The AAO Journal, 2024/06, 34(2):30. doi: 10.53702/i2375-5717-34.2.16, type of study: ,rct,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/16/500954/LBORC-NUFA-Poster-Abstracts-2024-Students)

Keywords:

arteries [16]
blood flow [34]
cervical spine [320]
heart rate [102]
high velocity low amplitude [64]
HVLA [58]
randomized controlled trial [947]

Abstract:

Introduction/Background: Introduction/Background: High-velocity, low-amplitude (HVLA) osteopathic manipulative technique improves range of motion in cervical facet joints and reduces neck pain. Objective: The primary aim of our study was to determine the effect of cervical HVLA on blood flow characteristics in the internal carotid (ICA), middle cerebral (MCA), and vertebral arteries (VA) using Doppler ultrasonography. We hypothesized that cervical HVLA would result in significant changes in blood flow through cervical and cerebral blood vessels. Methods: After receiving institutional review board approval, 19 volunteers were recruited and randomly assigned to cervical HVLA or sham treatment groups. Doppler ultrasonography was used to measure blood flow (peak systolic velocity [PSV]) and heart rate in the ICA, MCA, and VA before and after treatment. Blood pressure (BP) was also measured before and after treatment. Differences between pretreatment and posttreatment outcomes were compared using Welch’s 2-sample t tests. Results: Differences between groups were found for PSV in the MCA and for systolic BP. The mean PSV in the MCA increased 3.4 cm/s in the HVLA group and decreased 8.5 cm/s in the sham group (P<.001). Mean systolic BP decreased 0.5 mmHg in the HVLA group and increased 0.6 mmHg in the sham group (P=.003). No other differences were found. Discussion/Conclusion: The increased PSV in the MCA, but not in the ICA or VA, suggested a direct impact of HVLA on cerebral circulation, causing vasoconstriction and higher systolic velocity. Conversely, the decreased systolic BP suggested systemic vasodilation. These preliminary data suggest cervical HVLA has a different effect on cerebral and systemic vasculature. More studies with larger sample sizes are necessary to determine systemic effects of HVLA on the human body.