Sub Occipital Inhibition Technique on Postural Balance

Study Overview
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Brief Summary
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In the present study the investigators want to verify if the inhibition of the suboccipital muscles improves the postural balance in subjects with cervical pain objectified by stabilometry.

Official Title
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Immediate Effect of Sub Occipital Inhibition Technique on Postural Balance: Stabilometric Study.

Conditions
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Movement Disorders

Intervention / Treatment
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* Procedure: Suboccipital inhibition
* Procedure: Placebo technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals who suffer neck pain for at least 3 months Come to receive physiotherapy treatment at Clinica Osteomed (NRS: 8415-CV), Elche, Alicante, Spain. Age between 18 and 65 years old. Sign the informed consent. Exclusion Criteria: Suffering or having suffered pathologies of the postural control system (postural sensors, central nervous system or locomotor system) Presenting deformities or orthopedic injuries in the lower limbs or rachis Presenting pain at the moment of study Present contraindications to the intervention under study Have received physiotherapy treatment in the last six months Have undergone surgical treatment of any kind.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental Group<br>Application of the sub occipital inhibition technique. | Procedure: Suboccipital inhibition<br>* With the patient in the supine position and the therapist sitting at the head of the bed with the elbows resting on its surface. The therapist palpates the cervical spinous processes and slides the fingers upwards until contacting the posterior projection of the posterior arch of the atlas. Then, flexing the metacarpophalangeal at 90 degrees slowly raises the skull. The therapist's hands should remain together and the base of the skull should rest on his palms pressing with the index, middle and ring fingers of each hand in a sustained manner, but without causing pain. This pressure must be maintained during 4 minutes.<br>|
| Placebo Comparator: Placebo Group<br>Hand contact in the sub occipital region without executing any technique. | Procedure: Placebo technique<br>* A superficial contact in the same area as the intervention, to rule out the exteroceptive effect associated with the therapist's contact.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Surface of the ellipse open eyes | Determines the surface of the ellipse formed from the oscillations in the X and Y coordinates with open eyes. The measurement is made using a stabilometric platform with 4 pressure sensors per square centimeter. The software of the stabilometric platform collects 40 measurements per second through its pressure sensors, calculating the position of the projection of the center of gravity on the ground 40 times every second. The described variable evaluates the surface of the ellipse that contains the successive points of the displacement of the projection of the center of gravity in the ground during the standarized time for the stabilometric recording (51.2 seconds). It is a unique value, measured in a single moment. If the ellipse formed is larger, it implies a greater amplitude of the displacement of the center of gravity, and therefore a lower equilibrium capacity. Interval: 0-1000 (mm2). | Postintervention immediate | 
| Surface of the ellipse closed eyes | Determines the surface of the ellipse formed from the oscillations in the X and Y coordinates with closed eyes. The measurement is made using a stabilometric platform with 4 pressure sensors per square centimeter. The software of the stabilometric platform collects 40 measurements per second through its pressure sensors, calculating the position of the projection of the center of gravity on the ground 40 times every second. The described variable evaluates the surface of the ellipse that contains the successive points of the displacement of the projection of the center of gravity in the ground during the standarized time for the stabilometric recording (51.2 seconds). It is a unique value, measured in a single moment. If the ellipse formed is larger, it implies a greater amplitude of the displacement of the center of gravity, and therefore a lower equilibrium capacity. Interval: 0-1000 (mm2). | Postintervention immediate | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean of the oscillation on the X axis and on the Y axis. | It assesses the lateral and anteroposterior oscillation of the projection on the floor of the center of gravity during the 51 seconds of the stabilometric record. Interval: 0-50 (mm). Greater oscillation implies less postural balance. | Preintervention and Postintervention immediate. | 
| Speed of the oscillation on the X axis and on the Y axis | Determines the speed with which the projection of the center of gravity moves in lateral and anteroposterior direction during the 51 seconds of the stabilometric record. Interval: 0-10 (mm/s). Greater speed implies less postural balance. | Preintervention and Postintervention immediate. | 
| Average speed of the oscillation | Determines the average speed with which the projection of the center of gravity moves in lateral and anteroposterior direction during the 51 seconds of the stabilometric record. Interval: 0-10 (mm/s). Greater speed implies less postural balance. | Preintervention and Postintervention immediate. | 
| Length of oscillation | Determine the length of movement described by the projection on the ground of the center of gravity during the stabilometric measurement. Interval: 0-1000 (mm). Greater length implies less postural balance. | Preintervention and Postintervention immediate. |