Accuracy of physical assessment in nursing for cervical spine joint pain and stiffness: pilot study protocol

Background: Cervical spine dysfunction is a condition with high personal, social, and economic impact worldwide. Although its etiology is described as multifactorial, there is a need for further clarification. The literature has demonstrated the anatomical, physiological, and pathophysiological relationship among the cervical spine, temporomandibular joint, and visceral system. To guide and contribute to the accuracy of the physical assessment performed by nurses, we will study the influence of the stomatognathic system and viscerosomatic reflexes on pain and joint stiffness of the cervical spine. Objective: The aim of this study is to describe a pilot study protocol to investigate the influence of the stomatognathic system and viscerosomatic reflexes on cervical structures. Methods: A pilot study with a quasi-experimental design was conducted with 50 volunteers from the university population of the Universidade Católica Portuguesa-Porto. We studied the influence of changes in the usual intercuspation, the occlusal deprogramming, and the pressure stimulus of the reflex skin region of the ilium/colon in the cervical spine. This study was divided into 2 phases. In the first phase, we performed the kinematic and pain analysis during the passive mobilization of the upper cervical spine using the Motion Capture System at the Motion Capture Laboratory at UCP-Porto and the Visual Analog Scale. In the second phase, we evaluated the pain threshold on palpation of the erector neck muscles and the structures of the stomatognathic system using algometry. The influence of viscerosomatic reflexes on the structures of the stomatognathic system was also analyzed. Results: Selection and preparation of the data collection site, acquisition of materials, constitution of the sample group and data collection were completed. The analysis of the results is being carried out. Conclusions: The data from this study will allow for the detection of the possible influence of the stomatognathic system and viscerosomatic reflexes on pain and range of motion of the upper cervical spine, providing data for future randomized studies. We have also identified potential limitations of this study.