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NCT Number: NCT07670819

Effect of the Suboccipital Inhibition Technique on Balance Changes

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.

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Key information

Conditions

Age range

18 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Postural balance is a fundamental component of human motor function and is essential for maintaining functional autonomy and performing activities of daily living. It relies on the continuous and dynamic integration of sensory inputs from the visual, vestibular, and somatosensory systems, which are processed by the central nervous system to generate appropriate motor responses. These responses allow the body to maintain the center of mass within the base of support through constant postural adjustments.

Within this complex sensorimotor system, the upper cervical region plays a critical role in postural control. This region is responsible for the precise orientation of the head in space and contributes significantly to the coordination between the head, eyes, and trunk. The suboccipital muscles-namely the rectus capitis posterior major and minor, and the obliquus capitis superior and inferior-are deeply located between the occiput, atlas, and axis, and are characterized by a high density of muscle spindles. This anatomical feature suggests a strong proprioceptive function, making these muscles key contributors to cervical position sense and sensorimotor regulation.

In addition to their proprioceptive role, the suboccipital muscles are anatomically and functionally connected to the dura mater through the myodural bridge. This structure is thought to play a role in both mechanical and sensory integration, linking muscular activity with the central nervous system. Furthermore, the upper cervical region contains joint mechanoreceptors that provide additional afferent input, contributing to reflex mechanisms such as the cervico-ocular, cervico-collic, and tonic neck reflexes, which are essential for maintaining postural stability and gaze control.

Alterations in muscle tone, increased stiffness, or dysfunction in the suboccipital region may disrupt the quality of afferent information transmitted to the central nervous system. Such disturbances can impair proprioceptive accuracy and interfere with postural control mechanisms, potentially leading to increased body sway, altered head positioning, and changes in center of pressure (CoP) behavior. Since CoP displacement reflects the neuromuscular strategies used to maintain balance, it serves as an objective measure for assessing postural stability.

The suboccipital inhibition technique is commonly used in osteopathic practice as a manual intervention aimed at reducing myofascial tension in the upper cervical region. By promoting muscle relaxation and potentially restoring normal proprioceptive input, this technique may contribute to the optimization of postural control mechanisms. Previous studies have demonstrated its effects on cervical mobility, pain reduction, and flexibility; however, evidence regarding its immediate impact on postural balance remains limited and inconclusive.

Given the theoretical and neurophysiological rationale supporting the role of the suboccipital region in postural regulation, further investigation is warranted. The present study aims to evaluate the immediate effects of the suboccipital inhibition technique on postural balance in healthy young adults, using objective measures derived from center of pressure analysis, specifically Mean CoP and Mean Velocity.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Healthy individuals (defined by the absence of the exclusion criteria listed below)
  • Aged between 18 and 35 years
  • Signed informed consent form

Exclusion criteria

  • 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

Treatment and study plan

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.

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.

Primary outcomes

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

    Time frame: Immediately after the intervention

    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.

  2. Mean Standing Velocity Assessed During Quiet Standing

    Time frame: Immediately after the intervention

    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.

Study contacts

Contact information is provided by the study sponsor or research team.

Natalia MO Campelo

CONTACT

[email protected]

+351222061000

Sponsors and collaborators

Lead sponsor

Escola Superior de Tecnologia da Saúde do Porto

Other

Registry information

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Jun 26, 2026
Registry last updated
Jun 29, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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