination and contralateral rotation of the cervical. This procedure will increase the tension of the soft tissues to reduce the remaining slack and, finally, the thrust will be applied in pure rotation. Subsequently the head of the volunteer will be repositioned in the neutral position without applying any pressure and will wait 10 seconds in this position. Finally, the previous procedure will be repeated to the opposite side.

Intervention Type OTHER

Sham technique

The investigator will apply an anterior and lateral translation associated with extension, homolateral inclination and contralateral rotation of the cervical until the perception of tissue tension at the point of contact, holding this position for 10 seconds. The investigator then repositions the head of the volunteer in the neutral position without applying pressure, holding again this position for 10 seconds. Finally, the previous procedure will be repeated for the opposite side.

Intervention Type OTHER

Eligibility Criteria

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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.
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Escola Superior de Tecnologia da Saúde do Porto

OTHER

Sponsor Role lead

Responsible Party

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Natália Maria Oliveira Campelo

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Natália MO Campelo, PhD

Role: PRINCIPAL_INVESTIGATOR

Escola Superior de Tecnologia da Saúde do Porto

Locations

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Escola Superior da Saúde do Porto

Porto, , Portugal

Site Status

Countries

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Portugal

Central Contacts

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Natália MO Campelo, PhD

Role: CONTACT

00351 22 206 1000

References

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Siribumrungwong K, Sinchai C, Tangtrakulwanich B, Chaiyamongkol W. Reliability and Accuracy of Palpable Anterior Neck Landmarks for the Identification of Cervical Spinal Levels. Asian Spine J. 2018 Feb;12(1):80-84. doi: 10.4184/asj.2018.12.1.80. Epub 2018 Feb 7.

Reference Type BACKGROUND
PMID: 29503686 (View on PubMed)

Boussuges A, Gole Y, Blanc P. Diaphragmatic motion studied by m-mode ultrasonography: methods, reproducibility, and normal values. Chest. 2009 Feb;135(2):391-400. doi: 10.1378/chest.08-1541. Epub 2008 Nov 18.

Reference Type BACKGROUND
PMID: 19017880 (View on PubMed)

Hutting N, Kerry R, Coppieters MW, Scholten-Peeters GGM. Considerations to improve the safety of cervical spine manual therapy. Musculoskelet Sci Pract. 2018 Feb;33:41-45. doi: 10.1016/j.msksp.2017.11.003. Epub 2017 Nov 3.

Reference Type BACKGROUND
PMID: 29153924 (View on PubMed)

Kranenburg HA, Schmitt MA, Puentedura EJ, Luijckx GJ, van der Schans CP. Adverse events associated with the use of cervical spine manipulation or mobilization and patient characteristics: A systematic review. Musculoskelet Sci Pract. 2017 Apr;28:32-38. doi: 10.1016/j.msksp.2017.01.008. Epub 2017 Jan 23.

Reference Type BACKGROUND
PMID: 28171776 (View on PubMed)

de Camargo VM, Alburquerque-Sendin F, Berzin F, Stefanelli VC, de Souza DP, Fernandez-de-las-Penas C. Immediate effects on electromyographic activity and pressure pain thresholds after a cervical manipulation in mechanical neck pain: a randomized controlled trial. J Manipulative Physiol Ther. 2011 May;34(4):211-20. doi: 10.1016/j.jmpt.2011.02.002. Epub 2011 Mar 21.

Reference Type BACKGROUND
PMID: 21621722 (View on PubMed)

Moser N, Mior S, Noseworthy M, Cote P, Wells G, Behr M, Triano J. Effect of cervical manipulation on vertebral artery and cerebral haemodynamics in patients with chronic neck pain: a crossover randomised controlled trial. BMJ Open. 2019 May 28;9(5):e025219. doi: 10.1136/bmjopen-2018-025219.

Reference Type BACKGROUND
PMID: 31142519 (View on PubMed)

Bordoni B, Marelli F. The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment. J Multidiscip Healthc. 2015 Oct 30;8:489-94. doi: 10.2147/JMDH.S94702. eCollection 2015.

Reference Type BACKGROUND
PMID: 26586951 (View on PubMed)

Goyal M, Goyal K, Narkeesh K, Samuel AJ, Arumugam N, Chatterjee S, Sharma S. Efficacy of Osteopathic Manipulative Treatment Approach in the Patient with Pulmonary Fibrosis in Critical Care Outpatient Department. Indian J Crit Care Med. 2017 Jul;21(7):469-472. doi: 10.4103/0972-5229.210648.

Reference Type RESULT
PMID: 28808371 (View on PubMed)

Taylor HH, Murphy B. Altered sensorimotor integration with cervical spine manipulation. J Manipulative Physiol Ther. 2008 Feb;31(2):115-26. doi: 10.1016/j.jmpt.2007.12.011.

Reference Type RESULT
PMID: 18328937 (View on PubMed)

Perry J, Green A, Singh S, Watson P. A preliminary investigation into the magnitude of effect of lumbar extension exercises and a segmental rotatory manipulation on sympathetic nervous system activity. Man Ther. 2011 Apr;16(2):190-5. doi: 10.1016/j.math.2010.10.008. Epub 2010 Nov 23.

Reference Type RESULT
PMID: 21106433 (View on PubMed)

Mesquita Montes A, Tam C, Crasto C, Argel de Melo C, Carvalho P, Santos R, Vilarinho R, Vilas-Boas JP. Forward trunk lean with arm support affects the activity of accessory respiratory muscles and thoracoabdominal movement in healthy individuals. Hum Mov Sci. 2018 Oct;61:167-176. doi: 10.1016/j.humov.2018.07.011. Epub 2018 Aug 11.

Reference Type RESULT
PMID: 30107366 (View on PubMed)

Anderst WJ, Gale T, LeVasseur C, Raj S, Gongaware K, Schneider M. Intervertebral kinematics of the cervical spine before, during, and after high-velocity low-amplitude manipulation. Spine J. 2018 Dec;18(12):2333-2342. doi: 10.1016/j.spinee.2018.07.026. Epub 2018 Aug 22.

Reference Type RESULT
PMID: 30142458 (View on PubMed)

de Camargo VM, Alburquerque-Sendín F, Bérzin F, Stefanelli VC, Rodrigues Pedroni C, & Santos K. Immediate Effects of the Ashmore Manipulation Technique C5/C6, in Muscle Activity in patients with Mechanical Neck Pain. European Journal Osteopathy & Clinical Related Research, 2012; 7(1), 2-9.

Reference Type RESULT

Other Identifiers

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OST1-003

Identifier Type: -

Identifier Source: org_study_id

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