The Journal of the American Osteopathic Association, 2011/01, 111(1):55. doi: 10.7556/jaoa.2011.111.1.54, type of study: ,crs,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2011.111.1.54/html)

Keywords:

crossover study [17]
nervous system [249]
rib raising [21]
saliva [7]

Abstract:

Background: Our previous work suggested that salivary α-amylase may be a useful biomarker of the response to rib raising, a technique believed to alter sympathetic nervous system (SNS) activity. However, that study had a small number of subjects and did not address the possibility that not all patients will respond to rib raising. The goals of this follow-up study were to further examine the feasibility of using α-amylase to monitor the response to rib raising and to determine if the amount of pressure applied has any impact on the response. Hypothesis: Salivary α-amylase will decrease significantly in response to rib raising but not in response to a light touch control procedure. Methods: After institutional review board approval, 40 healthy adults were enrolled in this crossover study. Participants received both OMT and control procedures in random order at 2 different visits at least 1 week apart. Saliva samples were collected before and after each procedure and salivary α-amylase activity was measured. Fingertip pressure sensors were used to measure the amount of pressure applied during the procedures. Results: A total of 35 subjects completed the study and 3 different practitioners performed the procedures. No significant difference in the amount of pressure applied was seen between practitioners. Baseline α-amylase levels varied widely and the mean change from baseline after OMT was -38.7 U/mL. The mean change from baseline after the control procedure was -28.6 U/mL. This difference was not statistically significant (P=.804). However, a statistically significant difference was seen in the response to OMT between those who received the control first (mean change from baseline, -56.6 U/mL) and those who received rib raising first (mean change from baseline, -24.7 U/mL; P=.02). Analyses investigating the impact of other factors including which practitioner performed the manipulation, the amount of pressure applied, baseline amylase levels, subject perception, and salivary flow rate are ongoing. Conclusion: These preliminary results suggest that changes in SNS activity in response to rib raising vary greatly between individuals and that previous experience may affect this response. Additional analysis is needed to investigate practitioner differences and the impact of baseline sympathetic activity or pressure applied. This study was supported by a grant from the American Osteopathic Association.