The pathogenesis of gastroesophageal reflux disease (GERD) is multifactorial. The severity of abnormal reflux burden corresponds to the dysfunction of the antireflux barrier and inability to clear refluxate. The crural diaphragm is one of the main components of the esophagogastric junction and plays an important role in preventing gastroesophageal reflux. The diaphragm, as a skeletal muscle, is partially under voluntary control and its dysfunction can be improved via breathing exercises. Thus, diaphragmatic breathing training (DBT) has the potential to alleviate symptoms in selected patients with GERD. High-resolution esophageal manometry (HRM) is a useful method for the assessment of antireflux barrier function and can therefore elucidate the mechanisms responsible for gastroesophageal reflux. We hypothesize that HRM can help define patient phenotypes that may benefit most from DBT, and that HRM can even help in the management of respiratory physiotherapy in patients with GERD. This systematic review aimed to evaluate the current data supporting physiotherapeutic practices in the treatment of GERD and to illustrate how HRM may guide treatment strategies focused on respiratory physiotherapy.

• MeSH
• Breathing Exercises MeSH
• Esophagogastric Junction MeSH
• Gastroesophageal Reflux * MeSH
• Humans MeSH
• Manometry methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH
• Systematic Review MeSH

• MeSH
• Diffuse Noxious Inhibitory Control physiology   MeSH
• Shoulder Pain * diagnosis   etiology   MeSH
• Diagnosis, Differential MeSH
• Humans MeSH
• Palpation methods   MeSH
• Connective Tissue physiopathology   MeSH
• Shoulder Joint physiopathology   MeSH
• Reflexotherapy methods   MeSH
• Physical Therapy Modalities MeSH
• Visceral Pain * diagnosis   rehabilitation   MeSH
• Viscera physiopathology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

BACKGROUND: Intra-abdominal pressure (IAP) is an important mechanism stabilizing the spine and trunk. IAP regulation depends on the coordination of abdominal muscles, diaphragm and pelvic floor muscles. OBJECTIVE: To determine the differences in abdominal wall tension (AWT) of various postural positions, first without any correction, then after verbal and manual instructions according to Dynamic Neuromuscular Stabilization (DNS) principles. METHODS: In a cross-sectional observational study, thirty healthy individuals (mean age = 22.73 ± 1.91 years) were fitted with two Ohmbelt sensors contralaterally above the inguinal ligament and in the upper lumbar triangle. AWT was measured during five postural positions: sitting, supine with legs raised, squat, bear and hang position. First, spontaneous AWT was measured, then again after manual and verbal instructions following DNS principles. RESULTS: AWT increased significantly with DNS instructions compared to spontaneous activation. Both sensors recorded significant increases (p < .01; Cohen's d = -1.13 to -2.06) in all observed postural situations. The increase in activity occurred simultaneously on both sensors, with no significant differences noted in pressure increases between the sensors. The greatest activation for both sensors occurred in the bear position. Significant increases in activity were identified for both sensors in the supine leg raise position and in the bear position compared to spontaneous activation in sitting (p < .001). There were no statistically significant differences (for both sensors) between women and men in any position. CONCLUSION: The amount of AWT significantly increases after verbal and manual instructions according to DNS. The greatest abdominal wall activation was achieved in the bear position.

• MeSH
• Abdominal Wall * MeSH
• Abdominal Muscles MeSH
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Posture physiology   MeSH
• Cross-Sectional Studies MeSH
• Abdominal Oblique Muscles MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH

• MeSH
• Chest Pain * etiology   pathology   rehabilitation   MeSH
• Diaphragm pathology   MeSH
• Diagnosis, Differential MeSH
• Thorax pathology   MeSH
• Humans MeSH
• Joint Diseases diagnosis   etiology   pathology   rehabilitation   MeSH
• Spinal Diseases diagnosis   etiology   pathology   rehabilitation   MeSH
• Nociceptive Pain etiology   pathology   rehabilitation   MeSH
• Scheuermann Disease diagnosis   complications   pathology   rehabilitation   MeSH
• Trigger Points MeSH
• Myofascial Pain Syndromes diagnosis   etiology   pathology   rehabilitation   MeSH
• Physical Therapy Modalities * MeSH
• Tietze's Syndrome diagnosis   etiology   rehabilitation   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Anal Canal pathology   MeSH
• Humans MeSH
• Pubic Bone pathology   MeSH
• Digital Rectal Examination methods   MeSH
• Pelvic Floor * pathology   MeSH
• Trigger Points physiopathology   MeSH
• Muscles pathology   MeSH
• Myofascial Pain Syndromes * diagnosis   physiopathology   rehabilitation   MeSH
• Physical Therapy Modalities MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Úvod: V České republice dlouhodobou dostatečnou adherenci k terapii kontinuálním přetlakem (CPAP) vykazuje asi 70 % pacientů se syndromem obstrukční spánkové apnoe (OSA). Důležitým prostředkem pro udržení či zvýšení těchto hodnot může být dodatečná a opakovaná edukace, zahrnující i instruktáž ke cvičení. To v současné době není v tuzemských podmínkách běžně využíváno. Proto bylo cílem zjistit, jak opakovaná edukace s instruktáží ke cvičení ovlivní adherenci pacientů k používání CPAP terapie. Soubor a metodika: 6 pacientů se syndromem OSA podstoupilo vstupní edukaci, polovina z nich kromě úvodní edukace absolvovala 4týdenní edukačně motivační program, zahrnující instruktáž ke cvičení pod dohledem fyzioterapeuta. Druhá polovina byla pouze edukována, bez dodatečné intervence. Data o adherenci pacientů byla extrahována ze systému AirView, který zaznamenává aktivitu používaného přístroje. Výsledky a závěr: Výsledky naznačují pozitivní vliv edukačně-motivačního programu na adherenci pacientů se syndromem OSA. Dodatečná a opakovaná edukace a motivace, včetně instruktáže ke cvičení by se tak mohla stat novou úlohou fyzioterapeuta v rámci multidisciplinárního týmu věnujícího se léčbě pacientů se syndromem OSA.

• MeSH
• Patient Compliance statistics & numerical data   MeSH
• Behavior Therapy methods   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Sleep Apnea, Obstructive * complications   rehabilitation   therapy   MeSH
• Pilot Projects MeSH
• Surveys and Questionnaires MeSH
• Aged MeSH
• Sleep Hygiene MeSH
• Physical Therapy Modalities MeSH
• Exercise Therapy methods   MeSH
• Continuous Positive Airway Pressure * statistics & numerical data   MeSH
• Patient Education as Topic methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH

OBJECTIVES: Dysfunctions in the lower esophageal sphincter (LES) and the upper esophageal sphincter (UES) levels can occur owing to poor muscle coordination, contraction, or relaxation. Such condition can possibly be addressed by functional rehabilitation. The aim of this study was to measure pressure changes in the UES and LES at rest and during routine rehabilitation techniques, that is, cervical manual traction and trunk stabilization maneuver. METHODS: This study was conducted in a University Hospital Gastrointestinal Endoscopy Center. Cervical manual traction and a trunk stabilization maneuver were performed in a convenient group of 54 adult patients with gastroesophageal reflux disease. High-resolution manometry was used to measure pressure changes in the LES and UES at rest and during manual cervical traction and trunk stabilization maneuver. RESULTS: Average initial resting UES pressure was 90.91 mmHg. A significant decrease was identified during both cervical traction (average UES pressure = 42.13 mmHg, P < .001) and trunk stabilization maneuver (average UES pressure = 62.74 mmHg, P = .002). The average initial resting LES pressure was 14.31 mmHg. A significant increase in LES pressure was identified both during cervical traction (average LES pressure = 21.39 mmHg, P < .001) and during the trunk stabilization maneuver, (average pressure = 24.09 mmHg, P < .001). CONCLUSION: Cervical traction and trunk stabilization maneuvers can be used to decrease pressure in the UES and increase LES pressure in patients with gastroesophageal reflux disease.

• MeSH
• Esophageal Sphincter, Lower physiology   MeSH
• Adult MeSH
• Gastroesophageal Reflux physiopathology   rehabilitation   MeSH
• Esophageal Sphincter, Upper physiology   MeSH
• Muscle, Skeletal innervation   MeSH
• Middle Aged MeSH
• Humans MeSH
• Manipulation, Spinal methods   MeSH
• Manometry methods   MeSH
• Muscle Relaxation physiology   MeSH
• Pressure MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Randomized Controlled Trial MeSH
• Geographicals
• Czech Republic MeSH

• MeSH
• Headache * diagnosis   etiology   rehabilitation   MeSH
• Diagnosis, Differential MeSH
• Pharyngeal Muscles MeSH
• Paraspinal Muscles MeSH
• Neck Muscles MeSH
• Humans MeSH
• Musculoskeletal Manipulations methods   MeSH
• Oculomotor Muscles MeSH
• Hyoid Bone MeSH
• Palpation methods   MeSH
• Trigger Points * MeSH
• Myofascial Pain Syndromes diagnosis   etiology   rehabilitation   MeSH
• Check Tag
• Humans MeSH