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CV4 Alters Autonomic Balance During Paced Breathing

Journal: Journal of Osteopathic Medicine Date: 2008/08, 108(8):Pages: 415. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2008.108.8.413/html)

Keywords:

autonomic nervous system [145]
breathing [49]
cranio-sacral osteopathy [225]
CV4 technique [14]
randomized controlled trial [903]

Abstract:

Context: Compression of the fourth ventricle (CV4) has been shown to influence autonomic activity in several uncontrolled and non-randomized studies. It is unknown if the breathing rate influences these effects. This randomized controlled trial utilized paced breathing in the comparison of autonomic effects of CV4 OMT to sham (touch only). Objective: To evaluate the effects of CV4 on autonomic balance in healthy subjects with standardized breathing rate. Methods: Eighty healthy volunteer subjects (ages 20 to 65) gave informed consent to participate in the IRB approved study conducted in a temperature controlled room. Autonomic data was collected non-invasively from electrocardiogram (EKG) heart rate variability (HRV) and transcutaneous laser Doppler flowmeter (LDF) derived Traube-Hering (TH) wave measurements. LDF, EKG, and costal cage strain gauge respiratory rate measurements were collected while subjects lay supine on a padded table for three consecutive 7 minute periods: a resting baseline, an intervention (randomized CV4 or Sham, both provided by the same NMM/OMM specialist), and a post-intervention. Breathing was paced at .2 Hz (12 breaths per minute) via metronome to standardize the effects of respiration on heart rate and blood flow for all subjects. Data was analyzed with multivariate analysis and paired t-tests in SPSS. Results: One tailed paired t-test analysis of LDF data showed that the CV4 (p=.039) vs. sham (p=.175) caused a significant decrease in TH signal power from pre to post-intervention. Once age was accounted for in the HRV data, multivariate analysis demonstrated significant differences (p<.05) in CV4 vs. sham. Paired t-test analysis of the HRV variables showed two-tailed significant differences (p<.025) in various HRV measures from CV4 but not sham interventions. Although from baseline to post-intervention both CV4 and sham indicated significant changes (p<.025) in average heart rate (HRave) and average time between consecutive R signals (RRave), only CV4 showed significant changes (p<.025) in standard deviation of the average of R to R intervals (SDANN), root means squared of successive differences between R-R intervals (RMSSD), number of R-R intervals greater than 50 milliseconds (NN50), and the number of NN50 divided by the total number of R-R intervals (pNN50). Conclusion: The CV4 OMT procedure causes significant autonomic changes as measured by the LDF and EKG. These changes are unrelated to breathing rate or age.


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