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The temporal effect of a high velocity thrust technique to the lumbar spine on cutaneous blood flow in the lower limb, comparing smokers and non-smokers

Journal: International Journal of Osteopathic Medicine Date: 2006/03, 9(1):Pages: 40. doi: Subito , type of study: controlled clinical trial

Full text    (https://www.sciencedirect.com/science/article/pii/S1746068906000204)

Keywords:

blood flow [20]
controlled clinical trial [283]
high velocity low amplitude thrust [5]
lumbar spine [43]
OMT [2951]
osteopathic manipulative treatment [2973]
smoking [13]

Abstract:

Background The lumbar high velocity low amplitude thrust technique (HVLAT) is a frequently used technique for the relief of spinal restriction and local somatic dysfunction. While this has generally been in order to achieve a local somatic correction and it is known to evoke a visceral response,1, 3 and a short term vascular response,4 little has been published about the long term distal autonomic consequences. Smoking has a detrimental effect on the condition of blood vessels and the autonomic nervous system.2, 5 This experiment investigates the effect a lumbar HVLAT has on vascular perfusion in the lower limb over the period of an hour, and compares the effect of a lumbar HVLAT on non-smokers and smokers. Methods Thirty-six subjects received a unilateral HVLAT thrust at the lumbo-sacral junction. Twenty-six participated in the study, 15 non-smokers and 11 smokers. Five control subjects received no intervention. A laser Doppler Blood flow monitor measured subcutaneous blood flow in the dorsum of the foot in the L5 dermatome for a total of 60min. For statistical analysis the blood flow units were calculated as percentages with the baseline 5min reading being taken as 100% and subsequent 5min intervals being positive or negative. Results Following an HVT to the lumbo-sacral junction there was a significant difference (P=0.02) in the 5min post-HVLAT period in the ipsilateral foot comparing smokers and non-smokers. There was no significant (P>0.05) change in blood flow on the ipsilateral side of non-smokers. On the contralateral side there was a significant (P=0.01) difference at 30min post-HVLAT and a significant difference (P=0.006) at 55min post-HVLAT. In smokers there was a significant decrease (P=0.02) in blood flow on the ipsilateral side in the 5min post-HVLAT period, which was also significant (P=0.02) at 30min post-HVLAT but not at 55min. There was no significant change on the contralateral side of smokers. Conclusion This study indicates a difference in smoker and non-smoker response to the HVLAT. The author proposes that this is due to facilitation of the sympathetic nervous system in smokers causing a hyper-reactive predisposition.


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