VISCERAL MOBILIZATION: STATE OF ART FOR SYSTEMIC PATHOLOGIES MANAGEMENT

The global disease burden has evident about significant increase in many systemic diseases such as central obesity, diabetes mellitus and atherosclerosis. The concept of invasive and pharmacological management of various systemic diseases has seen a paradigm shift towards conservative management techniques like physical therapy in the last two decades for multiple conditions like type II Diabetes Mellitus, Complex Regional Pain Syndrome Type I, Atherosclerosis, Hypertension and Peripheral Arterial Disease. Multiple exercise guidelines have been created and customized and implemented worldwide to address discussed pathologies. However, it has been observed that the effects of exercises are short term requiring a life time commitment to continue the exercise regimen. Henceforth, the idea of visceral mobilization which is a hands-on treatment method implemented to mobilize the organs brought forward with pronounced systemic effects including angiogenesis and healing of aged or injured tissue along with symptomatic management1. A wide range of systemic effects have been observed with the spinal manipulation and soft tissue mobilization leading to the confirmation of physiological effectiveness of visceral mobilization. Spinal manipulation produces changes in muscle spindle response, nocifensive reflex response and neuronal activity, electromyography, and immunologic response. Further, it is observed to produce physiological changes including autonomic, circulatory, lymphatic and immunologic functions, visceral response, gene expression, neuroanatomy, function and pathology, and cellular response to in vitro simulated massage2. Further, Bindege webs massage, connective tissue (reflexogenie) massage” and Soft Tissue Mobilization (STM) are reported to mobilize skin fluids, reduce edema, increase skin temperature and provide analgesic effects in patients with systemic scelerosis3. Similar analgesic responses along with anti-oxidative effects were observed in patients with complex regional pain syndrome via application of manual therapy4. Significant decrease in blood pressure and heart rates were observed with the cervical and thoracic manipulation.