ORIGINAL PAPER
Therapeutic intervention on stabilisation parameters in patients with trigger points in suboccipital muscles: a case-control study
 
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Department of Physiotherapy, Faculty of Health Care, University of Prešov, Presov, Slovak Republic
 
 
Submission date: 2024-03-22
 
 
Acceptance date: 2024-08-15
 
 
Online publication date: 2025-07-24
 
 
Corresponding author
Miloslav Gajdoš   

Department of Physiotherapy, Faculty of Health Care, University of Prešov, Partizánska 1, 080 01 Presov, Slovak Republic
 
 
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Hypertonus and the presence of trigger points (TrPs) in the suboccipital muscles (sOMs) frequently contribute to cervical proprioception disorders. Impaired cervical proprioception inevitably affects postural stability, which necessitates therapeutic intervention in conjunction with cervical spine therapy. The aim of this study was to examine the influence of the myofascial release technique (MFR) on stability parameters in patients diagnosed with TrPs in the sOM region.

Material and Methods:
Twelve patients (eight females and four males, mean age = 37 ± 9.5 years) underwent postural stability assessment using a force platform (Sensor Medica, Rome, Italy) before and after sOM treatment, with a time interval of one hour. The study’s objectivity was supported by a control group comprising healthy participants (seven females and five males, mean age = 25 ± 3 years).

Results:
The results indicated significant changes in stability parameters immediately after applying the MFR technique, particularly in patients with TrPs in the sOMs.

Conclusions:
We recommend that patients undergoing MFR treatment maintain a safe position for at least a few minutes to prevent falls and dizziness.
REFERENCES (39)
1.
Mc Caskey MA, Schuster-Amft C, Wirth B, Suica Z, de Bruin ED. Effects of proprioceptive exercises on pain and function in chronic neck and low back pain rehabilitation: a systematic literature review. BMC Musculoskelet Disord. 2014;15:382; doi: 10.1186/1471-2474-15-382.
 
2.
McPartland JM, Brodeur RR. Rectus capitis posterior minor: a small but important suboccipital muscle. J Bodyw Mov Ther. 1999;3(1):30–5; doi: 10.1016/S1360-8592(99)80040-0.
 
3.
Peng B, Yang L, Li Y, Liu T. Cervical proprioception impairment in neck pain-pathophysiology, clinical evaluation, and management: a narrative review. Pain Ther. 2021;10(1):143–64; doi: 10.1007/s40122-020-00230-z.
 
4.
Humphreys BK. Cervical outcome measures: testing for postural stability and balance. J Manipulative Physiol Ther. 2008;31(7):540–6; doi: 10.1016/j.jmpt.2008.08.007.
 
5.
Mergner T, Nasios G, Maurer C, Becker W. Visual object localisation in space. Interaction of retinal, eye position, vestibular and neck proprioceptive information. Exp Brain Res. 2001;141(1):33–51; doi: 10.1007/s002210100826.
 
6.
Simons DG. Understanding effective treatments of myofascial trigger points. J Body Work Mov Ther. 2002;6:81–8; doi: 10.1054/jbmt.2002.0271.
 
7.
Burstein R, Noseda R, Borsook D. Migraine: multiple processes, complex pathophysiology. J Neurosci. 2015;35(17):6619–29; doi: 10.1523/JNEUROSCI.0373-15.2015.
 
8.
Fernández de las Peňas C, Alonso-Blanco C, Cuadrado ML, Gerrwin R, Pareja J. Myofascial trigger points in the suboccipital muscles and forward head posture in chronic tension type headache. Headache. 2006;46:454–60; doi: 10.1111/j.1526-4610.2006.00288.x.
 
9.
Ciubotariu A, Arendt-Nielsen L, Graven-Nielsen T. The influence of muscle pain and fatigue on the activity of synergistic muscles of the leg. Eur J Appl Physiol. 2004; 91(5–6):604; doi: 10.1007/s00421-003-1026-9.
 
10.
Thunberg J, Ljubisavljevic M, Djupsjobacka M, Johansson H. Effects on the fusimotor-muscle spindle system induced by intramuscular injections of hypertonic saline. Exp Brain Res. 2002;142(3):319–26; doi: 10.1007/s00221-001-0941-4.
 
11.
Yang L, Yang C, Pang X, Li D, Yang H, Zhang X, Yang Y, Peng B. Mechanoreceptors in diseased cervical intervertebral disc and vertigo. Spine. 2017;42(8):540–6; doi: 10.1097/BRS.0000000000001801.
 
12.
Amato A, Messina G, Giustino V, Brusa J, Brighina F, Proia P. A pilot study on non-invasive treatment of migraine: The self-myofascial release. Eur J Transl Myol. 2021;31(1):9646; doi: 10.4081/ejtm.2021.9646.
 
13.
Jull G, Amiri M, Bullock-Saxton J, Darnell R, Lander C. Cervical musculoskeletal impairment in frequent intermittent headache. Part 1: subjects with single headaches. Cephalalgia. 2007;27(7):793–802; doi: 10.1111/j.1468-2982.2007.01345.x.
 
14.
Smith L, Mehta M. The effects of upper cervical complex high velocity low amplitude thrust technique and sub-occipital muscle group inhibition techniques on standing balance. J Osteop Med. 2008;11:149–68; doi: 10.1016/j.ijosm.2008.08.020.
 
15.
Fernández de las Peňas C, Cuadrado ML. Therapautic options for cervicogenic headache. Expert Rev Neurother. 2014;14(1):39–49; doi: 10.1586/14737175.2014.863710.
 
16.
Karegeannes M, Fernández De las Peňas C, Finnegan M. Suboccipital muscles. In: Travell JG, Simons DG, Simons LS (eds). Myofascial Pain and Dysfunction. 3rd ed. Philadelphia: Wolters Kluwer; 2019, pp. 178–84.
 
17.
Treleaven J. Sensorimotor disturbances in neck disorders affecting postural stability, head and eyemovement control. Man Ther. 2008;13(1):2–11; doi: 10.1016/j.math.2007.06.003.
 
18.
Moraska A, Chandler C. Changes in clinical parameters in patients with tension-type headache following massage therapy: a pilot study. J Man Manip Ther. 2008;16(2):106–12; doi: 10.1179/106698108790818468.
 
19.
Giacomini P, Di Maure R, Topaxio D, Girolamo SD. Head tilt posturography: clinical value in peripheral labirinthine disorders. Ann Otol Rhinol. 2015;2(12):1073.
 
20.
Sprenger A, Wojak JF, Jandl NM, Helmchen CH. Postural control in bilateral vestibular failure: Its relation to visual, proprioceptive, vestibular, and cognitive input. Front Neurol. 2017;8:444; doi: 10.3389/fneur.2017.00444.
 
21.
Jull G, Stanton W. Predictors of responsiveness to physiotherapy management of cervicogenic headache. Cephalalgia. 2005;25(2):101–8; doi: 10.1111/j.1468-2982.2004.00811.x.
 
22.
Dommerholt J, Bron C, Franssen J. Myofascial trigger points: an evidence-informed review. J Man Manipul Ther. 2006;14(4):203–21; doi: 10.1179/106698106790819991.
 
23.
Chaitow L, Delany J. Neuromuscular techniques in orthopedics. Tech Orthop. 2003;18(1):74–86; doi: 10.1097/00013611-200303000-00013.
 
24.
Kamonseki DH, Lopes EP, Meer HA, Calixtre LB. Effectiveness of manual therapy in patients with tension-type headache. Asystematic review and meta-analysis. Disabil Rehabil. 2020;12:1–10; doi: 10.1080/09638288.2020.1813817.
 
25.
Ramezani E, Arab AM, Nourbakhsh MR. Sub-occipital myofascial release technique in subjects with cervicogenic headache. Pharmacophore. 2017;8(6S):e-1173299; doi: 10.1016/j.jbmt.2018.09.041.
 
26.
Schleip R. Fascial plasticity – a new neurobiological explanation Part 2. J Bodyw Mov Ther. 2003;7(2):104–16; doi: 10.1016/S1360-8592(02)00076-1.
 
27.
Beinert K, Taube W. The effect of balance training on cervical sensorimotor function and neck pain. J Mot Behav. 2013;45(3):271–8; doi: 10.1080/00222895.2013.785928.
 
28.
Norré ME. Posturography: head stabilisation compared with platform recording. Application in vestibular disorders. Acta Otolaryngol Suppl. 1995;520(2):434–6; doi: 10.3109/00016489509125291.
 
29.
Nacci A, Ferrazzi M, Berrettini S, Panicucci E, Matteucci J, Bruschini L, Ursino F, Fattori B. Vestibular and stabilometric findings in whiplash injury and minor head trauma. Acta Otorhinolaryngol Ital. 2011;31:378–89.
 
30.
Fisher AR, Bacon CJ, Mannion JVH. The effect of cervical spine manipulation on the postural sway in patients with non-specific neck pain. J Manipul Physiol Ther. 2015;38(1):65–73; doi: 10.1016/j.jmpt.2014.10.014.
 
31.
Reid SA, Rivett DA, Katekar MG, Callister R. Sustained natural apophyseal glides (SNAGs) are an effective treatment for cervicogenic dizziness. Man Ther. 2008;13(4):357–66; doi: 10.1016/j.math.2007.03.006.
 
32.
Nolan JH. The Effect of cervical spine chiropractic manipulation on balance. Johannesburg: Department of Chiropractic, University of Johannesburg; 2009.
 
33.
Schabrun SM, Jones E, Kloster J, Hodges PW. Temporal association between changes in primary sensory cortex and corticomotor output during muscle pain. Neurosci. 2013;235(3):159–64; doi: 10.1016/j.neuroscience.2012.12.072.
 
34.
Brumagne S, Janssens L, Janssens E, Goddyn L. Altered postural control in anticipation of postural instability in persons with recurrent low back pain. Gait Posture. 2008;28(4):657–62; doi: 10.1016/j.gaitpost.2008.04.015.
 
35.
Paulus I, Brumagne S. Aletred nterpretation of neck proprioceptive signals in persons with subclinical recurrent neck pain. J Rehabil Med. 2008;40(6):426–32; doi: 10.2340/16501977-0189.
 
36.
Pickar JG, Bolton PS. Spinal manipulative therapy and somatosensory activation. J Electromyogr Kinesiol. 2012;22(5):785–94; doi: 10.1016/j.jelekin.2012.01.015.
 
37.
Schomacher J, Farina D, Lindstroem R, Falla D. Chronic trauma-induced neck pain impairs the neural control of the deep semispinalis cervicis muscle. Clin Neurophysiol. 2012;123(7):1403–8; doi: 10.1016/j.clinph.2011.11.033.
 
38.
Gajdoš M, Nechvátal P, Kendrová L, Čuj J, Kozel M. The effect of myofascial therapy of the soboccipital muscles on postural stability – a pilot study. Rehabil Fyz Lek. 2022;29(4):208–13; doi: 10.48095/ccrhfl2022208.
 
39.
Vuillerme N, Pinsault N, Vaillant J. Postural control during quiet standing following cervical muscular fatigue: effects of changes in sensory inputs. Neurosci Lett. 2005;378(3):135–9; doi: 10.1016/j.neulet.2004.12.024.
 
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