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整骨手法治疗能否引起健康受试者的自主神经变化?一项热成像研究。

Does Osteopathic Manipulative Treatment Induce Autonomic Changes in Healthy Participants? A Thermal Imaging Study.

作者信息

Cerritelli Francesco, Cardone Daniela, Pirino Alessio, Merla Arcangelo, Scoppa Fabio

机构信息

Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy.

Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy.

出版信息

Front Neurosci. 2020 Aug 18;14:887. doi: 10.3389/fnins.2020.00887. eCollection 2020.

Abstract

Osteopathic manipulative treatment (OMT) has been demonstrated to be an effective therapy in several clinical conditions and age groups. Despite the clinical effectiveness, lack of robust data in terms of neurobiological, specifically autonomic, mechanisms of action is observed. Preliminary studies showed a parasympathetic effect leading to a trophotropic effect of OMT. However, these data are limited to heart rate variability (HRV) analysis. In order to study further the role of OMT on the autonomic nervous system, a cross-over randomized controlled trial RCT has been designed to test the effect of osteopathic treatment compared to sham therapy on a range of autonomic parameters. Thermal images, HRV and skin conductance data were collected on a sample of healthy adults. The study design consisted of two sessions (OMT and SHAM), 1 treatment per week, lasting 35 min each, composed of 5 min of baseline, 25 min of treatment, and 5 min of post-touch. During the baseline and the post-treatment, participants received no touch. Thirty-seven participants (aged 27 ± 5 years old, male ratio 40%) completed the study. Multivariate analysis showed a significant parasympathetic effect of group as well as of epoch on thermographic data of the nose (estimate 0.38; 95% CI 0.12-0.63; < 0.01), left (0.17; 0.06-0.27; <0.001) and right (0.16; 0.07-0.24; <0.001) perioral as well as on the forehead (0.07; 0.01-0.12; <0.01) regions but not for the chin (0.08; -0.02 to 0.18; 0.13). Consistent with a parasympathetic effect, analyses demonstrated a difference between OMT and sham groups on the nuHF ( < 0.001) and DFA-a1 ( < 0.01) as well as on skin conductance (<0.01). The present research supports the hypothesis that a single session of OMT as compared to sham induces autonomic consequences in healthy non-symptomatic adults. Clinicaltrial.gov identifier: NCT03888456, https://clinicaltrials.gov/ct2/show/NCT03888456.

摘要

整骨手法治疗(OMT)已被证明在多种临床病症和年龄组中是一种有效的治疗方法。尽管其临床疗效显著,但在神经生物学机制,特别是自主神经机制方面,缺乏有力的数据支持。初步研究显示,OMT具有副交感神经效应,可产生促营养作用。然而,这些数据仅限于心率变异性(HRV)分析。为了进一步研究OMT对自主神经系统的作用,我们设计了一项交叉随机对照试验(RCT),以测试与假治疗相比,整骨疗法对一系列自主神经参数的影响。我们收集了健康成年人样本的热成像、HRV和皮肤电导数据。研究设计包括两个阶段(OMT和假治疗),每周进行1次治疗,每次持续35分钟,包括5分钟的基线期、25分钟的治疗期和5分钟的治疗后接触期。在基线期和治疗后,参与者未接受任何接触。37名参与者(年龄27±5岁,男性比例40%)完成了研究。多变量分析显示,组间以及不同时期对鼻子(估计值0.38;95%可信区间0.12 - 0.63;P<0.01)、左侧(0.17;0.06 - 0.27;P<0.001)和右侧(0.16;0.07 - 0.24;P<0.001)口周以及前额(0.07;0.01 - 0.12;P<0.01)区域的热成像数据有显著的副交感神经效应,但对下巴(0.08;-0.02至0.18;P = 0.13)区域没有影响。与副交感神经效应一致,分析表明OMT组和假治疗组在低频心率变异性(P<0.001)、去趋势波动分析-a1(P<0.01)以及皮肤电导(P<0.01)方面存在差异。本研究支持这样的假设:与假治疗相比,单次OMT治疗可在健康无症状成年人中引发自主神经反应。临床试验.gov标识符:NCT03888456,https://clinicaltrials.gov/ct2/show/NCT03888456

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90d0/7461826/7cc45d70a36e/fnins-14-00887-g001.jpg

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