Effect of the Suboccipital Inhibition Technique on Balance Changes

NCT07670819 | Not Yet Recruiting

• 1 other identifier: OST1-020
• Study Type: interventional
• Target: 74
• Locations: 0 countries
• Sites: N/A

Brief Summary

Postural balance is an essential capacity for functional autonomy and the performance of activities of daily living, relying on the continuous integration of visual, vestibular, and somatosensory information. Within this system, the upper cervical region plays a particularly important role, as it contributes to the orientation of the head in space and to the coordination between the head, eyes, and trunk. Due to their deep location between the occiput, atlas, and axis, the suboccipital muscles have a high proprioceptive significance and are frequently associated with cervical position control and sensorimotor regulation. Changes in muscle tension, stiffness, or dysfunction in this region may alter the quality of afferent information transmitted to the central nervous system, potentially interfering with postural stability, head position awareness, body sway, and center of pressure control. In this context, the suboccipital inhibition technique is used in osteopathic practice as a manual intervention aimed at reducing myofascial tension, promoting relaxation of the upper cervical musculature, and potentially normalizing proprioceptive input.

Conditions

Balance Changes

Keywords

Balance Changes; Osteophaty; Balance; Suboccipital muscles; Suboccipital inhibition; Cervical proprioception; Postural control; Center of pressure

Outcome Measures

Primary Outcomes (2)

• Mean Center of Pressure (Mean CoP) Displacement Assessed Using a Force Platform

  Mean center of pressure displacement will be assessed using a force platform during \[static balance task\]. Lower COP displacement indicates better postural stability.assessment period.

  Immediately after the intervention

• Mean Standing Velocity Assessed During Quiet Standing

  Mean velocity during quiet standing will be assessed using \[measurement device/system name\]. Participants will stand in an upright position while postural sway is recorded. Mean velocity will be calculated as the average velocity of the center of pressure (COP) displacement over the assessment period and expressed in \[units, e.g., mm/s\]. Lower values indicate reduced postural sway and better postural stability.

  Immediately after the intervention

Study Arms (2)

Experimental Group

EXPERIMENTAL

The intervention group received the suboccipital muscle inhibition technique, in which the investigator applied a sustained pressure to the patient's suboccipital muscle region for 4 minutes.

Other: Intervention Technique

Control Group

PLACEBO COMPARATOR

In the control group, a clavicular palpation technique was performed, without any therapeutic intent.

Other: Placebo Technique

Interventions

Placebo Technique OTHER

For the placebo technique, the participant remained in the supine position on the osteopathic table, with the upper and lower limbs extended, the cervical spine in a neutral position, and the eyes closed. The therapist placed the hands in the clavicular region, performing only passive manual contact, without applying pressure, mobilisation, or any therapeutic intent. This technique was used to reproduce the manual contact present in the intervention, without producing specific therapeutic effects. The application also lasted 4 minutes.

Control Group

Intervention Technique OTHER

For the application of the suboccipital inhibition technique, the participant was positioned in the supine position on an osteopathic table, with the upper and lower limbs extended, the cervical spine in a neutral position, and the eyes closed. The therapist was seated at the head of the table, with the feet firmly supported on the floor. The technique was performed by placing the 2nd, 3rd, and 4th fingers of both hands in the region between the occiput and the atlas, at the level of the suboccipital musculature, with the metacarpophalangeal joints flexed at approximately 90°. After correct positioning, a gentle and sustained pressure was applied, combined with a slight cephalic traction, in order to promote relaxation of the suboccipital muscles. The technique was applied for 4 minutes.

Experimental Group

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may not qualify if:

• Aged between 18 and 35 years
• Signed informed consent form
• Recent history of falls
• History of spinal or foot surgery
• Cervical fractures
• Known postural instability
• Suspected neurovascular compromise
• Neurological deficits
• Neurological or vestibular disorders
• Use of medication or substances that may affect the nervous system
• Osteopathy students from the 2nd, 3rd, and 4th academic years

Sponsors & Collaborators

• Escola Superior de Tecnologia da Saúde do Porto: lead

Related Publications (12)

• Siatkowski, Idzi. "The Impact of Suboccipital Muscle Inhibition on Postural Stability in Young Individuals." Fizjoterapiapolska.pl, 2024, fizjoterapiapolska.pl/en/article/wplyw-inhibicji-miesni-podpotylicznych-na-stabilnosc-posturalna-u-mlodych-osob/.

  BACKGROUND

• Smith, Lucie, and Manoj Mehta. "The Effects of Upper Cervical Complex High Velocity Low Amplitude Thrust Technique and Sub-Occipital Muscle Group Inhibition Techniques on Standing Balance." International Journal of Osteopathic Medicine, vol. 11, no. 4, Dec. 2008, p. 162, https://doi.org/10.1016/j.ijosm.2008.08.020.

  BACKGROUND

• Kaur, Harsirjan. "Optimising Therapeutic Benefits: Suboccipital Muscle Inhibition Technique for Enhanced Balance and Alleviation of Pain Intensity in Individuals with Chronic Neck Pain." Chettinad Health City Medical Journal, vol. 13, no. 01, 30 Mar. 2024, pp. 81-86, https://doi.org/10.24321/2278.2044.202414. Accessed 14 Sept. 2024.

  BACKGROUND

• Campbell D, Murphy BA, Burkitt J, La Delfa N, Sanmugananthan P, Ambalavanar U, Yielder P. Cervico-Ocular and Vestibulo-Ocular Reflexes in Subclinical Neck Pain and Healthy Individuals: A Cross-Sectional Study. Brain Sci. 2023 Nov 18;13(11):1603. doi: 10.3390/brainsci13111603.

  PMID: 38002562 BACKGROUND

• Molina-Alvarez M, Arribas-Romano A, Rodriguez-Rivera C, Garcia MM, Fernandez-Carnero J, Armijo-Olivo S, Goicoechea Garcia C. Manual Therapy Effect in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Oct 28;19(21):14021. doi: 10.3390/ijerph192114021.

  PMID: 36360901 BACKGROUND

• Kang HS, Kwon HW, Kim DG, Park KR, Hahm SC, Park JH. Effects of the Suboccipital Muscle Inhibition Technique on the Range of Motion of the Ankle Joint and Balance According to Its Application Duration: A Randomized Controlled Trial. Healthcare (Basel). 2021 May 29;9(6):646. doi: 10.3390/healthcare9060646.

  PMID: 34072454 BACKGROUND

• Nayak SR, Swamy R, Krishnamurthy A, Dasgupta H. Bilateral anomaly of rectus capitis posterior muscles in the suboccipital triangle and its clinical implication. Clin Ter. 2011;162(4):355-6.

  PMID: 21912824 BACKGROUND

• Sung YH. Suboccipital Muscles, Forward Head Posture, and Cervicogenic Dizziness. Medicina (Kaunas). 2022 Dec 5;58(12):1791. doi: 10.3390/medicina58121791.

  PMID: 36556992 BACKGROUND

• Wannaprom N, Treleaven J, Jull G, Uthaikhup S. Neck muscle vibration produces diverse responses in balance and gait speed between individuals with and without neck pain. Musculoskelet Sci Pract. 2018 Jun;35:25-29. doi: 10.1016/j.msksp.2018.02.001. Epub 2018 Feb 5.

  PMID: 29427867 BACKGROUND

• Zamara, Weronika, et al. "The Impact of Suboccipital Muscle Inhibition on Postural Stability in Young Individuals." Fizjoterapia Polska, vol. 24, no. 1, 20 Mar. 2024, pp. 42-47, https://doi.org/10.56984/8zg2ef8369.

  BACKGROUND

• Proske U, Gandevia SC. The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiol Rev. 2012 Oct;92(4):1651-97. doi: 10.1152/physrev.00048.2011.

  PMID: 23073629 BACKGROUND

• de Vries J, Ischebeck BK, Voogt LP, Janssen M, Frens MA, Kleinrensink GJ, van der Geest JN. Cervico-ocular Reflex Is Increased in People With Nonspecific Neck Pain. Phys Ther. 2016 Aug;96(8):1190-5. doi: 10.2522/ptj.20150211. Epub 2016 Feb 4.

  PMID: 26847014 BACKGROUND

Study Officials

• Natalia MO Campelo

  Escola Superior de Saúde do Porto

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Natalia MO Campelo

CONTACT

+351222061000; nmc@ess.ipp.pt

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor Teacher

Study Record Dates

• First Submitted: June 22, 2026
• First Posted: June 26, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: June 29, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share