The Journal of the American Osteopathic Association, 2010/08, 110(8):450-451. doi: 10.7556/jaoa.2010.110.8.445, type of study: ,crs,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2010.110.8.445/html)

Keywords:

autonomic nervous system [154]
crossover study [17]
CV4 technique [14]
heart rate variability [69]
high velocity low amplitude [64]
HVLA [58]
suboccipital inhibition [2]

Abstract:

Hypothesis: It is a long held belief that some of the effects of osteopathic manipulative treatment (OMT) techniques are mediated by the regulation of autonomic function. We hypothesized that OMT would produce measurable changes in autonomic balance which could be detected by spectral analysis of heart rate variability (HRV). Methods: To test this hypothesis, we examined the effects of three cervical manipulative techniques, high-velocity, low-amplitude (HVLA), suboccipital inhibition (SOI) and fourth ventricle compression (CV4), and two control procedures, laser sham (LS) and no treatment (NT), in a crossover study of 35 healthy adult subjects with a minimum washout period of 1 week. HRV was based on 5-minute electrocardiograms taken immediately before and after the experimental procedure using Biocom Heart Rhythm Scanner 3.0 software with a Biocom 3000 ECG recorder. Results: Analysis of the data using the Wilcoxon signed ranks test revealed a significant increase in normalized high frequency HRV (HFnorm) following SOI (mean [SD]; pretreatment 39.03 [18.00] nu to posttreatment 43.27 [30.04] nu; P=.049). Following CV4, normalized low frequency HRV (LFnorm) increased (mean [SD]; pretreatment 54.68 [20.22] nu to posttreatment 60.14 [20.91] nu; P=.005) as did the ratio of low to high frequency (LF/HF; mean [SD]; pretreatment 1.89 [1.85] to post-treatment 2.37 [1.95]; P=.02). HVLA, LS and NT did not produce a significant change in these parameters. None of the experimental procedures produced a significant change in total HRV as evaluated by the standard deviation in the normalized inter-beat interval (SDNN). Conclusions: The increase in HFnorm following SOI is indicative of enhanced parasympathetic (vagal) tone while the increase in LFnorm and LF/HF likely reflects a shift in balance toward sympathetic dominance. These results support the belief that specific manipulative techniques are capable of modifying the balance of autonomic tone.