Haller AIH1, Buetzberger J1, Rogan S1
1Berner Fachhochschule, Bern, Switzerland
Background: The central nervous system and the autonomic nervous system work as one unit and their function can be influenced by manual therapy techniques. Studies showed an increased sympathetic nervous system (SNS) activity, following cervical spinal manual mobilization techniques. Segmental reaction after thoracic spine mobilization regarding heart-rate variability (HRV) and heart rate frequency (HF) has received little attention.
Purpose: This present study aims to examine the feasibility and the effectiveness of a grade IV thoracic spine rotation mobilization (TSRM) on SNS and parasympathetic nervous system (PNS).
Methods: Eighteen (18 - 35 years old) healthy students met the inclusion criteria and were randomly assigned into a manual therapy group (MTG) (n=8) or control group (CG) (n=9). MTG received TSRM intervention three times per week for two weeks. Primary outcomes were assessed using recruitment with target number of 10, retention (target 10%) and treatment adherence (target > 90%), safety (no side effects) and data collection and analysis (target of number of measurement errors / inconsistent data 5%). Secondary outcomes were HRV (Fast Fourier-Transformation (FFT) and Autoregressive-Model (AR)) and HF. The measurements were made for ten minutes shortly before going to bed and for 10 minutes shortly after waking up in bed. Data were analysed with nonparametric statistics and in case of missing data by means of Intention-to-Treat-analysis (ITT) were used.
Results: The pilot study could determine for the primary outcomes: high recruitment with 17 (70%), low retention (5.9%), high treatment adherence (94.1%) and the number of measurement errors and inconsistent data with 6% are observed. FFT LF/HF morning (p=0.023; ES: 0.54) and AR: LF/HF morning (p=0.015; ES: 0.88) increased significantly with large effect sizes (ES). Trends could be determined for HF AR morning (p: 0.08; ES 0.74).
Conclusion(s): This pilot study examined evidence that the study program was feasible. However, for future studies some adaptation must be made. For the next study, there must be strict monitoring of data transmission and sufficient amount of pulls watches must be available from the start of the study. It is preliminarily suggested that TSRM may result in parasympathetic responses.
Implications: TSRM might be a considered treatment method to improve PNS activity in healthy persons
Keywords: Manual therapy, sympathetic nervous system, parasympathetic nervous system
Funding acknowledgements: None
Purpose: This present study aims to examine the feasibility and the effectiveness of a grade IV thoracic spine rotation mobilization (TSRM) on SNS and parasympathetic nervous system (PNS).
Methods: Eighteen (18 - 35 years old) healthy students met the inclusion criteria and were randomly assigned into a manual therapy group (MTG) (n=8) or control group (CG) (n=9). MTG received TSRM intervention three times per week for two weeks. Primary outcomes were assessed using recruitment with target number of 10, retention (target 10%) and treatment adherence (target > 90%), safety (no side effects) and data collection and analysis (target of number of measurement errors / inconsistent data 5%). Secondary outcomes were HRV (Fast Fourier-Transformation (FFT) and Autoregressive-Model (AR)) and HF. The measurements were made for ten minutes shortly before going to bed and for 10 minutes shortly after waking up in bed. Data were analysed with nonparametric statistics and in case of missing data by means of Intention-to-Treat-analysis (ITT) were used.
Results: The pilot study could determine for the primary outcomes: high recruitment with 17 (70%), low retention (5.9%), high treatment adherence (94.1%) and the number of measurement errors and inconsistent data with 6% are observed. FFT LF/HF morning (p=0.023; ES: 0.54) and AR: LF/HF morning (p=0.015; ES: 0.88) increased significantly with large effect sizes (ES). Trends could be determined for HF AR morning (p: 0.08; ES 0.74).
Conclusion(s): This pilot study examined evidence that the study program was feasible. However, for future studies some adaptation must be made. For the next study, there must be strict monitoring of data transmission and sufficient amount of pulls watches must be available from the start of the study. It is preliminarily suggested that TSRM may result in parasympathetic responses.
Implications: TSRM might be a considered treatment method to improve PNS activity in healthy persons
Keywords: Manual therapy, sympathetic nervous system, parasympathetic nervous system
Funding acknowledgements: None
Topic: Musculoskeletal: spine; Outcome measurement
Ethics approval required: Yes
Institution: KEK-BE
Ethics committee: Kantonale Ethikkommission Bern KEK
Ethics number: 2016/00230
All authors, affiliations and abstracts have been published as submitted.
