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Comparing Changes in Serum Nitric Oxide Levels and Heart Rate After Osteopathic Manipulative Treatment (OMT) Using the Dalrymple Pedal Pump to Changes Measured After Active Exercise

Journal: The Journal of the American Osteopathic Association Date: 2009/01, 109(1):Pages: 41-42. doi: Subito , type of study: pretest posttest design

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

Keywords:

exercise [113]
heart rate [93]
LPT [27]
lymphatic pump technique [43]
nitric oxide [7]
pretest posttest design [210]

Abstract:

Introduction: Release of endothelial nitric oxide, NO, (in nM range) into circulation may play a causative role to enhance the benefits of active aerobic exercise as well as OMT. We compared OMT using the Dalrymple Pedal Lymphatic Pump (DPLP) to active exercise in order to determine their relative effects on serum NO levels. Hypotheses: We postulate both OMT and aerobic exercise will result in significant NO increases in the nM range when compared to baseline but only active exercise will increase heart rate. Methods: We recruited 17 healthy subjects (10 male; 7 female; ages 22-27) to perform a randomized sequence of procedures on separate visits at least 3 days apart. Using a supine bicycle, participants engaged in 5 minutes active exercise at 70% maximum heart rate (HR) as calculated by the Karvonean formula. OMT was performed using the DPLP with subjects holding an accelerometer to standardize OMT rate and force employed. During both procedures we used a pulse oximeter to record HR and O2 saturation. We drew pre- and post-procedure blood samples while the patient sat still and upright for 5 minutes prior to blood draw. The blood was centrifuged and analyzed using a Caymen Chemicals Nitrate/Nitrite Fluorometric Assay Kit. Results: All subjects demonstrated consistent individual median NO baselines=65-66 nM (range 60-74). Active exercise resulted in an average ΔNO=+2.38 nM (p=0.004), ΔHR=+73 bpm (p<0.0001), and ΔO2 saturation=-1.5% (p<0.0001). OMT resulted in an average ΔNO=+3.00 nM (p=0.005), ΔHR=+0.6 bpm (p=0.778), and ΔO2 saturation=-0.47% (p=0.048). DPLP average frequency and peak force were 2.92 Hz and 0.18 G respectively. While HR varied significantly (p<0.0001) between OMT and exercise, one factor ANOVA analysis of ΔNO and ΔO2 saturation levels failed to resolve a significant difference (p=0.398) between active exercise and OMT. Conclusion: This study demonstrates that OMT, specifically DPLP, and active exercise elicit physiologically equivalent NO responses in the nM range. Further study may reveal whether those who are unable to participate in active exercise due to physical limitations have the potential to experience the clinically beneficial aspects of exercise without stressing the heart.


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