The effects of diaphragm release in the upper back and neck on pain - literature review

Uvod: Bolečina v zgornjem delu hrbta in vratu postaja v sodobnem svetu vse bolj pogosta, dejavniki, ki vplivajo na njen začetek, so številni, mednje sodijo višja starost, ženski spol, bolečina v spodnjem delu hrbta, sedeč način življenja, vibracije, glavoboli, čustvene težave in slabo zadovoljstvo na delovnem mestu. Trebušna prepona je glavna dihalna mišica, poleg tega je pomembna tudi pri posturalni stabilnosti, preko fascij transversalis in thoracolumbalis pa predstavljata anatomsko povezavo z vratno hrbtenico. Njena zmanjšana zmogljivost je lahko dejavnik za pojav bolečine v zgornjem delu hrbta in vratu. Namen: Namen diplomskega dela je na podlagi pregleda literature analizirati učinke manualnega sproščanja trebušne prepone pri preiskovancih z bolečino v zgornjem delu hrbta in vratu . Metode dela: Iskanje literature je potekalo v elektronskih podatkovnih zbirkah PubMed, PEDro, Cochrane Library z brskalnikom Google Scholar. Rezultati: Po pregledu vključitvenih in izključitvenih meril je bilo v pregled literature vključenih šest raziskav. Avtorji so z uporabo različnih merilnih orodij ocenjevali kraniovertebralni kot, razširitev prsnega koša, gibanje trebušne prepone, bolečino in aktivni obseg gibljivosti vratne hrbtenice. Ugotovljen je bil pomemben učinek na zmanjšanje kraniovertebralnega kota in s tem zmanjšanja anteriornega položaja glave, razširitev prsnega koša in povečanje gibanja trebušne prepone. Pomemben učinek na zmanjšanje bolečine je bil ugotovljen le v eni raziskavi. Pomembnega učinka na aktivni obseg gibljivosti vratne hrbtenice avtorji niso potrdili. Razprava in zaključek: Na podlagi pregleda literature lahko sklepamo, da je manualna sprostitev trebušne prepone učinkovita tehnika za zmanjšanje kraniovertebralnega kota, povečanje razširitve prsnega koša in izboljšanje gibanja trebušne prepone. Za potrditev rezultatov bi bile potrebne nadaljnje raziskave na večjem vzorcu preiskovancev, ki bi spremljale dolgoročne učinke obravnave.Introduction: Pain in the upper back and neck is becoming increasingly common in the modern world, and there are numerous factors that contribute to its onset, including age, female gender, lower back pain, sedentary lifestyle, vibrations, headaches, emotional problems, and low job satisfaction. The diaphragm is the main respiratory muscle and is also crucial for postural stability. Through the transversalis and thoracolumbar fasciae, it is anatomically connected to the cervical spine. Its reduced function can be a factor in the development of upper back and neck pain. Objective: The purpose of this thesis is to analyse the effects of manual diaphragmatic relaxation in subjects with pain in the upper back and neck based on a literature review. Methods: The literature search was conducted in electronic databases including PubMed, PEDro, Cochrane Library, and Google Scholar. Results: After reviewing inclusion and exclusion criteria, six studies were included. Authors used various measurement tools to assess craniovertebral angle, chest expansion, diaphragmatic movement, pain, and active range of motion of the cervical spine. A significant effect on reducing the craniovertebral angle and, therefore, anterior head positioning, chest expansion, and increased diaphragmatic movement was observed. A significant effect on reducing pain was only found in one study. No significant effect on increasing active range of motion of the cervical spine was confirmed. Discussion and Conclusion: Based on the literature review, it can be concluded that manual diaphragmatic relaxation is an effective technique for reducing the craniovertebral angle, increasing chest expansion, and improving diaphragmatic movement. Further research on a larger sample of subjects, examining the long-term effects of this approach, would be necessary to confirm these results