Manual Cervical Traction and Trunk Stabilization Cause Significant Changes in Upper and Lower Esophageal Sphincter: A Randomized Trial |
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| Authors: | Petr Bitnar Jan Stovicek Stepan Hlava Pavel Kolar Josef Arlt Marketa Arltova Katerina Madle Andrew Busch Alena Kobesova |
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| Institution: | 1. Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic;2. Department of Internal Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic;3. Department of Statistics and Probability, Faculty of Informatics and Statistics, Prague University of Economics and Business, Prague, Czech Republic;4. Department of Public Finance, Faculty of Finance and Accounting, Prague University of Economics and Business, Prague, Czech Republic;5. Department of Health and Human Kinetics, Ohio Wesleyan University, Delaware, Ohio;1. Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy;2. Stress Control Lab, Collegio Italiano di Osteopatia, Parma, Italy;3. Clinical Human-based Research Department, Foundation COME Collaboration, Pescara, Italy;1. Health Services Research, Southern California University of Health Sciences, Whittier, California;2. Southern California University of Health Sciences, Whittier, California;3. RAND Corporation, Santa Monica, California;1. Occupational Health Engineering, Kashan University of Medical Sciences, Kashan, Iran;2. Occupational Health Engineering, Shiraz University of Medical Sciences, Shiraz, Iran;3. Tehran University of Medical Sciences, Tehran, Iran;4. Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran;1. iPhysio Research Group, Universidad San Jorge, Zaragoza, Spain;2. Toledo Physiotherapy Research Group, Facultad de Fisioterapia de Toledo, Universidad Castilla La Mancha, Toledo, Castilla La Mancha, Spain;3. Sensorimotor Function Group, Hospital Nacional de Parapléjicos, Toledo, Castilla La Mancha, Spain;4. Physical Therapy Unit, Hospital Provincial, Toledo, Spain;1. SCU Health Systems, Southern California University of Health Sciences, Whitter, California;2. Health Services Research, Southern California University of Health Sciences, Whittier, California;3. Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California;4. Department of Neurology, University of California, Irvine, Irvine, California;5. World Spine Care, Santa Ana, California |
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| Abstract: | ObjectivesDysfunctions in the lower esophageal sphincter (LES) and the upper esophageal sphincter (UES) levels can occur owing to poor muscle coordination, contraction, or relaxation. Such condition can possibly be addressed by functional rehabilitation. The aim of this study was to measure pressure changes in the UES and LES at rest and during routine rehabilitation techniques, that is, cervical manual traction and trunk stabilization maneuver.MethodsThis study was conducted in a University Hospital Gastrointestinal Endoscopy Center. Cervical manual traction and a trunk stabilization maneuver were performed in a convenient group of 54 adult patients with gastroesophageal reflux disease. High-resolution manometry was used to measure pressure changes in the LES and UES at rest and during manual cervical traction and trunk stabilization maneuver.ResultsAverage initial resting UES pressure was 90.91 mmHg. A significant decrease was identified during both cervical traction (average UES pressure = 42.13 mmHg, P < .001) and trunk stabilization maneuver (average UES pressure = 62.74 mmHg, P = .002). The average initial resting LES pressure was 14.31 mmHg. A significant increase in LES pressure was identified both during cervical traction (average LES pressure = 21.39 mmHg, P < .001) and during the trunk stabilization maneuver, (average pressure = 24.09 mmHg, P < .001).ConclusionCervical traction and trunk stabilization maneuvers can be used to decrease pressure in the UES and increase LES pressure in patients with gastroesophageal reflux disease. |
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