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Journal of Bodywork & Movement Therapies (2011) xx, 1e7

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available at www.sciencedirect.com

journal homepage: www.elsevier.com/jbmt

PREVENTION & REHABILITATION: ORIGINAL RESEARCH

Visceral mobilization can lyse and prevent peritoneal adhesions in a rat model
Geoffrey M. Bove, DC, PhD a,*, Susan L. Chapelle, RMT b
a

University of New England College of OsteopathicMedicine, Department of Pharmacology, 11 Hills Beach Rd., Biddeford, ME 04046, United States b Squamish Therapeutic Massage, 108-41105 Tantalus Rd., Squamish, BC, Canada Received 17 February 2011; received in revised form 23 February 2011; accepted 24 February 2011

KEYWORDS
Surgical complications; Bowel obstruction; Infertility; Pain

* Corresponding author. Tel.: þ1 207 602 2921; fax: þ1 207 6025931. E-mail address: gbove@une.edu (G.M. Bove). 1360-8592/$ - see front matter ª 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.jbmt.2011.02.004

Please cite this article in press as: Bove, G.M., Chapelle, S.L., Visceral mobilization can lyse and prevent peritoneal adhesions in a rat model, Journal of Bodywork & Movement Therapies (2011), doi:10.1016/j.jbmt.2011.02.004

PREVENTION &REHABILATION

Summary Objective: Peritoneal adhesions are almost ubiquitous following surgery. Peritoneal adhesions can lead to bowel obstruction, digestive problems, infertility, and pain, resulting in many hospital readmissions. Many approaches have been used to prevent or treat adhesions, but none offer reliable results. A method that consistently prevented or treated adhesions would benefitmany patients. We hypothesized that an anatomically-based visceral mobilization, designed to promote normal mobility of the abdominal contents, could manually lyse and prevent surgically-induced adhesions. Material and methods: Cecal and abdominal wall abrasion was used to induce adhesions in 3 groups of 10 rats (Control, Lysis, and Preventive). All rats were evaluated 7 days following surgery. Onpostoperative day 7, unsedated rats in the Lysis group were treated using visceral mobilization, consisting of digital palpation, efforts to manually lyse restrictions, and mobilization of their abdominal walls and viscera. This was followed by immediate post-mortem adhesion evaluation. The rats in the Preventive group were treated daily in a similar fashion, starting the day after surgery.Adhesions in the Control rats were evaluated 7 days after surgery without any visceral mobilization. Results: The therapist could palpate adhesions between the cecum and other viscera or the abdominal wall. Adhesion severity and number of adhesions were significantly lower in the Preventive group compared to other groups. In the Lysis and Preventive groups there were clear signs of disrupted adhesions.Conclusions: These initial observations support visceral mobilization may have a role in the prevention and treatment of post-operative adhesions. ª 2011 Elsevier Ltd. All rights reserved.

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G.M. Bove, S.L. Chapelle are no clinical or basic science investigations related to the efficacy or possible mechanisms of such treatments. We designed the current study to evaluate thehypothesis that visceral mobilization, currently in clinical use by one of the authors (SLC) and applied to a well-characterized rat model (Ar’Rajab et al., 1991; Irkorucu et al., 2009), can lyse established adhesions, and can prevent peritoneal adhesions from forming. In this initial report, we show that it is possible to identify, treat, and prevent experimentally induced visceral adhesions. Theseobservations open a line of investigation with the potential to benefit those who suffer adverse effects due to peritoneal adhesions.

Introduction
Peritoneal adhesions have been reported as an adverse side effect of surgery for more than a century (Hertzler, 1919), and occur in 90e100% of cases following surgery (Menzies and Ellis, 1990; Stanciu and Menzies, 2007). They are a leading cause of...