Short-term effects on heart rate variability of occipito-mastoid suture normalization in healthy subjects

Autonomic rehabilitation: Vagal and sympathetic impacts of modified occipitomastoid suture V-spread

BACKGROUND

Autonomic rehabilitation using osteopathic manipulative treatment (OMT) to stimulate the vagus nerve may be a good adjunct therapy by physiatrists who treat dysautonomia. Heart rate variability (HRV) may provide quantitative evidence for the benefits of OMT on autonomic nervous system function. Elevated HRV indicates optimal health and reduced mortality risk, whereas low HRV is associated with stress, pain, and chronic disease pathology.

OBJECTIVE

To analyze the impact of modified occipitomastoid suture v-spread OMT technique on vagal tone by measuring HRV.

DESIGN

Within-participant design with 5-minute HRV measurement pre- and post-OMT treatment.

SETTING

Clinical examination suites.

PARTICIPANTS

Thirty healthy osteopathic medical students.

INTERVENTIONS

A modified occipitomastoid suture v-spread treating somatic dysfunction by osteopathic physicians trained in osteopathic neuromusculoskeletal medicine.

MAIN OUTCOME MEASURES

HRV variables related to vagal tone including root mean square of successive differences (RMSSD), percentage of successive normal sinus RR intervals >50 ms (pNN50), high frequency (HF), Parasympathetic Nervous System Index (PNSI), and Sympathetic Nervous System Index (SNSI). Repeated measures t-test analyzed the difference in mean HRV values after OMT.

RESULTS

There were statistically significant increases in each of the HRV measures after OMT. Participants had a mean (95% confidence interval) RMSSD of 50.5 ms (38.3-62.8) at baseline and 55.0 ms (41.2-68.7, p = .013) post-OMT. pNN50 was 24.5% (17.6-31.3, n = 30) at baseline and 28.2% (20.8-35.6, p = .003) post-OMT. HF was 1549.6 ms2 (389.8-2709.4) at baseline and 1901.8 ms2 (618.2-3185.4, p = .103) post-OMT. PNSI was -0.1 (-0.5 to 0.2) at baseline and 0.1 (-0.3 to 1.5, p < .01) post-OMT, and SNSI was 0.2 (-0.1 to 0.6) at baseline and 0.05 (-0.3 to 0.4, p < .01) post-OMT. Normalization, due to high baseline variance, results include RMSSD 1.1 ms (1.0 to 1.1, p = .012), pNN50 1.3 (1.1 to 1.4, p = .011), and HF 1.2 ms2 (1.1 to 1.4, p = .018).

CONCLUSIONS

Modified occipitomastoid suture v-spread may provide clinical benefit through increased vagal tone and decreased sympathetic activity.

Impact of Osteopathic Techniques on Autonomic Regulation: A Study of Heart Rate Variability in Healthy Adults

BACKGROUND This study examined how osteopathic techniques, including compression of the fourth ventricle (CV4) and rib raising (RR), influence autonomic nervous system (ANS) activity using heart rate variability (HRV) as a measurement tool. This study aimed to evaluate the effects of the fourth ventricle compression technique and the rib raising osteopathic technique on the activity of the autonomic nervous system measured by heart rate variability in 100 healthy adults. MATERIAL AND METHODS A total of 100 healthy participants were divided into 3 groups: CV4+RR (33 subjects), CV4 only (34 subjects), and a control group (33 subjects) undergoing a simulated procedure. Three 30-minute sessions were performed. HRV was recorded during a 5-minute seated session to assess ANS activity. RESULTS While no significant differences in the overall HRV parameter were observed between groups, significant changes were found in specific frequency domain parameters. The low-frequency (LF) parameter differed significantly between groups (p=0.005). A significant interaction effect was observed for the high-frequency (HF) parameter (F2=(4,194)=3.262; p=0.013), indicating group-dependent variations. Additionally, the LF/HF ratio showed a significant interaction effect between group membership and measurement time points (F2=(4,194)=5.39; p<0.001), highlighting differences across groups and time points. CONCLUSIONS The findings demonstrate that osteopathic techniques, particularly the combined CV4+RR approach, significantly affect certain HRV parameters, such as LF%, HF%, and the LF/HF ratio. The CV4+RR group exhibited notable changes compared to the control group, which showed no significant changes. These results suggest the potential effectiveness of the applied interventions in modulating ANS activity.

Proposal for Manual Osteopathic Treatment of the Phrenic Nerve

The article reviews the anatomical path of the phrenic nerve and its anastomoses, with the most up-to-date knowledge reported in the literature. We have briefly reviewed the possible phrenic dysfunctions, with the final aim of presenting an osteopathic manual approach for the treatment of the most superficial portion of the nerve, using a gentle technique. The approach we propose is, therefore, a theory based on clinical experience and the rationale that we can extrapolate from the literature. We hope that the article will be a stimulus for further experimental investigations using the technique illustrated in the article. To the authors' knowledge, this is the first article that takes into consideration the hypothesis of an osteopathic treatment with gentle techniques for the phrenic nerve.