Acute effect of thoracal mobilization
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Acute Effects of Thoracic Mobilization: A Comprehensive Review
Introduction to Thoracic Mobilization
Thoracic mobilization is a therapeutic technique used to address various musculoskeletal issues, particularly those related to the spine. This article synthesizes recent research on the acute effects of thoracic mobilization, focusing on pain relief, range of motion (ROM), and autonomic function.
Immediate Pain Relief and Range of Motion Improvement
Mechanical Neck Pain
Thoracic spine self-mobilization has been shown to significantly improve cervical flexion and extension ROM in patients with mechanical neck pain. A study involving 52 patients demonstrated that those who performed thoracic spine self-mobilization experienced notable increases in active cervical flexion and extension ROM immediately after the intervention. Similarly, another study comparing cervicothoracic junction mobilization with thoracic manipulation found significant within-group improvements in cervical ROM and pain, although no significant differences were observed between the two groups.
Chronic Low Back Pain
In patients with chronic low back pain, thoracic mobilization has been found to reduce pain and improve ROM. A study focusing on thoracic mobilization by segment reported significant immediate effects on pain reduction and increased ROM in patients with chronic low back pain. Additionally, thoracic mobilization combined with specific low back pain treatments and breathing exercises significantly improved respiratory parameters and reduced disability in patients with chronic non-specific low back pain.
Autonomic Function and Pain Perception
Heart Rate Variability and Pressure Pain Threshold
Research on the autonomic effects of thoracic mobilization has yielded mixed results. One study found that adding thoracic mobilization to aerobic exercise did not alter autonomic function or pain pressure threshold (PPT) in asymptomatic young adults. Another study reported no significant changes in heart rate variability (HRV) or PPT following thoracic mobilization in asymptomatic subjects. However, a different study indicated that high-force thoracic mobilizations produced a greater hypoalgesic response compared to low-force mobilizations, suggesting a dose-dependent effect on pain perception.
Sympathetic Nervous System Response
A feasibility study investigating the effects of thoracic spine mobilization on the sympathetic nervous system found that anterior thrust mobilizations tended to reduce heart rate activity, although the sample size was small and further research is needed to confirm these findings.
Postoperative Outcomes
Early mobilization protocols, including thoracic mobilization, have been evaluated for their impact on postoperative outcomes following abdominal and thoracic surgery. A systematic review concluded that while early mobilization is beneficial, the quality of studies is poor and results are conflicting, making it difficult to draw definitive conclusions about the best practices for implementing these protocols.
Conclusion
Thoracic mobilization appears to offer immediate benefits in terms of pain relief and improved range of motion for patients with mechanical neck pain and chronic low back pain. However, its effects on autonomic function and pain perception are less clear, with some studies showing no significant changes. Further high-quality research is needed to better understand the optimal application and broader impacts of thoracic mobilization techniques.
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