Authors: Judith Walter & Paul Hendrickx
Supervisor: Daaf Dejaeghere, MSc Ost.
Background: Idiopathic shoulder problems are a common complaint in adult Europeans. Despite extensive research in this field, no treatment method has conclusively been proven effective. Osteopathy aims at detecting and treating causes rather than symptoms. It consequently perceives suchlike complaints without obvious cause holistically. Experience shows that visceral manipulation in the treatment of the musculoskeletal system are highly effective short as well as long term. This work thus sought to test the efficiency of a specific osteopathic visceral manipulation technique (“liver lift”), choosing the right shoulder mobility as an example.
Material and method: A blinded RCT was performed in Belgium and the Netherlands in January 2012. 25 volunteers, age 26 to 64 and with a restricted ROM of the right shoulder, were randomly allocated to receive a liver lift technique according to Barral (experimental group) or a sham ultrasound treatment (control group). A standard goniometer was used to perform measurements of passive as well as active anteflexion and external rotations with 45º respectively 90º abduction. ROM was measured pre- and post-intervention, and one week after it. A ROM improvement of a minimum of 10º was found clinically relevant and set as guideline. Pain was assessed with the Visual Analogue Scale. Subgroups were compiled according to a medical history questionnaire. Then a correlation of said personal determinants with the effect of the liver lift was assembled and statistically evaluated.
Results: Active anteflexion prevails in clinical relevant improvements (41.7% post, 26.7% after one week) followed by external rotations 45° (16.7% post, 20.0% after one week). They also achieve significance in some of the subgroups after one week (active anteflexion: P=0.045 in non- smokers, P=0.014 and P=0.004 in subject with sleeping disorders; external rotations 45° active: P=0.019, passive: P=0.048). The VAS scores revealed statistically significant pain relief mostly in external rotation 90°.
Shoulder disorders, shoulder treatment, visceral shoulder, adhesive capsulitis, shoulder
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