Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20180021
Brazilian Journal of Pain
Original Article

Influence of osteopathic cervical manipulation on blood flow velocity of the cerebral circulation in chronic neck pain: analysis of three groups

Influência da manipulação osteopática cervical na velocidade de fluxo sanguíneo da circulação cerebral em indivíduos com cervicalgia crônica: análise de três grupos

Rafael Stelle; Bianca Simone Zeigelboim; Marcos Christiano Lange; Jair Mendes Marques; François Ricard; Cleofás Rodríguez Blanco

http://dx.doi.org/10.5935/2595-0118.20180021 BrJP, vol.1, n2, p.103-110, 2018
PDF English
PDF Português
SciELO
Downloads: 0
Views: 548

Abstract

BACKGROUND AND OBJECTIVES: Spinal manipulation (SM) can reduce or improve the pain and dizziness originated in the neck. However, there is some criticism against SM. The objective of this study was to check if the osteopathic manipulation (OM) with a cervical rhythmic articulatory technique (CRAT) provides oscillations of the blood flow velocity (BFV) in the internal carotid arteries (ICA), vertebral arteries (VA) and basilar artery (BA), and if this technique is a risk factor for this circulatory system.

METHODS: The study was conducted with 73 individuals (men and women) with mechanical cervicalgia, with an average age of 37.7±6.4 years. Fifty-eight had mild to moderate pain, randomly divided into control group (CG) and experimental-1 (EG-1), and 15 with severe pain in the experimental-2 group (EG-2). All subjects were submitted to the artery ultrasound (ICA, VA, and BA) in a blind methodology for the tests 1 (E1) and 2 (E2). Between E1 and E2, one single OM-CRAT was performed in the EGs 1 and 2 and resting for the CG.

RESULTS: In the EG-1 there was a slight reduction of the BFV in the right ICA. In the EG-2 there was a significant increase of the BFV in the right VA. All samples presented normality. In the CG there was a reduction of the BFV in the left VA. When comparing the three groups, there was significance for the CG as EG-2 of the BFV in the right ICA (in E1) and of the BFV in the left ICA (in E2).

CONCLUSION: Despite the BFV oscillations, one can conclude that the OM-CRAT generates oscillation in the BFV within the normality parameters and it is not a risk factor for cerebral circulation.

Keywords

Carotid arteries, Cervicalgia, Doppler ultrasound, Neck pain, Spinal manipulation, Vertebral artery

Resumo

JUSTIFICATIVA E OBJETIVOS: A manipulação vertebral cervical (MVC) pode reduzir ou melhorar a dor e a tontura de origem cervical. No entanto, há críticas contra a MVC. O objetivo deste estudo foi verificar se a manipulação osteopática (MO) com técnica articulatória rítmica cervical (TARC) proporciona oscilações de velocidade de fluxo sanguíneo (VFS) nas artérias carótidas internas (ACI), vertebrais (AV) e basilar (AB), e se essa técnica é um fator de risco para esse sistema circulatório.

MÉTODOS: A casuística foi constituída de 73 indivíduos (homens e mulheres) com cervicalgia mecânica, com idade média de 37,7±6,4 anos, sendo 58 com dor leve a moderada, divididos por aleatorização em grupos controle (GC) e experimental-1 (GE-1), e 15 com dor intensa no grupo experimental-2 (GE-2). Todos foram submetidos à ultrassonografia arterial (em ACI, AV e AB) em metodologia encoberta para os exames 1 (E1) e 2 (E2). Entre E1 e E2 foi realizado única MO-TARC para os GE 1 e 2, e repouso para o GC.

RESULTADOS: Em GE-1 houve pequena redução de VFS da ACI direita. Em GE-2 houve aumento significativo de VFS na AV direita. Todas as amostras apresentaram normalidade. Em GC houve redução de VFS da AV esquerda. No comparativo entre os três grupos houve significância para o GC como GE-2 na VFS da ACI direita (em E1) e na VFS da ACI esquerda (em E2).

CONCLUSÃO: Apesar das oscilações de VFS, concluiu-se que a MO-TARC gera oscilação de VFS dentro dos parâmetros de normalidade e não é um fator de risco para a circulação cerebral.

Palavras-chave

Artérias carótidas, Artéria vertebral, Cervicalgia, Dor de pescoço, Manipulação da coluna, Ultrassonografia Doppler

References

Bevilagua-Grossi D, Pegoretti KS, Gonçalves MS, Speciali JG, Bordini CA, Bigal ME. Cervical mobility in women with migraine. Headache. 2009;49(5):726-31.

Rueda VG, Celis CL, López Meb, Uribarren AC, Tomás SC, García CH. Effectiveness of a specific manual approach to the suboccipital region in patients with chronic mechanical neck pain and rotation deficit in the upper cervical spine: study protocol for a randomized controlled trial. BMC Musculoskelet Disord. 2017;18:384.

Jørgensen MB, Skotte JH, Holtermann A, Sjøgaard G, Petersen NC, Søgaard K. Neck pain and postural balance among workers with high postural demands - a cross-sectional study. BMC Musculoskelet Disord. 2011;12:176.

Field S, Treleaven J, Jull G. Standing balance: a comparison between idiopathic and whiplash-induced neck pain. Man Ther. 2008;13(3):183-91.

Stelle R, Zeigelboim BS, Lange MC, Marques JM. Influence of osteopathic manipulation on blood flow velocity of the cerebral circulation in chronic mechanical neck pain. Rev Dor. 2014;15(4):281-6.

Stelle R, Zeigelboim BS, Lange MC, Marques JM. Influence of manipulation at range of rotation of the cervical spine in chronic mechanical neck pain. Rev Dor. 2013;14(4):284-9.

Bielinska M, Olszewski J. Results evaluation in cervical vertigo kinesitherapy--preliminary report. Otolaryngol Pol. 2009;63(7):24-7.

Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control - Part 2: case studies. Man Ther. 2008;13(3):266-75.

Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Man Ther. 2008;13(1):2-11.

Thomas LC, Rivett DA, Bolton PS. Pre-manipulative testing and the use of the velocimeter. Man Ther. 2008;13(1):29-36.

Silva AL, Marinho MR, Gouveia FM, Silva JG, Ferreira AS, Cal R. Benign paroxysmal positional vertigo: comparison of two recent international guidelines. Braz J Otorhinolaryngol. 2011;77(2):191-200.

Barbosa MF, Abdala N, Carrete Jr H, Nogueira RG, Nalli DR, Fonseca JR. [Reference values for measures of blood flow velocities and impedance indexes in healthy individuals through conventional transcranial Doppler]. Arq. Neuropsiquiatr.. 2006;64(3B):829-38.

Galindez-Ibarbengoetxea X, Setuain I, Ramírez-Velez R, Andersen LL, González-Izal M, Jauregi A. Short-term effects of manipulative treatment versus a therapeutic home exercise protocol for chronic cervical pain. A randomized clinical trial. J Back Musculoskelet Rehabil. 2018;31(1):133-45.

Cleland JA, Mintken PE, Carpenter K, Fritz JM, Glynn P, Whitman J. Examination of a clinical prediction rule to identify patients with neck pain likely to benefit from thoracic spine thrust manipulation and a general cervical range of motion exercise: multi-center randomized clinical trial. Phys Ther. 2010;90(9):1239-50.

Creighton D, Kondratek M, Krauss J, Huijbregts P, Qu H. Ultrasound analysis of the vertebral artery during non-thrust cervical translatoric spinal manipulation. J Man Manip Ther. 2011;19(2):84-90.

Pérez-Llanes R, Ríos-Díaz J, Martínez-Payá JJ, Del-Banõ-Aledo ME. Ultrasonography analysis of vertebral artery blood flow velocity changes on produced by the maximal cervical rotation. Fisioterapia. 2012;34(3):118-24.

Maduro-de-Camargo V, Alburquerque-Sendín F, Bérzin F, Cobos-Stefanelli V, Rodrigues-Pedroni C, Santos K. Immediate effects of the ashmore manipulation technique C5/C6, in muscle activity in patients with mechanical neck pain. Eur J Ost Clin Rel Res. 2012;7(1):2-9.

Orelli JG, Rebelatto JR. The effectiveness of manual therapy in individuals with headaches, with and without cervical degeneration: analysis of six cases. Rev Bras Fisioter. 2007;11(4):325-9.

Leon-Sanchez A, Cuetter A, Ferrer G. Cervical spine manipulation: an alternative medical procedure with potentially fatal complications. South Med J. 2007;100(2):201-3.

Mikkelsen R, Dalby RB, Hjort N, Simonsen CZ, Karabegovic S. Endovascular treatment of basilar artery thrombosis secondary to bilateral vertebral artery dissection with symptom onset following cervical spine manipulation therapy. Am J Case Rep. 2015;16:868-71.

Chung CL, Côte P, Stern P, L'Espérance G. The association between cervical spine manipulation and carotid artery dissection: a systematic review of the literature. J Manipulative Physiol Ther. 2015;38(9):672-6.

Herzog W, Leonard TR, Symons B, Tang C, Wuest S. Vertebral artery strains during high-speed, low amplitude cervical spinal manipulation. J Electromyogr Kinesiol. 2012;22(5):740-6.

Haneline M, Triano J. Cervical artery dissection. A comparison of highly dynamic mechanisms: manipulation versus motor vehicle collision. J Manipulative Physiol Ther. 2005;28(1):57-63.

Wynd S, Anderson T, Kawchuk G. Effect of cervical spine manipulation on a pre-existing vascular lesion within the canine vertebral artery. Cerebrovasc Dis. 2008;26(3):304-9.

Yazici B, Erdogmus B, Tugay A. Cerebral blood flow measurements of the extracranial carotid and vertebral arteries with Doppler ultrasonography in healthy adults. Diagn Interv Radiol. 2005;11(4):195-8.

Submitted date:
05/19/2017

Accepted date:
04/23/2018

5f1622cd0e88256a309517e2 brjp Articles
2595-3192 (Electronic) 2595-0118 (Printed)
BrJP ©2024 All rights reserved.

BrJP

Share this page
Page Sections