Influence of Manual Relaxation of the Diaphragm on the Tension of the Posterior Superficial Fascia

Study Overview
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Brief Summary
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The diaphragm performs many functions that are vital to the body as a whole. Some of them are not related only to ventilation. The diaphragm is part of the myofascial system in the human body. Therefore, the proper functioning of the diaphragm should be a significant element of physiotherapy, e.g. in patients reporting pain in the lumbosacral spine. Considering the complex role of the diaphragm, it seems reasonable to investigate the influence of the mobilization of the diaphragm (aimed at reducing diaphragm tension) on the tension of the extensor muscles of the lumbar spine. The assumption of this reserach is to investigate the correlation between the tension of the fascia in the area of the diaphragm to the tension of the muscles in the area of the lumbar spine. The fascial connections between the diaphragm and the muscles in the lumbar spine presented above suggest that the manual therapy performed within the diaphragm can effectively prevent the occurrence of pain, and might be a supportive measure in the treatment of pain in the spine. The aim of the study is to investigate the corellation between the tension of the fascia within the diaphragm and the tension of the posterior superficial tape. Research questions: How does manual therapy in the area of the tendon attachments of the diaphragm affect the relaxation of the extensor muscles of the lumbar spine? How can the therapy conducted only within the diaphragm, without interfering with the structures surrounding the spine, reduce the tension of the extensor muscles of the lumbar spine and, consequently, increase the range of its mobility in all planes? How will the introduced therapy change the tidal volume of the lungs?

Official Title
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Influence of Manual Relaxation of the Diaphragm on the Tension of the Posterior Superficial Fascia

Conditions
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Diaphragm; Relaxation, Low Back Pain

Intervention / Treatment
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* Procedure: Fascial release of diaphragm muscle.
* Procedure: Classic massage of the abdomen.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age within 20-40 yrs, BMI within normal range (18.5-24.9) lack of abdominal obesity lack of chronic musculoskeletal conditions written, conscious consent Exclusion Criteria: former abdominal surgery abdominal diseases (i.e. (np. kidney stones, ulcers, irritative bowel sindrome, etc.), pregnancy fever, tumors, blood hypertension, former surgery of respiratory system , condition after surgical procedures in the area of the spine, the occurrence of pain in the spine in the 3 months preceding the research experiment, lack of conscious consent

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 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: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Diaphragm fascial release group.<br>Ten minutes lasting fascial release techinques performed on diaphragm. | Procedure: Fascial release of diaphragm muscle.<br>* The intervention consists of deep tissue massage techniques and manual mobilization of the fascia performed within the diaphragm attachments in the area of the costal arches.<br>|
| Placebo Comparator: Classic massage group<br>Ten minutes lasting classic massage performed on abdomen. | Procedure: Classic massage of the abdomen.<br>* The intervention consists of selected classic massage techniques - mainly stroking (effleurage) - performed on the superficial layers of the abdominal region<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessemnt of change in muscle tension of selected muscles of lumbar region | Assessment of muscle superficial electromyography will be performed with sEMG device NuTrac Alpha2E (NeuroTrac Ltd.) on the following muscles: multifidus, longissimus and iliocostalis. | Twice - before and immediately after the treatment procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment of change of range of motion of the lumbar spine. | The range of motion of the lumbar spine will be performed with the digital inclinometer (Baseline) | Twice - before and immediately after the treatment procedure | 
| Assessment of change in peak expiratory flow in one second (PEF1) | The peak expiratory flow in one second will be performed with PF100 peakflometer (Microlife). | Twice - before and immediately after the treatment procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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diaphragm, low back pain, deep tissue massage, diaphragm relaxation