Are doming of the diaphragm and mid-lumbar HVLAT techniques having short term effects on the peak systolic flow rate in the common femoral artery?

Item

Title
Are doming of the diaphragm and mid-lumbar HVLAT techniques having short term effects on the peak systolic flow rate in the common femoral artery?
Author(s)
Pouget, A
Abstract
Title: Are doming of the diaphragm and mid-lumbar HVLAT techniques having short term effects on the peak systolic flow rate in the common femoral artery? Introduction: “The rule of the artery is supreme” is one of the fundamental osteopathic principles stated by A.T. Still (Stone, 2007), however, very few studies have demonstrated the effects of non soft tissue techniques on arterial blood flow. Some experiments have shown the effects of osteopathic manipulations on the cutaneous blood flow in the upper (Sugrue and Drysdale, 2008) and lower limbs (Karason and Drysdale, 2003) (Howard, 2006) but no research has been led to study the influence of high velocity low amplitude thrust (HVLAT) on the flow rate (FR) in deep distal arteries. In fact, although spinal manipulations have been performed for many years (Potter et al., 2005) with high evidence of efficacy in low back pain (Van Tulder et al., 1997), the physiological mechanisms taking place are still not completely understood (Evans, 2002). Similarly, many theories and thoughts state the effects and benefits of diaphragm treatments on the blood and lymphatic flow but little research has been performed. The main aim of this study was therefore to investigate the presence of any short term hemodynamic effect in the common femoral artery (CFA) following a mid-lumbar HVLAT and a diaphragm inhibition. A second objective of this experiment was the analysis of any influence of spinal cavitation on the FR in the CFA compared to no cavitation. Clinically, this study was aimed at questioning the osteopaths about potential risks and benefits of these techniques in patients with cardiovascular conditions such as peripheral arterial disease in the lower limbs. Methodology: Twenty two healthy and asymptomatic students from the European School of Osteopathy (ESO) (11 males and 11 females) between 20 and 44 years of age were recruited based on volunteering and inclusion/exclusion criteria. This project used a controlled repeated measure design comprising three groups (Control, Inhibition, and HVLAT) with the measurements performed over a period of one week. The data were collected utilizing an ultrasound machine and a rectilinear transducer (5-8MHz). The peak systolic flow velocity (PSFV) and diameter of the CFA were measured inferior to the right inguinal ligament before and after each technique. The "after measurements" were gathered at t=1min and t=5min after the interventions. From these measurements, the peak systolic flow rate (PSFR) was calculated. A pilot study was initially accomplished to ensure the feasibility of the experiment. Results:No significant changes in PSFR were found within the control and inhibition groups (P > 0.05). Nevertheless, significant differences (P=0.0045) in PSFR were obtained within the HVLAT group five minutes (Table 8) after the lumbar manipulation with a 12.5% reduction. The corresponding PSFV P value was 0.0125 whereas the diameter P value was 0.936 (Table 9 and 10). The between groups analysis revealed no significant difference (P>0.05). Regarding the HVLAT “cavitation”/“no cavitation” sub-groups comparisons, the within sub-groups analysis revealed significant differences in PSFR for the HVLAT “cavitation” group one and five minutes after the mid-lumbar manipulation with P=0.031 and P=0.037 respectively (Table 16). The PSFV P values were 0.0471 and 0.0674 one and five minutes following the manipulation in contrast to greatest diameter P values: 0.848 and 0.576 (Table 17). The between sub-groups analysis indicated significant differences one minute after the intervention (P=0.044) with a 15.5% change in PSFR but no significant difference after five minutes (P>0.05) (Table 18). Conclusion:From these outcomes, the null hypothesis 1 and 2 could not be rejected, therefore, side lying HVLAT of the mid-lumbars and diaphragm inhibition do not have significant short term effects on the PSFR in the CFA compared to the control group. Also, the null hypothesis 3 could be rejected at t=1min but accepted at t=5min. This implies that significant differences in PSFR within the CFA were shown between the “cavitation” and “no cavitation” sub-groups one minute post-manipulation. Clinically, results from this study would demonstrate no potential risk of atheromatous plaque disruption following mid-lumbar HVLAT and diaphragm inhibition.
presented at
European School of Osteopathy
Date Accepted
2014
Date Submitted
20.1.2015 16:43:40
Type
osteo_thesis
Language
English
Submitted by:
62
Pub-Identifier
15523
Inst-Identifier
1229
Keywords
HVLAT, Doppler, Vessel diameter
Recommended
0
Item sets
Thesis

Pouget, A, “Are doming of the diaphragm and mid-lumbar HVLAT techniques having short term effects on the peak systolic flow rate in the common femoral artery?”, Osteopathic Research Web, accessed May 19, 2024, https://www.osteopathic-research.com/s/orw/item/641