The effect of light exercise upon blood flow velocity determined by laser-Doppler flowmetry

PRIMARY OBJECTIVE

The dominant, 0.1 Hz frequency, Traube-Hering component of blood flow velocity, which is related to baroreflex activity, may be modulated through the established techniques of manipulative medicine. Light exercise programmes, appropriate for use by the elderly and collectively termed gymnastique douce, also are believed to impact the baroreflex in a positive manner. Our objective was to test the relationship between the Traube-Hering oscillation and light exercise.

METHODS

Using laser-Doppler flowmetry to quantify the Traube-Hering and other components of the blood flow velocity oscillation, we compared flowmetry records of 10 subjects before and immediately following a light-exercise programme.

RESULTS

The data show that the light exercise programme amplifies the 0.1 Hz component of the blood flowmetry record.

CONCLUSIONS

The 0.1 Hz component of blood-flow velocity is physiologically linked to baroreflex activity. It is this component that is augmented by a light exercise programme.

The Effect of an Alternative Medical Procedure Upon Low-Frequency Oscillations in Cutaneous Blood Flow Velocity

OBJECTIVE

Compression of the fourth ventricle (CV-4) is a manual, noninvasive procedure that reportedly affects the cranial rhythmic impulse, a phenomenon recognized by practitioners of cranial manipulation, that is concomitant with low-frequency Traube-Hering (TH) oscillations in blood flow velocity. This study examines the CV-4 and its effect upon blood flow velocity.

METHODS

Human subjects were paired with 28 individual physicians for application of the CV-4, and the duration of the application was recorded. Flowmetry records tracking the course of the procedure were obtained, 20 of which were useable for intergroup comparisons. Segments of these records (control, treatment, response) were Fourier-transformed; the Fourier-transformed spectra were subtracted from one another and the resultant difference-spectra compared.

RESULTS

The mean CV-4 procedure length was 4.43 +/- 2.22 minutes. The mean frequency of the TH waveform visible in the blood flowmetry record was 7.10 +/- 2.07 cpm. The CV-4 procedure specifically affected the low-frequency oscillations in blood flow velocity. After application, the amplitude of the TH, 0.10 Hz, frequency wave increased (relative area units: control minus treatment [0.08010 units) compared with control minus response [-0.03358 units]; P = .011).

CONCLUSIONS

This study showed that CV-4 has an effect on the TH frequency component of blood flow velocity. The practitioners of cranial manipulation who participated in this study affected their subjects in a quantifiable manner with the application of the CV-4 procedure.

Recording the rate of the cranial rhythmic impulse

The rate of the cranial rhythmic impulse can be obtained by both palpation and instrumentation. However, the literature has reported higher rates obtained by instrumentation compared with palpation. The cranial rhythmic impulse has been demonstrated to be synchronous with the Traube-Hering oscillation, measured in blood flow velocity. The current study demonstrates that physicians tend to palpate the cranial rhythmic impulse and Traube-Hering oscillation in a 1:2 ratio. This finding provides an explanation for the difference between palpated and instrumentally recorded rates for the cranial rhythmic impulse.

Palpatory diagnosis of plagiocephaly

INTRODUCTION

The term plagiocephaly, from the Greek plagios (oblique) and kephalê (head), means distortion of the head, and refers clinically to cranial asymmetry. Cranial Osteopathy, since it was first proposed, has focussed upon the diagnosis and treatment of birth trauma and cranial asymmetries, and consequently specific therapy for plagiocephalic deformities has been described. Osteopathic manipulation also has been proposed as a treatment for torticollis, a condition associated with plagiocephaly. For these reasons, we decided to look at the mechanics of the occipital bone and the adjacent atlas and bones of the cranial base, in relation to functional plagiocephaly.

METHODS

The records of 649 children seen in an osteopathic practice in Lyon, France, were reviewed retrospectively, in compliance with the legal requirements of the Commission Nationale de l'Informatique et des Libertés (CRIL) and the Helsinki accord, for gender, age at presentation, birth history, obstetrical data (breech presentation, vacuum extraction, forceps delivery or Caesarean section), presenting complaint, side of posterior plagiocephaly, side of frontal plagiocephaly, torticollis, motion pattern of the occipital bone upon the atlas, and motion pattern of the spheno-occipital synchondrosis.

RESULTS

We found significant correlations between plagiocephaly (right/left) and primipara (P=0.024), use of forceps (P=0.055) and extractor suction (P=0.055). Correlations were also found between flattening of the occiput (right/left) and lateral strain of the spheno-occipital synchondrosis (P=0.002) and between plagiocephaly (right/left) and occipito-atlantal motion (P=0.000).

CONCLUSION

We found a significant correlation between the lateral strain pattern of the spheno-occipital synchondrosis and plagiocephaly and between rotational dysfunction of the occiput upon the atlas and the side of posterior plagiocephaly. We suggest that thorough neonatal osteopathic examination can identify individuals predisposed to develop posterior plagiocephaly.

The effect of cranial manipulation on the Traube-Hering-Mayer oscillation as measured by laser-Doppler flowmetry

CONTEXT

A correlation has been established between the Traube-Hering-Mayer oscillation in blood-flow velocity, measured by laser-Doppler flowmetry, and the cranial rhythmic impulse.

OBJECTIVE

To determine the effect of cranial manipulation on the Traube-Hering-Mayer oscillation.

DESIGN

Of 23 participants, 13 received a sham treatment and 10 received cranial manipulation.

SETTING

Osteopathic Manipulative Medicine Department, Midwestern University, Downers Grove, Ill.

PARTICIPANTS

Healthy adult subjects of both sexes participated (N = 23).

INTERVENTION

A laser-Dopper flowmetry probe was placed on the left earlobe of each subject to obtain a 5-min baseline blood-flow velocity record. Cranial manipulation, consisting of equilibration of the global cranial motion pattern and the craniocervical junction, was then applied for 10 to 20 min; the sham treatment was palpation only.

MAIN OUTCOME MEASURE

Immediately following the procedures, a 5-min posttreatment laser-Doppler recording was acquired. For each cranial treatment subject, the 4 major components of the blood-flow velocity record, the thermal (Mayer) signal, the baro (Traube-Hering) signal, the respiratory signal, and the cardiac signal, were analyzed, and the pretreatment and posttreatment data were compared.

RESULTS

The 10 participants who received cranial treatment showed a thermal signal power decrease from 47.79 dB to 38.49 dB (P < .001) and the baro signal increased from 47.40dB to 51.30 dB (P < .021), while the respiratory and cardiac signals did not change significantly (P > .05 for both).

CONCLUSION

Cranial manipulation affects the blood-flow velocity oscillation in its low-frequency Traube-Hering-Mayer components. Because these low-frequency oscillations are mediated through parasympathetic and sympathetic activity, it is concluded that cranial manipulation affects the autonomic nervous system.

Cranial rhythmic impulse related to the Traube-Hering-Mayer oscillation: comparing laser-Doppler flowmetry and palpation

The primary respiratory mechanism (PRM) as manifested by the cranial rhythmic impulse (CRI), a fundamental concept to cranial osteopathy, and the Traube-Hering-Mayer (THM) oscillation bear a striking resemblance to one another. Because of this, the authors developed a protocol to simultaneously measure both phenomena. Statistical comparisons demonstrated that the CRI is palpably concomitant with the low-frequency fluctuations of the THM oscillation as measured with the Transonic Systems BLF 21 Perfusion Monitor laser-Doppler flowmeter. This opens new potential explanations for the basic theoretical concepts of the physiologic mechanism of the PRM/CRI and cranial therapy. Comparison of the PRM/CRI with current understanding of the physiology of the THM oscillation is therefore warranted. Additionally, the recognition that these phenomena can be simultaneously monitored and recorded creates a new opportunity for further research into what is distinctive about the science and practice of osteopathic medicine.