Clinical trial NCT06761391: Effects of Suboccipital Release on Sensorial and Functional Parameters
Official title: Immediate Effects of Suboccipital Myofascial Release on Pain Pressure Threshold, Range of Motion, Balance, and Proprioception
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Suboccipital Muscles
Keywords: suboccipital release
neck proprioception
pain pressure threshold
Lead sponsor: Bezmialem Vakif University
Sponsor class: OTHER
First posted: 2025-01-07
Enrollment: 30
Sex: ALL
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Suboccipital release is a straightforward technique beneficial for addressing musculoskeletal complaints like neck pain and headaches. This versatile method aids the autonomic system by manipulating the occipital-atlanto region, specifically regulating the parasympathetic system rather than the sympathetic system targeted by most osteopathic treatments. Studies indicate this technique enhances range of motion and balance in the lower extremities of both healthy and pre-existing patients due to fascia connections throughout the body. Suboccipital muscle release increases cervical spine range of motion, facilitating physical therapy. Myofascial release significantly boosts joint flexibility and range of motion (ROM) without reducing strength or performance. The rectus capitus posterior minor (RCPM) muscle, dense with spindles, is crucial in the suboccipital region for balance and pain proprioception. Trauma-induced atrophy in this muscle is strongly linked to chronic neck pain and reduced standing balance. A case report showed that a patient undergoing a personalized balance program exhibited significant balance improvement, suggesting that balance training should be considered for cervicogenic pain intervention strategies. Neck muscle spasms or fatigue can impair proprioception and postural control, with prolonged unilateral cervical muscle contraction increasing neck proprioceptor sensitivity. Muscle fatigue-related interstitial inflammatory mediators can sensitize muscle spindles. This study will explore suboccipital relaxation's acute effects on pressure pain threshold, range of motion, balance, and joint position sense in healthy individuals based on existing literature.

Detailed description: Suboccipital release is a relatively easy technique that a person can use to help with musculoskeletal complaints such as neck pain and headaches. This technique is also very versatile and can help regulate the autonomic system in the body due to the manipulation of the occipital-atlanto region. This technique has been noted to regulate the parasympathetic system rather than the sympathetic system that most osteopathic treatments target. Studies have shown that this technique improves range of motion and balance in the lower extremities of healthy and pre-existing patients due to the connection of the fascia throughout the body. The release of the suboccipital muscles increases the range of motion of the cervical spine, which makes it easier for the physical therapist. Myofascial release has been shown to significantly increase joint flexibility and range of motion (ROM) without causing any loss of strength or decreased performance . Studies on the rectus capitus posterior minor (RCPM) muscle indicate that it is one of the most important muscles in the suboccipital region. Because of the high density of muscle spindles, it is presumed that this muscle plays a role as a proprioceptive monitor important for balance and pain. Trauma has been shown to cause atrophy in this muscle, and this atrophy is strongly associated with chronic neck pain and decreased standing balance (4). A case report has shown that a patient who underwent a personalized balance program showed significant improvement in balance as measured by sensory organization testing; this improved balance control suggests that balance training should be considered when determining appropriate intervention strategies for patients with cervicogenic pain. Neck muscle spasms or fatigue can alter proprioception and postural control, and prolonged contraction of unilateral cervical muscles can significantly increase the sensitivity of neck proprioceptors. Interstitial inflammatory mediators produced by muscle fatigue can sensitize muscle spindles. The acute effects of suboccipital relaxation on pressure pain threshold, range of motion, balance, and joint position sense in healthy individuals have been examined in the literature.

Eligibility criteria: Inclusion Criteria:

Volunteers willing to participate in the study.

Exclusion Criteria:

Diagnosed with an upper extremity musculoskeletal system disease. Experiencing chronic headaches or migraine complaints. Presence of any pathology causing sensory or balance impairments. Diagnosed with a pathology in the cervical regio

Primary outcomes:
measure: Neck Proprioception
timeFrame: Change from baseline to final examination immediate after 5 minutes of manual therapy
Secondary outcomes:
measure: Pain Pressure Threshold
timeFrame: Change from baseline to final examination immediate after 5 minutes of manual therapy
measure: Range of Motion
timeFrame: Change from baseline to final examination immediate after 5 minutes of manual therapy
measure: Balance Error Scoring
timeFrame: Change from baseline to final examination immediate after 5 minutes of manual therapy
Other outcomes:
Locations:
city: Istanbul
country: Turkey
facility: Bezmialem Vakif University
Study officials:
References: