The Journal of the American Osteopathic Association, 2013/08, 113(8):e5. doi: 10.7556/jaoa.2013.026, type of study: ,ppt,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2013.026/html)

Keywords:

nervous system [249]
OMT [3924]
osteopathic manipulative treatment [3945]
pilot study [215]
pretest posttest design [240]
skin blood flow [3]

Abstract:

Background: Modulating peripheral sympathetic nervous system (pSNS) function may be a mechanism by which osteopathic manipulative treatment (OMT) impacts numerous disorders, particularly visceral disorders and possibly peripheral skin blood flow (pSkBF). Increased pSkBF has been associated with a hypoalgesic effect on musculoskeletal pain after different therapeutic modalities. Published outcomes on pSkBF changes after OMT are scarce, have not considered a dose-related effect, and have conflicting results, although OMT is usually associated with a short-term sympathoexcitatory effect. Objective: To investigate short-term dose-response effects of non-noxious pressures by means of standardized OMT applied on the cervico-thoracic junction on pSkBF changes in the upper limbs and on pulse rate variability (PRV), an indirect measurement of pSNS function. Methods: This project was approved by our institutional review board. The proposed methodology recorded and analyzed pSkBF and PRV data without motion artifacts as in previously published studies. We used a crossover design on 4 asymptomatic participants who underwent 4 different procedures on 4 different days: control (no touch), placebo (touch), low-pressure OMT, and high-pressure OMT. The OMT was the same cervical mobilization applied rhythmically with different non-noxious pressures. Using a Biopac MP36 system, we collected pSkBF data as percent changes from baseline and PRV data as the low to high frequency ratio of PRV spectra (LF/HF). Pressure data (kPa) were recorded with a Novel Pliance-X system. Results: Our pilot data revealed a positive, though nonsignificant, relationship between normalized pSkBF and raw kPa, but the same OMT was associated with a decrease or increase in pSkBF. The PRV data had no clear pattern. However, we observed opposite changes in the LF/HF ratios after low-pressure and high-pressure OMT. Conclusion: Meaningful pSkBF, PRV, and pressure data were collected in this study. Although not significant, our data may suggest opposite short-term changes in pSkBF and the LF/HF ratio depending on the amount of non-noxious pressure used to perform the same OMT. A larger sample may provide more data to specifically address these trends.