Effect of the Suboccipital Inhibition Technique on Balance Changes

June 22, 2026 updated by: Natália Maria Oliveira Campelo, Escola Superior de Tecnologia da Saúde do Porto

Postural balance is an essential capacity for functional autonomy and the performance of activities of daily living, relying on the continuous integration of visual, vestibular, and somatosensory information. Within this system, the upper cervical region plays a particularly important role, as it contributes to the orientation of the head in space and to the coordination between the head, eyes, and trunk. Due to their deep location between the occiput, atlas, and axis, the suboccipital muscles have a high proprioceptive significance and are frequently associated with cervical position control and sensorimotor regulation.

Changes in muscle tension, stiffness, or dysfunction in this region may alter the quality of afferent information transmitted to the central nervous system, potentially interfering with postural stability, head position awareness, body sway, and center of pressure control. In this context, the suboccipital inhibition technique is used in osteopathic practice as a manual intervention aimed at reducing myofascial tension, promoting relaxation of the upper cervical musculature, and potentially normalizing proprioceptive input.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Postural balance is a fundamental component of human motor function and is essential for maintaining functional autonomy and performing activities of daily living. It relies on the continuous and dynamic integration of sensory inputs from the visual, vestibular, and somatosensory systems, which are processed by the central nervous system to generate appropriate motor responses. These responses allow the body to maintain the center of mass within the base of support through constant postural adjustments.

Within this complex sensorimotor system, the upper cervical region plays a critical role in postural control. This region is responsible for the precise orientation of the head in space and contributes significantly to the coordination between the head, eyes, and trunk. The suboccipital muscles-namely the rectus capitis posterior major and minor, and the obliquus capitis superior and inferior-are deeply located between the occiput, atlas, and axis, and are characterized by a high density of muscle spindles. This anatomical feature suggests a strong proprioceptive function, making these muscles key contributors to cervical position sense and sensorimotor regulation.

In addition to their proprioceptive role, the suboccipital muscles are anatomically and functionally connected to the dura mater through the myodural bridge. This structure is thought to play a role in both mechanical and sensory integration, linking muscular activity with the central nervous system. Furthermore, the upper cervical region contains joint mechanoreceptors that provide additional afferent input, contributing to reflex mechanisms such as the cervico-ocular, cervico-collic, and tonic neck reflexes, which are essential for maintaining postural stability and gaze control.

Alterations in muscle tone, increased stiffness, or dysfunction in the suboccipital region may disrupt the quality of afferent information transmitted to the central nervous system. Such disturbances can impair proprioceptive accuracy and interfere with postural control mechanisms, potentially leading to increased body sway, altered head positioning, and changes in center of pressure (CoP) behavior. Since CoP displacement reflects the neuromuscular strategies used to maintain balance, it serves as an objective measure for assessing postural stability.

The suboccipital inhibition technique is commonly used in osteopathic practice as a manual intervention aimed at reducing myofascial tension in the upper cervical region. By promoting muscle relaxation and potentially restoring normal proprioceptive input, this technique may contribute to the optimization of postural control mechanisms. Previous studies have demonstrated its effects on cervical mobility, pain reduction, and flexibility; however, evidence regarding its immediate impact on postural balance remains limited and inconclusive.

Given the theoretical and neurophysiological rationale supporting the role of the suboccipital region in postural regulation, further investigation is warranted. The present study aims to evaluate the immediate effects of the suboccipital inhibition technique on postural balance in healthy young adults, using objective measures derived from center of pressure analysis, specifically Mean CoP and Mean Velocity.

Study Type

Interventional

Enrollment (Estimated)

74

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Natalia MO Campelo
  • Phone Number: +351222061000
  • Email: nmc@ess.ipp.pt

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Healthy individuals (defined by the absence of the exclusion criteria listed below)
  • Aged between 18 and 35 years
  • Signed informed consent form

Exclusion Criteria:

  • Recent history of falls
  • History of spinal or foot surgery
  • Cervical fractures
  • Known postural instability
  • Suspected neurovascular compromise
  • Neurological deficits
  • Neurological or vestibular disorders
  • Use of medication or substances that may affect the nervous system
  • Osteopathy students from the 2nd, 3rd, and 4th academic years

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental Group
The intervention group received the suboccipital muscle inhibition technique, in which the investigator applied a sustained pressure to the patient's suboccipital muscle region for 4 minutes.
Other: Intervention Technique

For the application of the suboccipital inhibition technique, the participant was positioned in the supine position on an osteopathic table, with the upper and lower limbs extended, the cervical spine in a neutral position, and the eyes closed. The therapist was seated at the head of the table, with the feet firmly supported on the floor.

The technique was performed by placing the 2nd, 3rd, and 4th fingers of both hands in the region between the occiput and the atlas, at the level of the suboccipital musculature, with the metacarpophalangeal joints flexed at approximately 90°. After correct positioning, a gentle and sustained pressure was applied, combined with a slight cephalic traction, in order to promote relaxation of the suboccipital muscles. The technique was applied for 4 minutes.
Placebo Comparator: Control Group
In the control group, a clavicular palpation technique was performed, without any therapeutic intent.
Other: Placebo Technique

For the placebo technique, the participant remained in the supine position on the osteopathic table, with the upper and lower limbs extended, the cervical spine in a neutral position, and the eyes closed. The therapist placed the hands in the clavicular region, performing only passive manual contact, without applying pressure, mobilisation, or any therapeutic intent.

This technique was used to reproduce the manual contact present in the intervention, without producing specific therapeutic effects. The application also lasted 4 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mean Cop
Time Frame: Immediately after the intervention
Mean CoP represents the average position of the center of pressure throughout the assessment period. This variable characterizes how the participant distributes body pressure over the base of support, helping to identify potential changes in postural stability organization before and after the intervention.
Immediately after the intervention
Mean Velocity
Time Frame: Immediately after the intervention
Mean Velocity represents the average speed of the center of pressure displacement during the assessment period. This variable is important in postural control analysis because it reflects how quickly the body makes adjustments to maintain stability. Higher mean velocity values may indicate a greater need for postural corrections, whereas lower values may suggest more efficient postural control.
Immediately after the intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Escola Superior de Tecnologia da Saúde do Porto

Investigators

  • Principal Investigator: Natalia MO Campelo, Escola Superior de Saúde do Porto

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

September 1, 2026

Study Completion (Estimated)

September 1, 2026

Study Registration Dates

First Submitted

June 22, 2026

First Submitted That Met QC Criteria

June 22, 2026

First Posted (Actual)

June 26, 2026

Study Record Updates

Last Update Posted (Actual)

June 26, 2026

Last Update Submitted That Met QC Criteria

June 22, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • OST1-020

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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