Visceral Manipulation Decreases Pain, Increases Cervical Mobility and Electromyographic Activity of the Upper Trapezius Muscle in Non-Specific Neck Pain Subjects with Functional Dyspepsia: Two Case Reports

Background and Purpose: The lack of clear knowledge about the etiology of nonspecific neck pain (NS-NP) strengthens the need for other mech-anisms, still poorly described in the literature, to be investigated. Therefore, a quantitative analysis of two cases of NS-NP in subjects with functiona dyspepsia was conducted in order to verify the immediate and seven-day postintervention effects of visceral manipulation (VM) to the stomach and liver on neck pain, cervical range of motion (ROM), and electromyographic (EMG) activity of the upper trapezius muscle. Case Description: Case A was an 18-year-old female with a complaint of nonspecific neck pain for one year, with reported pain on waking, momentary intermittent pain, and occasional symptoms of paresthesia in the upper limbs. Case B was a 25-year-old female with a complaint of cervical pain for one year, accompanied by pain in the unilateral temporomandibular joint, and medial thoracic region. Both cases presented functional dyspepsia.Outcomes: The results demonstrated (sub-jects A and B, respectively) a general increase in cervical ROM (range: 12.5% to 44.44%) and amplitude of the EMG signal (immediately postintervention: 57.62 and 20.78; post seven days: 53.54% and 18.83%), and an increase in muscle fiber conduction velocity immediately postintervention (4.44% and 7.44%) and a de-crease seven days postintervention (25.25% and 21.18%). For pain, a decrease was observed immediately postintervention (23.07% and 76.92%) and seven days postintervention (100% for both subjects). Discussion: A single VM provided important clinical improvement in neck pain, cervical spine range of motion, and EMG activity of the upper trapezius muscle, immediately and seven days postintervention in two NS-NP subjects with func-tional dyspepsia

Effect of Facial Massage on Static Balance in Individuals with Temporomandibular Disorder – a Pilot Study

Introduction: The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture. Purpose: The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoPAP) and mediolateral (CoPML) directions in individuals with temporomandibular disorder (TMD). Methods: Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoPAP and CoPML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage). Results: No significant differences were found regarding CoPAP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoPML velocity, RMS of CoPAP, RMS of CoPML, and sway area. The only significant difference was found for mean CoPAP velocity with eyes closed. Conclusions: While the results of the present study demonstrate the reliability of the reproduction of the data, facial massage had no immediate influence on postural control in individuals with TMD