401 lines
16 KiB
XML
401 lines
16 KiB
XML
import Article from "@/components/Article";
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import { Metadata } from "next";
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export const metadata: Metadata = {
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title:
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"Article - The Effect of Cranial Manipulation on the Traube-Hering-Mayer Oscillation as Measured by Laser-Doppler Flowmetry | Dr. Feely",
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authors: [{ name: "Nicette Sergueff" }, { name: "Kenneth E. Nelson" }],
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description: `A correlation has been established between the
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Traube-Hering-Mayer oscillation in blood-flow velocity, measured by
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laser-Dopper-flowmetry, and the cranial rhythmic impulse.`,
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};
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const ArticleCranialManipulation = () => {
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return (
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<Article
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title="The Effect of Cranial Manipulation on the Traube-Hering-Mayer Oscillation as Measured by Laser-Doppler Flowmetry"
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author=""
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>
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<h2>Source</h2>
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<p>
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Alternative Therapies, Nov/Dec 2002, Vol. 8 No. 6<br />
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<a href="http://www.alternative-therapies.com/">
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http://www.alternative-therapies.com/
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</a>
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</p>
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<h2>Authors</h2>
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<p>
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Nicette Sergueff lectures throughout Europe on manual principles,
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diagnosis, and treatment, and maintains a private practice in Corbas,
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France. She is an assistant professor.
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</p>
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<p>
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<em>Kenneth E. Nelson </em>is a professor, and Thomas Glonek is a
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research professor in the Department of Osteopathic Manipulative
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Medicine, Chicago College of Osteopathic Medicine, Midwestern
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University, Downers Grove, Illinois.
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</p>
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<h2>Context</h2>
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<p>
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A correlation has been established between the Traube-Hering-Mayer
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oscillation in blood-flow velocity, measured by laser-Dopper-flowmetry,
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and the cranial rhythmic impulse.
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</p>
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<h2>Objective</h2>
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<p>
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To determine the effect of cranial manipulation on the
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Traube-Hering-Mayer oscillation.
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</p>
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<h2>Design</h2>
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<p>
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Of 23 participants, 13 received a sham treatment and 10 received cranial
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manipulation.
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</p>
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<h2>Setting</h2>
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<p>
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Osteopathic Manipulative Medicine Department, Midwestern University,
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Downers Grove, Illinois.
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</p>
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<h2>Participants</h2>
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<p>Healthy adult subjects of both sexes participated (N=23).</p>
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<h2>Intervention</h2>
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<p>
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A laser-Doppler flowmetry probe was place on the left earlobe of each
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subject to obtain a 5-min baseline blood flow velocity record. Cranial
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manipulation, consisting of equilibration of the global cranial motion
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patter and the craniocervical junction, was then applied for 10 to 20
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minutes; the sham treatment was manipulation only.
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</p>
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<h2>Main Outcome Measure</h2>
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<p>
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Immediately following the procedures, a 5-min postreatment laser-Doppler
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recording was acquired. For each cranial treatment subject, the 4 major
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components of the blood-flow velocity record, the thermal (Mayer)
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signal, the baro (Traube-Hering) signal, the respiratory signal, and the
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cardiac signal, were analyzed, and the pretreatment and posttreatment
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data were compared.
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</p>
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<h2>Results</h2>
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<p>
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The 10 participants who received cranial treatment showed a thermal
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signal power decrease from 47.79 dB to 38.490 dB (P < .001) and the
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baro signal increased from 47.40 dB to 51.30 dB (P < .021), while the
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respiratory and cardiac signals did not change significantly (P > .05
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for both).
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</p>
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<h2>Conclusion</h2>
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<p>
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Cranial manipulation affects the blood-flow velocity oscillation in its
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low-frequency Traube-Hering-Mayer components. Because these
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low-frequency oscillations are mediated through parasympathetic and
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sympathetic activity, it is concluded that cranial manipulation affects
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the autonomic nervous system.
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</p>
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<h2>Introduction</h2>
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<p>
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Cranial manipulation is a form of broadly practiced alternative, manual
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medicine. A fundamental component of cranial manipulation is the primary
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respiratory mechanism (PRM).<sup>1</sup> It is described as an
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oscillation that is palpable; the cranial rhythmic impulse (CRI)2 has an
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agreed-upon frequency of 10-14 cycles per minute (cpm).<sup>2,3</sup>{" "}
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The PRM/CRI is a subtle phenomenon that is readily palpable only by
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experienced individuals, making its very existence subject to debate.{" "}
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<sup>4,5</sup>
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</p>
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<p>
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The Traube-Hering-Mayer (THM) wave is a complex oscillation in blood
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pressure and blood-flow velocity. The Traube-Hering (TH) component of
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this oscillation has a frequency of 6 to 10 cpm. Analysis of the TH was
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first described in 1865, when Ludwig Traube reported the measurement of
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a fluctuation in pulse pressure that occurred with a particular
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frequency of respiration but persisted after respiration had been
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arrested.<sup>6</sup> Fourier-transform analysis applied to blood
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physiologic parameters shows that this fluctuation consists of 3
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principal spectral peaks: the thermal or Mayer (M) wave (1.2-5.4 cmp),
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the baro or TH wave (6.0-10.0 cpm), and the respiratory wave, which
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shifts in frequency with changes in the respiratory rate.7 Multiple
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authors have commeted on the similarity between the TH wave and the CRI.
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<sup>8-11</sup>
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</p>
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<p>
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By comparing cranial manipulation with laser-Doppler flowmetery, we have
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demonstrated that the PRM/CRI is congruous with the TH component of the
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THM oscillation in blood flow velocity.<sup>12</sup> A question,
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therefore, logically arises: can cranial manipulation affect the THM
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oscillation?
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</p>
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<h2>Method</h2>
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<p>
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Healthy adult subjects (both sexes, N=23, institutional review
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board-approved informed consent obtained) were divided randomly into
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cranial palpation (n=13) and cranial manipulation groups (n=10). A
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laser-Doppler probe (BLF 21 Perfusion Monitor, Transonic Systems, Inc.
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Ithaca, NY) was placed on the left earlobe of each subject. After the
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subject was allowed to lie quietly on the examination table for 3
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minutes of equilibration, a 5-minute baseline blood-flow velocity record
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was obtained. Cranial manipulation or manipulation, with the physician
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blinded to the flowmetry recording, was then performed for 10 to 20
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minutes. Following palpation or treatment, a 5-minute postcontact
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laser-Doppler recording was acquired. During this entire procedure, the
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subject remained on the examination table, and the laser-Doppler probe
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was not disturbed.
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</p>
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<p>
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Cranial palpation (simply counting the CRI but without intervention) and
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manipulation (therapeutic intervention) were performed while the
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subjects were supine. The individual performing the procedure was seated
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at the end of the examination table with hi or her forearms resting upon
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it. The examiner's palms conformed to the curvature of the subject's
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head, contacting the lateral aspect of the great wings of the sphenoid
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bone and the temporal, occipital and parietal bones bilaterally. For
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this study, similar contact pressure, firm, but light enough not to
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ablate the sensation of the CRI, was employed for both palpation and
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manipulation. Manipulation was directed at modulation of the rate,
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rhythm, and amplitude of the CRI and perceived functional asymmetry
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through equilibration of the craniocervical junction and global
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anerioposterior cranial motion. Specific interventions were dictated by
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the physical findings of the individual's cranial pattern.
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</p>
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<h2>Results</h2>
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<p>
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For each subject, 4 component parts of the blood flow velocity record
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were analyzed: the thermal (M) signal, the baro (TH) signal and the
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respiratory signal of the THM, and the cardiac signal. The mean
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precontact and postcontact data for each group were compared using the
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paired-samples 2 tailed t statistic (see Table). After palpation only,
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the thermal signal power decreased 3 dB (42.93 to 39.58 Db, P <
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.054), while the baro (39.83 to 40.10 dB, P < .805), respiratory
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(27.54 to 27.20 dB, P < .715) and cardiac (37.92 to 37.14 dB, P <
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.511) signals did not change.
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</p>
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<p>
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After cranial manipulation, the thermal signal power decreased 9 dB
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(47.40 to 51.30 dB, P < .021), while the respiratory (29.72 to 30.02
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dB, P < .747) and cardiac (41.11 to 40.70 dB, P < .788) signals
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did not change.
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</p>
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<p>
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The 2 examples illustrated (see Figure), though visually exceptional,
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illustrate the effects that can be obtained to varying degrees with any
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subjecd, provided the treating physician possesses the requisite skill.
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</p>
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<h2>Comments</h2>
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<p>
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From the above data, we have drawn 3 conclusions. First, cranial
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manipulation has an effect on low-frequency oscillations observed in
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blood-flow velocity. It decreases the amplitude of the M wave and
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increases the amplitude of the TH wave. Second, we conclude that cranial
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manipulation affects the autonomic nervous system because it has been
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demonstrated that the M an TH waves are mediated through parasympathetic
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and sympathetic activity.7 Third, because palpation alone did not
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greatly affect blood-flow velocity oscillations, we conclude that there
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is a quantifiable difference between palpation and cranial treatment.
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This conclusion suggests that palpation alone may be used as a sham
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treatment in future research in the field of cranial manipulation.
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</p>
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<table>
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<tbody>
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<tr>
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<td colSpan={8}>
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<strong>
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Traube-Hering-Mayer signal power comparison before and after
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palpation only and cranial manipulation
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</strong>
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</td>
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</tr>
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<tr>
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<td colSpan={2}></td>
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<td colSpan={3}>
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<strong>Palpation only n=13</strong>
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</td>
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<td colSpan={3}>
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<strong>Cranial manipulation n=10</strong>
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</td>
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</tr>
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<tr>
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<td>
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<strong>Signal</strong>
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</td>
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<td>
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<strong>Doppler record segment</strong>
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</td>
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<td>
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<strong>
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Mean signal
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<br />
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power (dB)
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</strong>
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</td>
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<td>
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<strong>
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Paired difference
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<br />
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before-after +/- SD
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</strong>
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</td>
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<td>
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<em>P</em>
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</td>
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<td>
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<strong>
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Mean signal
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<br />
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power (dB)
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</strong>
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</td>
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<td>
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<strong>
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Paired difference
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<br />
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before-after +/- SD
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</strong>
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</td>
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<td>
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<em>P</em>
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</td>
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</tr>
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<tr>
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<td valign="top">
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<strong>Thermal (M)</strong>
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</td>
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<td>
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<strong>Before After</strong>
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</td>
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<td valign="top">
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42.93
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<br />
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39.58
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</td>
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<td valign="top">3.36+/-5.69</td>
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<td valign="top">.054</td>
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<td valign="top">
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47.79
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<br />
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38.49
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</td>
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<td valign="top">9.30+/-5.65</td>
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<td valign="top">.001</td>
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</tr>
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<tr>
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<td valign="top">
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<strong>Baro (TH)</strong>
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</td>
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<td>
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<strong>Before After</strong>
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</td>
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<td valign="top">
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39.83
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<br />
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40.10
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</td>
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<td valign="top">-.27 +/-3.85</td>
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<td>.805</td>
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<td valign="top">
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47.40
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<br />
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51.30
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</td>
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<td valign="top">-3.90+/-4.40</td>
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<td valign="top">.021</td>
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</tr>
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<tr>
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<td valign="top">
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<strong>Resp.</strong>
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</td>
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<td>
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<strong>Before After</strong>
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</td>
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<td valign="top">
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27.54
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<br />
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27.20
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</td>
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<td valign="top">.34+/-3.23</td>
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<td valign="top">.715</td>
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<td valign="top">
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29.72
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<br />
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30.02
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</td>
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<td valign="top">-.30+/-2.89</td>
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<td valign="top">.747</td>
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</tr>
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<tr>
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<td valign="top">
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<strong>Cardiac</strong>
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</td>
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<td>
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<strong>Before After</strong>
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</td>
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<td valign="top">
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37.92
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<br />
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37.14
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</td>
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<td valign="top">.78+/-4.15</td>
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<td valign="top">.511</td>
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<td valign="top">
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41.11
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<br />
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40.70
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</td>
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<td valign="top">.41+/-4.67</td>
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<td valign="top">.788</td>
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</tr>
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</tbody>
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</table>
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<h2>References</h2>
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<p>
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1. Sutherland WG. The Cranial Bowl. Indianapolis, Ind: American Academy
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of Osteopathy, 1986. (Original work published 1939).
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</p>
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<p>
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2. Woods JM. Woods RH. A physical finding relating to psychiatric
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disorders. J Am Osteopath Assoc. 1961;60:988-993.
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</p>
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<p>
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3. Lay E. Cranial Feild. In: Ward RC, ed. Foundations for Osteopathic
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Medicine. Baltimore, MD: Williams and Wilkins; 1997:901-913
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</p>
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<p>
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4. Ferre JC. Barbin JY. The osteopathic cranical concept: fact or
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fiction? Surg Radial Anat, 1991:13-65-179
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</p>
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<p>5. Norton JM. Dig on [Letter to the editor]. AAOJ. 2000;10(2):16:17</p>
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<p>
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6. Traube L. Uber periodische Thatigkeits-Aeusserungen des
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vasomotorishen un Hemmungs-Nervenzentrums. Centralblatt fur die
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medicinischen Wissenschaften 1865:56:881-885
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</p>
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<p>
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7. Akselrod S. Gordon D. Madwed JB, Snidman NC, Shannon DC, Cohen RJ.
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Hemodynamic regulation: investigation by spectral analysis. Am J
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Physiol. 1985:249-H867-H875
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</p>
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<p>
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8. Frymann VA. A study of the rhythmic motions of the living cranium. J
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Am Ossteopath Assoc. 1971:70-928-945
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</p>
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<p>
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9. Upledger JE. Vredevoogd JD. Craniosacral Therapy. Chicago, IL:
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Eastland Press; 1983.
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</p>
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<p>
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10. Geiger AJ. Letter to the editor. J Am Osteopath Assoc.
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1992:92-1088-1093
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</p>
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<p>
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11. McPartland JM, Mein EA. Entrainment and the cranial rhythmic
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impulse. Altern Ther Health Med. 1997:3(1):40-45
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</p>
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<p>
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12. Nelson KE, Sergueef N, Lipinski CL, Chapman A, Glonek T. The cranial
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rhythmic impulse related to the Traube-Hering-Mayer oscillation:
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comparing laser-Doppler flowmetry and palpation. J Am Osteopath Assoc.
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2001:101(3):163-173
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</p>
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</Article>
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);
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};
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export default ArticleCranialManipulation;
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