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

Item

Title
The temporal effect of a high velocity thrust technique to the lumbar spine on cutaneous blood flow in the lower limb, comparing smokers to non-smokers
Author(s)
Howard Julian
Abstract
Background
The lumbar 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, little has been published about the distal autonomic consequences. It is not known whether changes in blood perfusion in the lower limb following an HVLAT are transient or long term in nature. Smoking is a confounding influence on blood flow and is known to have a detrimental effect on the condition of blood vessels and the autonomic nervous system. No published research has been found which compares the difference in cutaneous blood flow in non-smokers and smokers following the application of a high velocity thrust technique, or which measures the temporal after effect. 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
After completion of a questionnaire, then orthopaedic and neurological testing, thirty six subjects received a unilateral high-velocity low amplitude thrust at the lumbo-sacral junction. Of these twenty six were use in the study, 15 non-smokers and 11 smokers. In addition 5 control subjects received no intervention.
A laser Doppler Blood flow monitor was used to measure subcutaneous blood flow in the dorsum of the foot in the L5 dermatome. Each non-smoking and smoking subject acted as their own control by receiving a sham technique (set up for the HVLAT but not following through). Each non-smoking and smoking subject had blood flow measured for a five minute period to obtain a baseline reading, was set up in a sham HVT position and had blood flow measured for the following 5 minutes. The HVLAT was performed and blood flow measured for the remaining 50 minutes. For statistical analysis the blood flow units were calculated as percentages with the baseline reading 5 minute reading being taken as 100% and subsequent 5 minute intervals being positive or negative. The data was analysed with paired and unpaired t-tests.
Results
Following an HVT to the lumbo sacral junction there was a significant difference (P=0.02) in the five minute post HVLAT period in microvascular subcutaneous perfusion to the dorsal aspect of the ipsilateral foot when comparing asymptomatic smokers and non-smokers. Although there was a meaningful trend, 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 30 minutes post HVLAT and a significant difference (P=0.006) at 55 minutes post HVLAT. In asymptomatic smokers there was a significant decrease (P=0.02) in blood flow on the ipsilateral side in the 5 minute post HVLAT period which was also significant (P=0.02) at 30 minutes post HVLAT but not at 55 minutes. There was no significant change on the contralateral side of smokers.
Conclusion
This study reveals a difference in smokers and non-smoker in response to the HVLAT. The author proposes that this is due to facilitation of the sympathetic nervous system causing a hyper-reactive condition in smokers. Further studies investigating electro-myography simultaneously with blood flow changes in the distal limb of smokers and non-smokers are required to help explain the neuro-physiological mechanism in this process.
presented at
British College of Osteopathic Medicine
Date Accepted
0
Date Submitted
1.1.1970 00:00:00
Type
osteo_thesis
Language
English
Submitted by:
62
Pub-Identifier
13671
Inst-Identifier
1076
Recommended
0
Item sets
Thesis

Howard Julian, “The temporal effect of a high velocity thrust technique to the lumbar spine on cutaneous blood flow in the lower limb, comparing smokers to non-smokers”, Osteopathic Research Web, accessed April 25, 2024, https://www.osteopathic-research.com/s/orw/item/1086