Effects of Sub Occipital Muscle Inhibition Technique on Hamstring Flexibility in Post-laminectomy Patients

NCT ID: NCT06584682

Last Updated: 2025-02-21

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 38 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-08-01
• Study Completion Date: 2025-01-10

Brief Summary

to find out the effects of sub-occipital muscle inhibition technique in combination with upper cervical spine exercises on hamstring muscle flexibility in post-laminectomy patients.

Detailed Description

Laminectomy is a decompression surgery which is performed to decrease pressure on spinal nerves. In this surgical procedure a small bone of vertebrae called lamina is removed. Hamstring muscle stiffness is a major problem in post-laminectomy patients, which results in chronic pain, functional limitation and affect patients activity of daily life.

In post-laminectomy patients hamstring stiffness is more profound than iliotibial Band and piriformis stiffness. Sub-occipital muscle and hamstring are connected via a single neural pathway called superior back line which passes through dura matter. Dura matter is the outer most covering of meninges, Sub Occipital Muscles attached to dura matter by Myodural Bridge through vertebral dural ligament. This connection provides a window for relaxation of dural fascia to decrease tone of connected muscular-skeletal units (in which hamstring is also included). So if any of these muscle units become tight, or tone deterioration occur the other unit is automatically malfunctioned. The study shows that if tone sub-occipital muscle falls, it has been reported that the tone of knee flexors such as hamstring also decreases due to relaxation of myofascia.

However, in post-laminectomy patients, incorporating a neural pathway connection technique involving sub-occipital muscle inhibition for upper neural pathway Dura release may offer more effective and immediate results on hamstring muscle flexibility in the lower neural pathway The sub-occipital muscle inhibition technique is a method of inducing relaxation of the fascia by applying soft pressure to the sub-occipital area.

The rationale of the present study is to find out the effectiveness of Sub Occipital Muscle inhibition technique for stiff hamstring muscle in post-laminectomy patients, pain and disability. To compare the effectiveness of SOM inhibition technique in combination of upper cervical spine muscle stretching,traction etc. with hamstring muscle stretching, lower limb neurodynamic etc.

Conditions

Hamstring Tightness

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Sub-occipital muscle inhibition technique

Therapist puts finger pads just beneath the superior nuchal line (below the occiput and above the C2 vertebra), and lifts the patient head slightly and apply an anterior force with cephalic traction on cervical spine this area. Then straighten the fingers to press the finger tips into muscle and hold until relaxation(30 sec) and then drop the head into palm in new position, give this technique in 10 rep/2 sets (each set have 5 repetitions).hot packs for 15 minutes prior to session, cervical muscle stretching,cervical mechanical traction for 8-10 minutes, force is applied 1/6th of the patient body weight, for C1-C2 at 0 degree of cervical flexion and for below C2 at 20 degree of cervical spine flexion. and cervical muscle Muscle Energy Techniques.

Group Type: EXPERIMENTAL

Sub-occipital muscle inhibition technique

Intervention Type: OTHER

Therapist puts finger pads just beneath the superior nuchal line (below the occiput and above the C2 vertebra), and lifts the patient head slightly and apply an anterior force with cephalic traction on cervical spine this area. Then straighten the fingers to press the finger tips into muscle and hold until relaxation(30 sec) and then drop the head into palm in new position, give this technique in 10 rep/2 sets (each set have 5 repetitions).hot packs for 15 minutes prior to session, cervical muscle stretching,cervical mechanical traction for 8-10 minutes, force is applied 1/6th of the patient body weight, for C1-C2 at 0 degree of cervical flexion and for below C2 at 20 degree of cervical spine flexion and cervical muscle METs

conventional therapy

stretching of hamstring muscle, METs, sciatic nerve glides, lower limb neurodynamic.

Group Type: OTHER

conventional therapy

Intervention Type: OTHER

stretching of hamstring muscle, METs, sciatic nerve glides, lower limb neurodynamics.

Interventions

Sub-occipital muscle inhibition technique

Therapist puts finger pads just beneath the superior nuchal line (below the occiput and above the C2 vertebra), and lifts the patient head slightly and apply an anterior force with cephalic traction on cervical spine this area. Then straighten the fingers to press the finger tips into muscle and hold until relaxation(30 sec) and then drop the head into palm in new position, give this technique in 10 rep/2 sets (each set have 5 repetitions).hot packs for 15 minutes prior to session, cervical muscle stretching,cervical mechanical traction for 8-10 minutes, force is applied 1/6th of the patient body weight, for C1-C2 at 0 degree of cervical flexion and for below C2 at 20 degree of cervical spine flexion and cervical muscle METs

Intervention Type: OTHER

conventional therapy

stretching of hamstring muscle, METs, sciatic nerve glides, lower limb neurodynamics.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Hamstring muscle tightness, (AKE < 80) or (more than 20 degree lag in knee extension).
• Back of the thigh pain.
• Prior laminectomy surgical procedure at lumber spine.
• Patients who are willing to participate.

Exclusion Criteria

• Prior femur and back related fracture,
• Bilateral lower limb pain,
• Any systemic issue.
• Visual hamstring swelling.
• Individual with cervical ligaments instability and migraine.
• Unable to understand the consent form,
• Patients who are not willing to participate in procedure

• Minimum Eligible Age: 35 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

maria Khalid, MSOMPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Health and wellness rehabilitation center

Swābi, KPK, Pakistan

Countries

Pakistan

Other Identifiers

REC 01935 Safia Gul

Identifier Type: -

Identifier Source: org_study_id