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Effects of Osteopathic Visceral Treatment in Patients with Gastroesophageal Reflux: A Randomized Controlled Trial. J Clin Med 2019; 8:jcm8101738. [PMID: 31635110 PMCID: PMC6832476 DOI: 10.3390/jcm8101738] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
Osteopathic manual treatment has been recommended as a non-pharmacological therapy for Gastroesophageal Reflux Disease (GERD). However, to date, no study has supported the effectiveness of this intervention with respect to the symptoms of the disease. Our goal was to assess the effect of an osteopathic manual technique for the lower esophageal sphincter on GERD symptoms, cervical mobility and on the C4 spinous process pressure pain threshold (PPTs). METHODS A randomized, double-blind placebo-controlled trial was performed. Sixty subjects suffering from GERD participated in this study and were randomly assigned to either an experimental group (EG) (n = 29), who received the osteopathic technique for the lower esophageal sphincter, or to a control group (CG) (n = 31), who received a manual contact, which mimicked the osteopathic technique without exerting any therapeutic force. Randomization was computer-generated, with allocation concealed by sequentially numbered, opaque, sealed envelopes. The GerdQ questionnaire was used to assess symptom changes the week after intervention. Cervical Range of Motion (CROM) and algometer were used to evaluate cervical mobility and PPTs before and after both treatments. Before-after between groups comparison (t-test) was used for statistical analysis of the outcome, with two measurement points (GerdQ), while repeated-measures ANOVA was used for those outcomes with four measurement points (CROM and PPT). RESULTS The application of the osteopathic manual treatment in subjects with GERD produced a significant improvement in symptoms one week after the intervention (p = 0.005) with a between-groups difference of 1.49 points in GerdQ score (95% CI: 0.47-2.49). PPT C4 improved in the EG after the treatment (p = 0.034; η2 = 0.048) (between-groups difference 8.78 Newton/cm2; 95% CI: 0.48-17.09). CROM also increased in the EG compared to the CG (p < 0.001; η2 = 0.108) (between-groups difference 33.89 degrees; 95% CI: 15.17-52.61). CONCLUSIONS The manual osteopathic technique produces an improvement in GERD symptoms one week after treatment, cervical mobility, and PPTs. This may mean that osteopathic treatment is useful for improving symptoms of GERD.
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Bucci R, Michelotti A. Somatosensory changes in orthodontics—findings from quantitative sensory testing (QST) studies. Semin Orthod 2018. [DOI: 10.1053/j.sodo.2018.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Peña-Salinas M, Oliva-Pascual-Vaca J, Heredia-Rizo AM, Rodriguez-Blanco C, Ricard F, Oliva-Pascual-Vaca Á. No immediate changes on neural and muscular mechanosensitivity after first rib manipulation in subjects with cervical whiplash: A randomized controlled trial. J Back Musculoskelet Rehabil 2018; 30:921-928. [PMID: 28372320 DOI: 10.3233/bmr-160645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Upper rib manipulative therapy appears to be effective on primary complaint of shoulder pain, but its efficacy has not been evaluated in subjects with whiplash-associated disorders. OBJECTIVE To assess the immediate changes on neural and muscular mechanosensitivity after first-rib manipulation in patients with neck or cervicobrachial pain secondary to cervical whiplash (CW). METHODS A single-blind (evaluators were blinded to subject allocation) randomized trial was conducted. Fifty-three (N = 53) subjects, 34.7 (SD 10.8 years; 56.6% females), with cervical or cervicobrachial pain following CW, were distributed into two groups. The experimental group (n = 27) underwent a single first-rib high-velocity low-amplitude manipulation technique, while the control group (n = 26) received a sham placebo intervention. Outcome measures were taken at baseline and immediately after intervention, of the pressure pain threshold over the trigeminal, median and ulnar nerves, and over the area described for the location of tense bands in the upper trapezius, masseter, biceps brachii and triceps brachii muscles. RESULTS No significant differences in mechanosensitivity values were observed after intervention in the between-groups comparison (p > 0.05). CONCLUSION The use of a sole first-rib thrust technique has no immediate effect on neural or muscular mechanosensitivity, when compared to placebo, in subjects with cervical or cervicobrachial pain after CW.
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Affiliation(s)
- Marta Peña-Salinas
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - Jesús Oliva-Pascual-Vaca
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain.,Department of Physical Therapy, Universitary School of Osuna, Sevilla, Spain.,Madrid Osteopathic School, Madrid, Spain
| | - Alberto Marcos Heredia-Rizo
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain
| | - Cleofás Rodriguez-Blanco
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain.,Madrid Osteopathic School, Madrid, Spain
| | | | - Ángel Oliva-Pascual-Vaca
- Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Sevilla, Spain.,Madrid Osteopathic School, Madrid, Spain
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Long H, Wang Y, Jian F, Liao LN, Yang X, Lai WL. Current advances in orthodontic pain. Int J Oral Sci 2016; 8:67-75. [PMID: 27341389 PMCID: PMC4932774 DOI: 10.1038/ijos.2016.24] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 02/05/2023] Open
Abstract
Orthodontic pain is an inflammatory pain that is initiated by orthodontic force-induced vascular occlusion followed by a cascade of inflammatory responses, including vascular changes, the recruitment of inflammatory and immune cells, and the release of neurogenic and pro-inflammatory mediators. Ultimately, endogenous analgesic mechanisms check the inflammatory response and the sensation of pain subsides. The orthodontic pain signal, once received by periodontal sensory endings, reaches the sensory cortex for pain perception through three-order neurons: the trigeminal neuron at the trigeminal ganglia, the trigeminal nucleus caudalis at the medulla oblongata and the ventroposterior nucleus at the thalamus. Many brain areas participate in the emotion, cognition and memory of orthodontic pain, including the insular cortex, amygdala, hippocampus, locus coeruleus and hypothalamus. A built-in analgesic neural pathway—periaqueductal grey and dorsal raphe—has an important role in alleviating orthodontic pain. Currently, several treatment modalities have been applied for the relief of orthodontic pain, including pharmacological, mechanical and behavioural approaches and low-level laser therapy. The effectiveness of nonsteroidal anti-inflammatory drugs for pain relief has been validated, but its effects on tooth movement are controversial. However, more studies are needed to verify the effectiveness of other modalities. Furthermore, gene therapy is a novel, viable and promising modality for alleviating orthodontic pain in the future.
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Affiliation(s)
- Hu Long
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Li-Na Liao
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Yang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wen-Li Lai
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Shen H, Shao S, Zhang J, Wang Z, Lv D, Chen W, Svensson P, Wang K. Fixed orthodontic appliances cause pain and disturbance in somatosensory function. Eur J Oral Sci 2015; 124:26-32. [PMID: 26715259 DOI: 10.1111/eos.12234] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2015] [Indexed: 01/02/2023]
Abstract
This study aimed to assess the short-term effects of orthodontic pain on quantitative sensory testing (QST) in subjects receiving fixed orthodontic treatment. Twenty patients and 12 healthy volunteers (as controls) participated. All 20 patients had bonded AO self-ligating brackets, with a 0.014 super elastic nickel-titanium arch wire placed in the brackets. Pain [self-reported on a visual analog scale (VAS)], and thermal and mechanical thresholds, were tested at six time points--before (baseline), and 2 h, 24 h, 7 d, 14 d, and 30 d after, force application--in the treatment group. The attached gingiva adjacent to the left upper central incisor (21 gingiva) was hypersensitive to cold stimuli (i.e. increased cold detection thresholds were detected) in the treatment group. The pressure pain thresholds of the left upper central incisor (21) and 21 gingiva were significantly reduced. Our results suggest clear signs of sensitization of the trigeminal nociceptive system up to 1 month after force application and orthodontic pain. Quantitative assessment of somatosensory function may help to provide a better understanding and profiling of the underlying neurobiological mechanisms related to orthodontic pain.
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Affiliation(s)
- Huijie Shen
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Institute of Stomatology and Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Sheng Shao
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Institute of Stomatology and Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Jinglu Zhang
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Zhendong Wang
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Institute of Stomatology and Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Dong Lv
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Institute of Stomatology and Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Wenjing Chen
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Institute of Stomatology and Department of Orthodontics, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, School of Dentistry, Aarhus University, Aarhus, Denmark.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Kelun Wang
- Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.,Center for Sensory-Motor Interaction (SMI) Aalborg University, Aalborg, Denmark
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Rodriguez-Blanco C, Cocera-Morata FM, Heredia-Rizo AM, Ricard F, Almazán-Campos G, Oliva-Pascual-Vaca Á. Immediate Effects of Combining Local Techniques in the Craniomandibular Area and Hamstring Muscle Stretching in Subjects with Temporomandibular Disorders: A Randomized Controlled Study. J Altern Complement Med 2015. [PMID: 26218883 DOI: 10.1089/acm.2014.0332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To assess the immediate effects on vertical mouth opening, orofacial mechanosensitivity, and lumbar and suboccipital mobility after adding a myofascial induction technique to a multimodal protocol in subjects with temporomandibular disorders (TMD). DESIGN A randomized and double-blind controlled trial was carried out. SETTINGS/LOCATION University-based physical therapy research clinic. SUBJECTS Sixty subjects (35±11.22 years) with TMD, and restricted mobility of the mandibular condyles and the first cervical vertebrae, were recruited and randomized to either a control group (CG) (n=30) or an experimental group (EG) (n=30). INTERVENTIONS The CG underwent a neuromuscular technique over the masseter muscles and passive hamstring muscle stretching. A suboccipital muscle inhibition technique was added to this protocol in the EG. OUTCOME MEASURES Primary measurements were made of vertical mouth opening and pressure pain threshold of the masseter muscles. Secondary outcome measures included pressure algometry of the trigeminal nerve, suboccipital range of motion, and lumbar spine mobility, assessed with the sit-and-reach (SAR) test and lumbar forward bending. All evaluations were collected at baseline and immediately after intervention. RESULTS In the intragroup comparison, the EG observed an increase in suboccipital flexion (p<0.001; F1,29=14.47; R(2)=0.33) and the SAR test (p=0.009; F1,29=7.89; R(2)=0.21). No significant differences were found in the between-group comparison for any variable (p>0.05). CONCLUSION The inclusion of a myofascial induction maneuver in a protocol combining local (neuromuscular treatment) and distal techniques (hamstring stretching) in subjects with TMD has no impact on improving mouth opening, suboccipital and lumbar mobility, and orofacial sensitivity to mechanical pressure.
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Affiliation(s)
- Cleofás Rodriguez-Blanco
- 1 Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla , Sevilla, Spain
| | | | - Alberto Marcos Heredia-Rizo
- 1 Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla , Sevilla, Spain
| | | | | | - Ángel Oliva-Pascual-Vaca
- 1 Physiotherapy Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla , Sevilla, Spain
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Risk of headache, temporomandibular dysfunction, and local sensitization in male professional boxers: a case-control study. Arch Phys Med Rehabil 2014; 95:1977-83. [PMID: 24996064 DOI: 10.1016/j.apmr.2014.06.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 06/04/2014] [Accepted: 06/13/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate differences in the incidence of headache, trigeminal nerve mechanosensitivity, and temporomandibular functionality in professional male boxers (exposed to repetitive craniofacial trauma) who were actively training and without severe previous injuries compared with handball players. DESIGN Case-control study. SETTING University-based physical therapy research clinic. PARTICIPANTS Eighteen boxers (mean age, 23±4.61y) as the cases group, and 20 handball players as the comparison group (mean age, ±2y, and sex matched), were included. All participants (N=38) completed the assessment protocol. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Measurements were taken of the headache impact (Headache Impact Test-6) and the pressure pain threshold over the trigeminal nerve sensory branches, the masseter muscle, and the tibialis anterior muscle. The secondary outcome measure included the temporomandibular function (Helkimo Clinic Index). RESULTS The boxers showed slight mandibular function impairment, local muscular and neural sensitization, and a higher impact from headaches than did the handball players. The between-group comparison found significant differences in all outcome measures (P<.05), except in the tibialis anterior muscle pressure pain threshold on the dominant (P=.958) and the nondominant (P=.453) sides. CONCLUSIONS Professional male boxers seem to suffer a greater headache impact and local sensitization of the craniomandibular region than do professional handball players. It cannot be determined whether these findings are short-lasting, as a result of the training activity, or long-lasting.
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