Leg raise increases pressure in lower and upper esophageal sphincter among patients with gastroesophageal reflux disease

Bitnar, Petr; Šťovíček, Jan; Andel, Ross; Arlt, Josef; Arltová, Markéta; Smejkal, M; Kolář, Pavel; Kobesová, Alena

doi:10.1016/j.jbmt.2015.12.002

Cited by 18 publications

(12 citation statements)

References 23 publications

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“…Abdominal wall muscle coordination and fascia play an important role in postural stabilization [6,22]. Mus-cles of the abdominal wall work in concert with diaphragm and pelvic floor regulating intra-abdominal pressure (IAP) that increases stiffness of the lumbar spine [23].…”

Section: Discussionmentioning

confidence: 99%

Diastasis of rectus abdominis muscles in low back pain patients

Doubkova

Andel

Palascakova-Springrova

et al. 2018

BMR

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Section: Discussionmentioning

confidence: 99%

Diastasis of rectus abdominis muscles in low back pain patients

Doubkova

Andel

Palascakova-Springrova

et al. 2018

BMR

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“…16 This synergy is also essential for the development of proper reflex-locomotion patterns, as well as viscerosomatic patterns. [16][17][18] It is possible patient A's abdominal surgery had affected the muscle synergy. Altered gastrointestinal tract dysfunction, pelvic floor dysfunction, and aberrant breathing patterns can cause several changes that include joint dysfunction, soft tissue dysfunction, and aberrant movement pattern.…”

Section: Discussionmentioning

confidence: 99%

“…Altered gastrointestinal tract dysfunction, pelvic floor dysfunction, and aberrant breathing patterns can cause several changes that include joint dysfunction, soft tissue dysfunction, and aberrant movement pattern. [16][17][18] The DNS rehabilitative protocol was incorporated to correct patient A's movement patterns providing biomechanical changes for improved somatovisceral and viscerosomatic input for optimal gut function.…”

Section: Discussionmentioning

confidence: 99%

Chiropractic Management Using Multimodal Therapies on 2 Pediatric Patients With Constipation

Iyer

Skokos

Piombo

2017

Journal of Chiropractic Medicine

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“…There exists a growing body of literature demonstrating value in using increased intra-abdominal pressure to determine individuals with abnormal EGJ function. 10,11 However, not all patients can successfully perform SLR, which can limit utility of the maneuver. Only 57.4% of patients in our study were able to adequately augment intra-abdominal pressure during SLR.…”

Section: Egj Morphologymentioning

confidence: 99%

“…There is limited data using abdominal binders, Valsalva maneuver, and straight leg raise (SLR) during HRM, each of which assess if intra-abdominal pressure transmits into the intra-thoracic cavity during the maneuver. [10][11][12] Using SLR our group has demonstrated that trans-EGJ pressure phenomena can predict EGJ morphology. 12 However, the clinical impact of SLR-related pressure changes on esophageal acid burden has not been studied.…”

Section: Introductionmentioning

confidence: 99%

Straight leg raise metrics on high‐resolution manometry associate with esophageal reflux burden

Rogers

Rengarajan

Ali

et al. 2020

Neurogastroenterology Motil

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Background: Straight leg raise (SLR) is a provocative maneuver that assesses esophagogastric junction (EGJ) barrier function during high-resolution manometry (HRM). We evaluated the value of SLR in symptomatic reflux patients undergoing ambulatory reflux monitoring. Methods: Adult patients being evaluated for reflux symptoms with esophageal physiologic testing off antisecretory therapy over a 12 month period were studied. Demographics, clinical presentation, HRM studies, and reflux monitoring studies were analyzed. Intra-abdominal and intra-esophageal pressures were extracted at baseline and during SLR from HRM studies. Acid exposure time (AET) was derived from reflux monitoring studies, and EGJ morphology and tone from HRM studies. SLR pressure metrics predicting abnormal AET were evaluated. Key Results: Of 122 patients, 70 (57.4%) had ≥50% peak intra-abdominal pressure increase during SLR (58.0 ± 1.4 years, 75.7% female). Peak intra-esophageal pressure gradient between baseline and SLR predicted pathologic AET when ≥100% (AUC 0.78, sensitivity 71%, specificity 75%, P < .001), seen in 60.7% with AET > 6%, but only 23.7% with AET < 4% (P = .01). Peak intra-esophageal pressure gradient ≥100% was most discriminative in identifying abnormal acid burden in type 1 EGJ morphology (P = .005) but trended toward significance in type 2 and type 3 morphology (P = .1). Normal and abnormal EGJ contractile integral did not associate with peak intra-esophageal pressure gradient either collectively or when subdivided by EGJ morphology (P ≥ .2). Conclusions & Inferences: Analysis of intra-esophageal pressure gradients during SLR, a simple HRM maneuver, may augment evaluation of symptomatic GERD, and provide adjunctive evidence supporting GERD.

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Leg raise increases pressure in lower and upper esophageal sphincter among patients with gastroesophageal reflux disease

Cited by 18 publications

References 23 publications

Diastasis of rectus abdominis muscles in low back pain patients

Diastasis of rectus abdominis muscles in low back pain patients

Chiropractic Management Using Multimodal Therapies on 2 Pediatric Patients With Constipation

Straight leg raise metrics on high‐resolution manometry associate with esophageal reflux burden

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