A Comparison of the Immediate Effects of Chiropractic Thoracic High-Velocity Low-Amplitude Manipulation Applied Supine and Prone on the Autonomic Nervous System

Year 2024, , 161 - 167, 25.01.2024

Yasemin Aygün , Hazal Genç , Berkay Eren Pehlivanoğlu

https://doi.org/10.33438/ijdshs.1366733

Abstract

Thoracic manipulation is one of the spinal manipulative treatment methods frequently used by clinicians. However, when carrying out this task, several methods could be preferred. This study aimed to compare the immediate effects of supine and prone thoracic high-velocity-low-amplitude chiropractic manipulations on the autonomic nervous system. The study included 62 healthy and volunteer participants aged 18-45 years. Participants were randomly assigned to supine and prone manipulation groups. Both groups, heart rate variability data were obtained with the Elite HRV CorSense device for 1 minute before the application, systolic and diastolic blood pressures were measured, pulse and saturation values were recorded. After the measurement, supine chiropractic manipulation was applied to the mid-thoracic region and the same measurements were repeated. Heart rate variability data were analyzed with Elite HRV application, pulse rate, saturation, systolic and diastolic blood pressure values were recorded, and the results were statistically evaluated. In the intra-group comparison, LF/HF ratio increased in the prone group (p=0.025). When the difference between the groups was analyzed, the change in LF/HF ratio was found to be statistically significant between the two groups (p=0.008). The effect of prone application on the autonomic nervous system was found to be higher than supine application. This study revealed that prone and supine thoracic chiropractic HVLA application was effective on OSS in healthy individuals and that the efficiency of prone manipulation was significantly higher.

Keywords

Chiropractic, Autonomic Nervous System, Spinal Manipulation, Parasympathetic Nervous System

Ethical Statement

Research Ethics Committee of Bandırma University obtained for the study 2022186.

References

• Araujo, F. X., Ferreira, G. E., Angellos, R. F., Stieven, F. F., Plentz, R. D. M., & Silva, M. F. (2019). Autonomic Effects of Spinal Manipulative Therapy: Systematic Review of Randomized Controlled Trials. J Manipulative Physiol Ther, 42(8), 623–634 [PubMed]
• Cakir, A. G., Ozden, A. V., Alptekin, H. K., Alptekin, J. O. (2019). Immediate effects of chiropractic thoracic manipulations on the autonomic nervous system. J Orthop Trauma Surg Relat Res. 2 (3), 137-145. [PubMed]
• Carnevali, L., Lombardi, L., Fornari, M., Sgoifo, A. (2020). Exploring the Effects of Osteopathic Manipulative Treatment on Autonomic Function Through the Lens of Heart Rate Variability. Front Neurosci, 14, 579365. [PubMed]
• Chhetri, P., Shrestha, L., Mahotra, N. B. (2022). Validity of Elite-HRV Smartphone Application for Measuring Heart Rate Variability Compared to Polar V800 Heart Rate Monitor. J Nepal Health Res Counc, 19(4), 809-813. [PubMed]
• Erdem, E. U., Ünver, B., Akbas, E., Kinikli, G. I. (2021). Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: A randomized controlled trial. J Back Musculoskelet Rehabil, 34(5), 735-743. [PubMed]
• Gatterman, M. (2005). Foundations of chiropractic: subluxation. Second ed. Missouri: Elsevier.
• Jowsey, P., Perry, J. (2010). Sympathetic nervous system effects in the hands following a grade III postero-anterior rotatory mobilisation technique applied to T4: a randomized, placebo-controlled trial. Man Ther, 15(3), 248-253. [PubMed]
• Lascurain-Aguirrebena, I., Newham, D., Critchley, D.J. (2016). Mechanism of action of spinal mobilizations: a systematic review. Spine (Phila Pa 1976), 41(2), 159-172. [PubMed]
• McDevitt, A.W., Cleland, J.A., Rhon, D.I., et al. (2022). Thoracic spine thrust manipulation for individuals with cervicogenic headache: a crossover randomized clinical trial. J Man Manip Ther, 30(2), 78-95. [PubMed]
• Navarro-Santana, M. J., Gómez-Chiguano, G. F., Somkereki, M. D., Fernández-de-Las-Peñas, C., Cleland, J. A., & Plaza-Manzano, G. (2020). Effects of joint mobilisation on clinical manifestations of sympathetic nervous system activity: a systematic review and meta-analysis. Physiother (United Kingdom), 107, 118–132. [PubMed]
• Picchiottino, M., Honoré, M., Leboeuf-Y de, C. et al. (2017). Neuroendocrine response following a thoracic spinal manipulation in healthy men. J Orthop Sports Phys Ther, 47(9), 617-627. [PubMed]
• Picchiottino, M., Leboeuf-Yde, C., Gagey, O., & Hallman, D. M. (2019). The acute effects of joint manipulative techniques on markers of autonomic nervous system activity: A systematic review and meta-analysis of randomized sham-controlled trials. Chiropr Man Ther, 27(1), 1–21. [PubMed]
• Picchiottino, M., Honoré, M., Leboeuf-Yde, Gagey, C.O., Cottin F. &. Hallman D.M. (2020). The effect of a single spinal manipulation on cardiovascular autonomic activity and the relationship to pressure pain threshold: A randomized, cross-over, sham-controlled trial. Chiropr Man Ther, 28(1), 1–16. [PubMed]
• Rodrigues, P.T.V., Corrêa, L.A., Reis, F.J.J., Meziat-Filho, N.A., Silva, B.M., Nogueira, LAC. (2021). One Session of Spinal Manipulation Improves the Cardiac Autonomic Control in Patients with Musculoskeletal Pain: A Randomized Placebo-Controlled Trial. Spine (Phila Pa 1976). [PubMed]
• Rogan, S., Taeymans, J., Clarys, P., Clijsen, R., Tal-Akabi, A. (2019). Feasibility and effectiveness of thoracic spine mobilization on sympathetic/parasympathetic balance in a healthy population - a randomized controlled double-blinded pilot study. Arch Physiother, 9(1), 1–9. [PubMed]
• Roura, S., Álvarez, G., Solà, I., Cerritelli, F. (2021). Do manual therapies have a specific autonomic effect? An overview of systematic reviews. PLoS One, 16(12), e0260642. [PubMed]
• Sener, B., Hatik, S. H., Özden A.V., Çörekci, A. (2021). Instant Effect of Chiropractic Upper and Middle Thoracic Zone Manipulations on Autonomic Nervous System. Int J Tradit Complement Med Res, 2(3), 137-145. [CrossRef]
• Sillevis, R., Cleland, J. (2011). Immediate effects of the audible pop from a thoracic spine thrust manipulation on the autonomic nervous system and pain: a secondary analysis of a randomized clinical trial. J Manipulative Physiol Ther, 34(1), 37-45. [PubMed]
• Sillevis, R., Trincado, G., Shamus, E. (2021). The immediate effect of a single session of pain neuroscience education on pain and the autonomic nervous system in subjects with persistent pain, a pilot study. PeerJ, 9, e11543. [PubMed]
• Tsegay, G.S., Gebregergs, G.B., Weleslassie, G.G., Hailemariam, T.T. (2023). Effectiveness of Thoracic Spine Manipulation on the Management of Neck Pain: A Systematic Review and Meta-Analysis of Randomized Control Trials. J Pain Res, 16, 597-609. [PubMed]
• Ward, J., Tyer, K., Coats, J., Williams, G., Kulcak, K. (2015). Immediate effects of upper thoracic spine manipulation on hypertensive individuals. J Man Manip Ther, 23(1), 43-50. [PubMed]
• Wirth ,B., Gassner, A., de Bruin, E.D. Axén, I., Swanenburg, J., Humphreys, B.K. and Schweinhardt,P. (2019). Neurophysiological Effects of High Velocity and Low Amplitude Spinal Manipulation in Symptomatic and Asymptomatic Humans: A Systematic Literature Review. Spine (Phila Pa 1976), 44(15), E914–E926. [PubMed]