Investigating the viscerosomatic effect of direct and indirect visceral manipulation applied to the root of the mesentery on thoracic paraspinal resting muscle tone (T9-11) in asymptomatic patients; a randomized control study.

Item

Title
Investigating the viscerosomatic effect of direct and indirect visceral manipulation applied to the root of the mesentery on thoracic paraspinal resting muscle tone (T9-11) in asymptomatic patients; a randomized control study.
Author(s)
Wood, A
Abstract
Background: Referred visceral pain is commonly documented in the osteopathic profession. Visceral manual therapy (VMT) techniques are practiced and taught in the UK, but there is a paucity of research into the efficacy of this approach. Currently, there is no scientific research investigating the viscerosomatic effect on muscle tone. Objective: Investigation of the viscerosomatic effect of direct and indirect VMT of the root of the mesentery on resting paraspinal muscle tone at T9-11 using an MYO in asymptomatic patients compared to control. Design: Independent measures, single-blinded randomized control study. Methods: Asymptomatic students from the European School of Osteopathy (ESO) were recruited Participants were excluded if a history of abdominal aneurysm, surgery involving the small intestine, internal bleeding or previous infections uncontrolled by antibiotics were reported. Additional exclusion factors included abdominal or thoracic pain greater than 5 out of 10. Eligible participants were further screened by a qualified ESO osteopath and included if they had palpable tenderness either over the root of the mesentery, the inferior collateral sympathetic ganglion or the thoracic vertebra T9-11. Participants were randomly allocated into one of three groups. The osteopath was responsible for the application of either direct or indirect VMT and supervision of the control group. The primary outcome measure was T9-11 paraspinal resting muscle tone (RMT), measured by the researcher with a Myotonometer (MYO). Descriptive characteristics and AUC parameters were analyzed using Analyse-IT. Normal distribution was verified using a Shapiro-Wok test and parametric data was tested for equality of variance with the Levene test. ANOVA tested for equal means of two or more groups. Non-parametric testing assessed for differences between the medians of two or more groups with Kruskal-Wallis. Results: 60 students participated in the study. Results from ANOVA (p=0.90) revealed no significant difference between direct VMT, indirect VMT compared to control. Analysis of individual vertebral segments T9-11 using ANOVA showed no significant difference (p=0.92, 0.67 and 0.43, respectively). Discussion: Neither technique had a viscerosomatic effect in asymptomatic participants. Statistically significant effects following VMT have only recently been reported as hypoalgesic changes at segmentally associated paraspinal muscles. Several factors may have limited this study including reliability of visceral assessment procedures, sample size, duration of techniques and additional follow-up measurements with an anchor to establish the minimal clinical important difference (MCID). Conclusion: The results of the study do not demonstrate that VMT has a viscerosomatic effect on muscle tone. Further research in this field with symptomatic participants is recommended.
presented at
European School of Osteopathy
Date Accepted
2016
Date Submitted
2.12.2016 17:29:04
Type
osteo_thesis
Language
English
Submitted by:
62
Pub-Identifier
15976
Inst-Identifier
1229
Keywords
Muscle tone, Root of the mesentery, Visceral manual therapy, Viscerosomatic.
Recommended
0
Item sets
Thesis

Wood, A, “Investigating the viscerosomatic effect of direct and indirect visceral manipulation applied to the root of the mesentery on thoracic paraspinal resting muscle tone (T9-11) in asymptomatic patients; a randomized control study.”, Osteopathic Research Web, accessed May 4, 2025, https://www.osteopathicresearch.com/s/orw/item/505