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Changes in Salivary a–Amylase After Osteopathic Manipulative Treatment

Journal: The Journal of the American Osteopathic Association Date: 2009/01, 109(1):Pages: 42-43. doi: Subito , type of study: randomized controlled trial

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2009.109.1.40/html)

Keywords:

biomarkers [15]
pilot study [186]
randomized controlled trial [866]
rib raising [21]
saliva [7]

Abstract:

While Osteopathic Manipulative Treatment (OMT) is a widely used treatment modality, little is known about the mechanisms underlying its activity. The identification of salivary biomarkers that change in response to OMT would provide convenient tools to advance this area of research. The purpose of this pilot study was to investigate the feasibility of using salivary biomarkers to study OMT by investigating changes in salivary α-amylase levels in response to rib raising. Rib raising is a commonly used technique believed to initially increase sympathetic nervous system activity but result in a prolonged reduction of sympathetic outflow. Because salivary α-amylase is a marker of sympathetic activity, it was hypothesized that rib raising would lead to a transient increase in α-amylase levels but have a minimal effect on salivary flow rate. After obtaining IRB approval, 23 healthy adult subjects were recruited and randomly assigned to OMT or placebo groups. The subjects provided saliva samples before receiving rib raising or a light touch control procedure and at two time points after the procedure. Salivary flow rate, total protein concentration and α-amylase activity were measured for each sample. Six subjects were ultimately excluded from the analysis for reasons including undetectable baseline α-amylase activity and the presence of blood in the sample. The first group of subjects (n=3 after exclusions) provided saliva samples 10 and 20 minutes after the procedure. Although an initial increase in α-amylase activity was expected, a decrease was seen at both time points in subjects who received OMT. To determine if a rapid initial increase was being missed, saliva samples were collected from the remaining subjects (n=14 after exclusions) immediately after and 10 minutes after receiving OMT or placebo. There was a significant decrease in α-amylase activity in the OMT group both immediately after (p=.014) and 10 minutes after (p=0.008) the procedure. This decrease was independent of changes in flow rate and total protein concentration. No statistically significant difference in α-amylase activity was seen in the placebo group at either time point. Although additional studies with larger sample sizes are needed, these results suggest that salivary α-amylase may be a useful biomarker for OMT.


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