Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Research Article

Analysis of the influence of Visceral Manual Therapy associated with Dry Needling on affections of the upper limbs.

Adson Ferreira Morais, Paulo Henrique Altran Veiga

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Introduction: The viscera play a key role in the accommodation of recurring forces of their own weight, being influenced by the membranes that surround them. Analysis of the outermost membranes demonstrates that its anatomy makes direct connections with the membranes and fasciae that form the joint capsule of the shoulder. The functionality of this region is maintained through the synergism between these various membranes. One of the major causes of shoulder dysfunction is the lack of muscle flexibility and fascial adhesions that may interfere with the functionality of the shoulder joint. Objective: This study aims to compare the efficacy of visceral manipulation and dry needling and propose a therapeutic protocol for the capsular ligament affections of the shoulders. Method: Experimental study of pre and post cohort type, composed of 30 subjects with pain and decreased range of motion in the shoulder, performed from December 2016 to November 2017. Data collection was performed by electromyography, goniometry and visual analog scale (VAS) and immediately after was applied the visceral manipulation or dry needling or both and were reassessed. The data were submitted to a statistical analysis in which was used the software GraphPad Prism 4 with level of significance of 95% (p˂0.05). Results: It was verified that there was a higher prevalence in the liver, it was also observed in post-application electromyography of the visceral mobilization and Dry Needling that the deltoid presented superior performance. Conclusion: The method mobilization and dry needling showed benefit for the glenohumeral joint, which may be others form of treatment.


Visceral Manipulation; Dry Needling; Visceral Osteopathy.


1. Minkalis AL, Vining RD, Long CR, Hawk CL, Luca KT. A systematic review of thrust manipulation for non-surgical shoulder conditions. Chiropr Man Therap. 2017;25(1):1-10.

2. Almeida CCV, Barbosa CGD, Araújo AR, Braga NHM. Relação da fáscia tóraco lombar com o mecanismo ativo de estabilização lombar. R. bras. Ci. e Mov. 2006;14(3):105-112.

3. Voigt L, Vale RGS, Abdala DW, Freitas WZ, Novaes JS, Dantas EHM. Efeitos de uma repetição de dez segundos de estímulo do método estático para o desenvolvimento da fexibilidade de homens adultos jovens. Fit Perf J. 2007;6(6):352-356.

4. Kisner C, Colby LA. Exercícios terapêuticos: fundamentos e técnicas. 6ª ed. São Paulo: Manole; 2005. In: Shuback, B; Hooper,J.; Salisbury,L. A comparision of a self-strech incorporating proprioceptive neuromuscular facilitation components and a therapist-applied PNF-technique on hamstring flexibility. Physiotherapy. 2004;90:151-157.

5. Yeng LT, Kaziyama HHS, Teixeira MJ. Síndrome dolorosa miofascial. JBA, Curitiba, v.3, n.9, p.27-43, jan./mar. 2003.

6. Bienfait M. Bases Physiologiques de La Therapie Manuelle et de L’osteopathie, 2000. A systematic review. Cephalalgia. 2014;34(12):994- 1003.

7. Barral JP, Mercier P. Visceral Manipulation. Seattle: Eastland Press Inc.; 2005.

8. Barral JP, Visceral Manipulation II. Seattle: Eastland Press Inc.; 2007.

9. Lech O, Severo A. Ombro e cotovelo. In: Hebert S, Xavier R. Ortopedia e traumatologia: princípios e prática. 2a ed. Porto Alegre: Artmed; 1998. p. 124-154.

10. Fresno MJ, Mediavilla P, Mayoral O. Dry needling of miofascial trigger points for hypertonia spastica in incomplete spinal Cord injuries. Report of two cases. J Musculoskelet Pain. 2004;12(Suppl 9):75 [abstract].

11. Dilorenzo L, Traballesi M, Morelli D, Pompa A, Brunelli S, Buzzi MG, et al. Hemiparetic shoulder pain syndrome treated with deep dry needling during early rehabilitation: a prospective, open-label, randomized investigation. J Musculoskelet Pain. 2004;12:25-34.

12. Osborne NJ, Gatt IT. Management of shoulder injuries using dry needling in elite volleyball players. Acupuncture in Medicine. 2010;28(1):42-45.

13. Huang YT, Neoh CA, Lin SY, Shi HY. Comparisons of prediction models of myofascial pain control after dry needling: a prospective study. Evid-Based Compl Alt. 2013; Jun 18.

14. Huang YT, Lin SY, Neoh CA, Wang KY, Jean YH, Shi HY. Dry needling for myofascial pain: prognostic factors. J Altern Complement Med. 2011;17(8):755–762.

15. Barral J, Croibier A. Visceral vascular manipulations. Churchill Livingstone; 2011.

16. Paoletti S. The fascie: anatomy disfuncion & tratament. Easteland Press; 2006.

17. Pegreffi F, Pellegrini A, Paladini A, Merolla G, Belli G, Velarde PU, et al. Deltoid muscle activity in patients with reverse shoulder prosthesis at 2-year follow-up. Musculoskelet Surg. 2017;101(Suppl 2):129-135.

18. Rock J, Rainey CE. Treatment of nonspecific thoracic spine pain with trigger point dry needle ligand intramuscular electrical stimulation: a case series. Int J Sports Phys Ther. 2014;9(5):699-711.

19. Koppenhaver SL, Walker MJ, Rettig C, Davis J, Nelson C, Su J, et al. The association between dry needling-induced twitch response and change in pain and muscle function in patients with low back pain: a quasiexperimental study. Physiotherapy. 2017;103(2):131-137.

20. Dar G, Hicks GE. The immediate effect of dry needling on multifidus muscles’ function in healthy individuals. Journal of Back and Musculoskeletal Rehabilitation. 2016;29(3):273-278.

21. Finet, G. Treating Visceral Dysfunction: An Osteopathic Approach to Understanding and Treating the Abdominal Organs. Stillness Press, Portland, OR; 2000.

22. Souza KRSB. A ação do tratamento do agulhamento a seco no controle da síndrome dolorosa miofascial. Goiânia. Monografia [Pós-graduação em reabilitação em ortopedia e traumatologia com ênfase em terapia manual]- Faculdade Cambury; 2013.

23. Hueguenin L, Brukner PD, McCrory P, Smith P, Wajswelner H, Bennell K. Effect of dry needling of gluteal muscles on straight leg raise: a randomised, placebo controlled, double blind trial. British Journal of Sports Medicine. 2005;39(2):84-90.

24. Kietrys DM, Palombaro KM, Azzaretto E, Hubler R, Schaller B, Schlussel JM, et al. Effectiveness of Dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. Journal of Orthopedic and Sports Physical Therapy. 2013;43(9):620-634.

25. Ong J, Claydon LS. The effect of dry needling for myofascial trigger points in the neck and shoulders: a systematic review and meta-analysis. J Bodyw Mov Ther. 2014;18(3):390-398.

26. Myers, TW. Trilhos Anatômicos. Meridianos Miofasciais para terapeutas manuais e do movimento. 2ª edição. Brasil: Elsevier; 2010.

27. Moreira D, Godoy JR, Silva Junior W. Anatomia e cinésiologia clínica do aparelho do movimento. 1ª edição. Brasil: Thesaurus; 2004.

28. Walker BF, Hebert JJ, Stomski NJ, Clarke BR, Bowden RS, Losco B, et al. Outcomes of usual chiropractic. The OUCH randomized controlled trial of adverse events. Spine. Phila Pa 1976. 2013;38:1723–29.

29. Bove, GM, DC, Chapelle, SL, Visceral mobilization can lyse and prevent peritoneal adhesions in a rat model. J Bodyw Mov Ther. 2012;16:76–82.

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