Brief Report  |   September 2017
Single Osteopathic Manipulative Therapy Session Dampens Acute Autonomic and Neuroendocrine Responses to Mental Stress in Healthy Male Participants
Author Notes
  • From the Stress Control Lab at the Collegio Italiano di Osteopatia in Parma, Italy (Mr Fornari and Drs Carnevali and Sgoifo) and the Stress Physiology Lab in the Department of Chemistry, Life Sciences and Environmental Sustainability at the University of Parma in Italy (Drs Carnevali and Sgoifo). 
  • Financial Disclosures: None reported. 
  • Support: Funding for this study was provided by Collegio Italiano di Osteopatia. 
  •  *Address correspondence to Andrea Sgoifo, PhD, Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Campus–Parco Area delle Scienze 11/a, 43123 Parma, Italy. E-mail: andrea.sgoifo@unipr.it
     
Article Information
Cardiovascular Disorders / Endocrinology / Osteopathic Manipulative Treatment
Brief Report   |   September 2017
Single Osteopathic Manipulative Therapy Session Dampens Acute Autonomic and Neuroendocrine Responses to Mental Stress in Healthy Male Participants
The Journal of the American Osteopathic Association, September 2017, Vol. 117, 559-567. doi:10.7556/jaoa.2017.110
The Journal of the American Osteopathic Association, September 2017, Vol. 117, 559-567. doi:10.7556/jaoa.2017.110
Abstract

Context: The efficacy of osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) is supported by observational data and patient feedback, but there is still a need for objective, quantitative biomarkers that allow measurement of the underlying mechanisms. No study exploring the protective potential of OMTh for mental stress has been published, to the authors’ knowledge.

Objectives: To explore the modulating effect of OMTh on autonomic neural regulation of the heart and verifiy its ability to influence the activity of the hypothalmic-pituitary-adrenocortical axis.

Methods: Healthy young adult men who had never received OMTh were exposed to either a brief protocol using craniosacral techniques or sham therapy (control) involving the same anatomical areas. A laboratory stress episode consisting of a 5-minute arithmetic task participants were required to perform in front of a committee preceded the therapy sessions. Continuous electrocardiograph recordings were done before, during, and after the stress episode. Heart rate and frequency-domain parameters of heart rate variability (specifically, high-frequency component power in normalized units and the ratio of low-frequency to high-frequency power) were measured to quantify the activity of the parasympathetic nervous system and the state of sympathovagal balance at the level of the heart, respectively. Saliva samples were also collected at points throughout the study to determine cortisol levels.

Results: Osteopathic manipulative therapy reduced the overall chronotropic effect of the stressor (t=−2.9, P<.05) and counteracted the vagal withdrawal and the shift of autonomic balance toward sympathetic prevalence (t=−2.8, P<.05) that were observed in control participants. Moreover, OMTh participants had a much lower overall cortisol level during the mental stressor compared with control participants (t=−2.3, P<.05). Participants in the OMTh group did not show the statistically significant reduction in the amplitude of the cortisol awakening response observed in their control counterparts after the stress episode (control: t=2.7, P<.05; OMT: P=.83).

Conclusion: The application of a single OMTh session to healthy participants induced a faster recovery of heart rate and sympathovagal balance after an acute mental stressor by substantially dampening parasympathetic withdrawal and sympathetic prevalence. The OMTh session also prevented the typical increase in cortisol levels observed immediately after a brief mental challenge.

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