Effect of osteopathic visceral manipulation with shakers exercise in patients with gastroesophageal reflux: A randomized controlled trial

**Effect of Osteopathic Visceral Manipulation with Shakers exercise in patients with Gastroesophageal Reflux:**A Randomized controlled trial

AIM : To determine The Effect of Osteopathic Visceral Manipulation with Shakers exercise in patients with Gastroesophageal Reflux**.**

Objectives of the study

To evaluate and compare the effect of Osteopathic Visceral Treatment with Shakers exercise in patients with Gastroesophageal Reflux using The GerdQ questionnaire a  Frequency Scale for Symptoms of GERD (FSSG) and Carlsson dent questionnaire(CDC).

HYPOTHESIS

NULL HYPOTHESIS:

There will be no difference in the effect of Osteopathic Visceral Manipulation with Shakers exercise in patients with Gastroesophageal Reflux.

ALTERNATE HYPOTHESIS:

There will be difference in the effect of Osteopathic Visceral Manipulation with Shakers exercise in patients with Gastroesophageal Reflux.

Inclusion  Criteria:

1.      Participants who are willing to participate.

2.      Referred cases from Gastroenterologist

3.       Both male and female subjects aged 18-60 years

    Exclusion  Criteria:

4.       Past history of any pharyngeal surgery procedures

5.      Lack of cognition or comprehend commands

6.      Previous or present gastric cancer

Inclusion  Criteria:

1.      Participants who are willing to participate.

2.      Referred cases from Gastroenterologist

3.       Both male and female subjects aged 18-60 years

OUTCOME MEASURES:

Frequency Scale for Symptoms of GERD (FSSG).

The GerdQ questionnaire.

PROCEDURE

Ethical clearance will be obtained from the Institutional Ethical Committee

Participants will be selected according to the Inclusion and Exclusion criteria.

The purpose and procedure of the study will be explained to the participant.

An informed consent will be obtained from them.

The purpose and the detailed of the study will be explained to the participants

Participants will be randomly assigned into Group A and Group B by chit   method.

Group A will be given shakers exercise.

Group B will be given  Osteopathic Visceral Treatment and shakers exercise.

Group A will be given of a total of 5 sessions per week over two week period.

Group B will be given  only two sessions, per week followed by shakers exercise for two week period.

Group A

•      Shaker’s Exercise: the exercises are performed in two parts viz. Isometric hold contractions followed by isokinetic repeated contractions.

•       Initially subjects performed sustained head lifts for the 1-min in the supine position with a 1- minute rest between lifts for 3 consecutive repetitions.

•       This was then progressed by participants’ tolerance to 30 consecutive repetitions of head raisings in supine position. For both sustained and repetitive head rising, volunteers were instructed to raise the head high enough to be able to observe their toes without raising their shoulders.

•       Participants were instructed to stop the exercises right away if the they start to feel light headed, become short of breath or get a headache.

•       They were also instructed not to hold breath with isometric holds.

•       Participants were advised neck stretching exercises to help ease the soreness.

 Group B

•      Visceral osteopathic technique along with shakers exercises which is commonly used for GERD.

•      To perform the technique, the patient will be in seating, and the osteopath stayed behind, with the osteopath´s hands placed in the patient´s epigastric area.

•      The patient was then asked to bend in flexion while breathing in, so the osteopath deepened her hands on the patient´s epigastrium.

•       After that, the patient was asked to straighten his whole spine and to extend his neck while breathing out, and at that time the osteopath pushed caudally with her hands. The procedure was repeated for 5 min.

•       This technique has been proposed for patients suffering from GERD.