Effects of diaphragm stretching on posterior chain muscle kinematics and rib cage and abdominal excursion: a randomized controlled trial

Francisco J González-Álvarez, Marie C Valenza, Irene Torres-Sánchez, Irene Cabrera-Martos, Janet Rodríguez-Torres, Yolanda Castellote-Caballero, Francisco J González-Álvarez, Marie C Valenza, Irene Torres-Sánchez, Irene Cabrera-Martos, Janet Rodríguez-Torres, Yolanda Castellote-Caballero

Abstract

Background: Few studies have explored the effects of stretching techniques on diaphragm and spine kinematics.

Objective: To determine whether the application of diaphragm stretching resulted in changes in posterior chain muscle kinematics and ribcage and abdominal excursion in healthy subjects.

Method: Eighty healthy adults were included in this randomized clinical trial. Participants were randomized into two groups: the experimental group, which received a diaphragmatic stretching technique, or the placebo group, which received a sham-ultrasound procedure. The duration of the technique, the position of participants, and the therapist who applied the technique were the same for both treatments. Participant assessment (cervical range of movement, lumbar flexibility, flexibility of the posterior chain, and rib cage and abdominal excursion) was performed at baseline and immediately after the intervention by a blinded assessor.

Results: The mean between-group difference [95% CI] for the ribcage excursion after technique at xiphoid level was 2.48 [0.97 to 3.99], which shows significant differences in this outcome. The remaining between-group analysis showed significant differences in cervical extension, right and left flexion, flexibility of the posterior chain, and ribcage excursion at xiphoid level (p<0.05) in favor of the experimental group.

Conclusion: Diaphragm stretching generates a significant improvement in cervical extension, right and left cervical flexion, flexibility of the posterior chain, and ribcage excursion at xiphoid level compared to a placebo technique in healthy adults.

Trial registration: ClinicalTrials.gov NCT01753726.

Figures

Figure 1. Diaphragm stretching technique.
Figure 1. Diaphragm stretching technique.
Figure 2. Flow diagram of the progress…
Figure 2. Flow diagram of the progress through the phases of the randomized trial.

References

    1. Hodges PW, Gurfinkel VS, Brumagne S, Smith TC, Cordo PC. Coexistence of stability and mobility in postural control: evidence from postural compensation of respiration. Exp Brain Res. 2002;144(3):293–302.
    1. Hamaoui A, Le Bozec S, Poupard L, Bouisset S. Does postural chain muscular stiffness reduce postural steadiness in a sitting posture? Gait Posture. 2007;25(2):199–204.
    1. Nason LK, Walker CM, McNeeley MF, Burivong W, Fligner CL, Godwin JD. Imaging of the diaphragm: anatomy and function. Radiographics. 2012;32(2):E51–70.
    1. Hodges PW, Gandevia SC. Changes in intra-abdominal pressure during postural and respiratory activation of the human diaphragm. J Appl Physiol. 2000;89(3):967–976.
    1. De Troyer A, Kirkwood PA, Wilson TA. Respiratory action of th intercostal muscles. Physiol Rev. 2005;85(2):717–756.
    1. Granata KP, Wilson SE. Trunk posture and spinal stability. Clin Biomech. 2001;16(8):650–659.
    1. Wicke J, Gainey K, Figueroa M. A comparison of self-administered proprioceptive neuromuscular facilitation to static stretching on range of motion and flexibility. J Strength Cond Res. 2014;28(1):168–172.
    1. Young W, Clothier P, Otago L, Bruce L, Liddell D. Acute effects of static stretching on hip flexor and quadriceps flexibility, range of motion and foot speed in kicking a football. J Sci Med Sport. 2004;7(1):23–31.
    1. Noll DR, Degenhardt BF, Johnson JC, Buró SA. Immediate effects of osteopathic manipulative treatment in elderly patients with chronic obstructive pulmonary disease. J Am Optom Assoc. 2008;108(5):251–259.
    1. Noll DR, Degenhardt BF, Johnson JC, Burt SA. The immediate effect of individual manipulation techniques on pulmonary function measures in persons with COPD. Osteopath Med Prim Care. 2009;3(1):9.
    1. Souchard P-E, Meli O, Sgamma D, Pillastrini P. Rieducazione postural globale. Paris: Elsevier Masson SAS; 2009. (Medicina Riabilitativa).
    1. Cunha AC, Burke TN, França FJ, Marques AP. Effect of global posture reeducation and of static stretching on pain, range of motion, and quality of life in women with chronic neck pain: a randomized clinical trial. Clinics. 2008;63(6):763–770.
    1. Fernandez-de-Las-Peñas C, Alonso-Blanco C, Alguacil-Diego IM, Miangolarra-Page JC. One-year follow-up of two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial. Am J Phys Med Rehabil. 2006;85(7):559–567.
    1. Valenza MC, Cabrera-Martos I, Torres-Sánchez I, Garcés-García A, Mateos-Toset S, Valenza-Demet G. The Immediate Effects of Doming of the Diaphragm Technique in Subjects With Short Hamstring Syndrome: A Randomized Controlled Trial. J Sport Rehabil. 2015 In press.
    1. Mayer T, Brady S, Bovasso E, Pope P, Gatchel RJ. Noninvasive measurement of cervical tri-planar motion in normal subjects. Spine (Phila Pa 1976). 1993;18(15):2191–2195.
    1. Youdas JW, Garrett TR, Suman VJ, Bogard CL, Hallman HO, Carey JR. Normal range of motion of the cervical spine: an initial goniometric study. Phys Ther. 1992;72(11):770–780.
    1. Macedo CSG, Souza PR, Alves PM, Cardoso JR. Study of validity and intra and interobserver reliability of the modified version of Schöber test modified in individuals with low back pain. Fisioter Pesqui. 2009;16(3):233–238.
    1. Rahali-Khachlouf H, Poiraudeau S, Fermanian J, Ben Salah FZ, Dziri C, Revel M. Validité et reproductibilité des mesures cliniques rachidiennes dans la spondylarthrite ankylosante. Ann Readapt Med Phys. 2001;44(4):205–212.
    1. Perret C, Poiraudeau S, Fermanian J, Colau MM, Benhamou MA, Revel M. Validity, reliability, and responsiveness of the fingertip-to-floor test. Arch Phys Med Rehabil. 2001;82(11):1566–1570.
    1. Cahalin LP, Braga M, Matsuo Y, Hernandez ED. Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: a review of the literature. J Cardiopulm Rehabil. 2002;22(1):7–21.
    1. Derom E, Marchand E, Troosters T. Pulmonary rehabilitation in chronic obstructive pulmonary disease. Ann Readapt Med Phys. 2007;50(7):615–26, 602-14.
    1. Chaitow L, Bradley D, Gilbert C. Patterns of breathing dysfunction in hyperventilation syndrome and breathing pattern disorders. In: Chaitow L, Bradley D, Gilbert C, editors. Multidisciplinary approaches to breathing pattern disorders. London: Churchill Livingstone; 2002. pp. 51–86.
    1. Downey R. Anatomy of the normal diaphragm. Thorac Surg Clin. 2011;21(2):273–9, ix.
    1. Saíz-Llamosas JR, Fernández-Pérez AM, Fajardo-Rodríguez MF, Pilat A, Valenza-Demet G, Fernández-de-Las-Peñas C. Changes in Neck Mobility and Pressure Pain Threshold Levels Following a Cervical Myofascial Induction Technique in Pain-Free Healthy Subjects. J Manipulative Physiol Ther. 2009;32(5):352–357.
    1. Batista LH, Vilar AC, Ferreira JJA, Rebelatto JR, Salvini TF. Active stretching improves flexibility, joint torque, and functional mobility in older women. Am J Phys Med Rehabil. 2009;88(10):815–822.
    1. Moreno MA, Catai AM, Teodori RM, Borges BL, Cesar MC, Silva E. Effect of a muscle stretching program using the Global Postural Reeducation method on respiratory muscle strength and thoracoabdominal mobility of sedentary young males. J Bras Pneumol. 2007;33(6):679–686.
    1. Kasunich NJ. Changes in low back pain in a long distance runner after stretching the iliotibial band. J Chiropr Med. 2003;2(1):37–40.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera