Pilot study protocol: cervical spine joint pain and stiffness - accuracy of physical assessment in nursing

Bruno Garrido Soares, Fátima Raquel Fonseca, Patrícia Fonseca, Paulo Jorge Alves

Research output: Working paperPreprint



Background: Cervical spine dysfunction (CSD) is a problem with high personal, social and economic impact worldwide. Although its etiology is described as multifactorial, there is a need for better clarification. Literature has shown the relationship between the cervical condition, the mandibular functioning and the visceral condition. In order to guide and contribute to the accuracy of the physical assessment performed by nurses, we decided to study the influence of the stomatognathic system (SS) and viscerosomatic reflexes (VR) on pain and joint stiffness of the cervical spine. Objective: Describe the pilot study protocol of the influence of SS and RV on cervical structures. Methods: Pilot study, with a quasi-experimental design, carried out in 2019, with 50 volunteer participants from the university population of the Academic Federation of Porto, where the influence of the usual intercuspation change, the occlusal deprogramming and the pressure stimulus of the reflex skin region of the ilium/colon in the cervical spine were analyzed. This study was divided into two moments, where we first performed the kinematic and pain analysis in the passive mobilization of the upper cervical spine, using the Motion Capture System® and the Visual Analog Scale. In the second moment, 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 the observation of the possible influence of SS and VR on pain and range of motion of the upper cervical spine, providing data for future randomized studies. Potential limitations have been identified.
Original languageEnglish
Publication statusPublished - 13 Jul 2021

Publication series

NameJMIR Research Protocols
PublisherJMIR Publications Inc.
ISSN (Print)1929-0748


  • Nursing process
  • Nursing assessment
  • Pain
  • Referred pain
  • Range of motion
  • Neck pain
  • Stomatognathic system
  • Viscerosomatic reflexes


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