The effect of different rates of application of a rib raising technique on pain pressure threshold in asymptomatic individuals

Introduction

Articulation or mobilisation is a commonly utilised treatment and diagnostic technique in osteopathic practice.¹ Mobilisation techniques have previously been shown to produce a hypoalgesic response in association with sympathoexcitation, which can vary due to the rate of application.⁵ Rib raising (RR) is a form of articulation that has been previously investigated and shown to increase lung function in individuals with and without asthma.⁶ Its effects on pain measures are as yet unclear. The aim of the current study was to determine changes in pain pressure threshold after the application of a rib raising technique performed at two different rates.

Design

Randomised, controlled, crossover, prospective study.

Methods

Participants: Thirty asymptomatic volunteers recruited from the Victoria University student population.

Intervention: Each participant attended four sessions over four consecutive weeks and received a rapid RR treatment (2Hz), a slow RR treatment (0.5Hz), a control treatment or a placebo treatment in a randomised order.

Outcome Measures: Pain pressure threshold (PPT) was measured using a hand held algometer (Somedic, Sweden) and determined at the T4 spinous process level. Measures were calculated as % change from rest.

Results

PPT increases were observed in all groups (slow RR – 9.75% increase, rapid RR – 5.63% increase, control – 4.89% increase, placebo – 3.62%). A one-way ANOVA revealed there were no significant differences (P=0.437) between groups after application of the RR technique.

Conclusions

Slow application of an RR technique produces a greater increase in PPT in asymptomatic participants compared to all other treatment interventions although it was not significantly different.

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