Effectiveness of an osteopathic abdominal manual intervention in pain thresholds, lumbopelvic mobility, and posture in women with chronic functional constipation.

Abstract

Objectives: To assess the effect of an osteopathic abdominal manual intervention (AMI) on pressure pain thresholds (PPTs), mobility, hip flexibility, and posture in women with chronic functional constipation. Design: Randomized, double-blind placebo-controlled trial. Setting/Location: Subjects were recruited for the study by referral from different gastroenterology outpatient clinics in the city of Madrid (Spain). Subjects: Sixty-two patients suffering from chronic functional constipation according to the guidelines of the Congress of Rome III. Interventions: The experimental group (n = 31) received an osteopathic AMI, and the control group (n = 31) received a sham procedure. Outcome measures: PPTs at different levels, including vertebral levels C7, T3, T10, T11, and T12, trunk flexion range of motion (ROM), hip flexibility, and posture, were measured before and immediately after the intervention. A comparison between the difference between the pre- and postintervention values using the Student's t test for independent samples or nonparametric U-Mann-Whitney test depending on the distribution normality of the analyzed variables was perfomed. Results: In the intergroup comparison, statistically significant differences were found in PPT at T11 ( p = 0.011) and T12 ( p = 0.001) and also in the trunk flexion ROM ( p < 0.05). Moreover, women showed no adverse effects with acceptable pain tolerance to the intervention. Conclusion: The application of an osteopathic AMI is well tolerated and improves pain sensitivity in areas related to intestinal innervation, as well as lumbar flexion. Keywords: abdominal massage, constipation, pain threshold, posture, range of motion, articular