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The Somatic Connection  |   October 2017
Manual Therapy Shown to Increase Lumbar Blood Flow
Author Notes
  • University of California, San Diego School of Medicine 
Article Information
The Somatic Connection   |   October 2017
Manual Therapy Shown to Increase Lumbar Blood Flow
The Journal of the American Osteopathic Association, October 2017, Vol. 117, 669-670. doi:10.7556/jaoa.2017.129
The Journal of the American Osteopathic Association, October 2017, Vol. 117, 669-670. doi:10.7556/jaoa.2017.129
Shah Y, Arkesteijn M, Thomas D, Whyman J, Passfield L. The acute effects of integrated myofascial techniques on lumbar paraspinal blood flow compared with kinesio-taping: a pilot study. J Bodyw Mov Ther. 2017;21(2):459-467. doi:10.1016/j.jbmt.2016.08.012 
Sports therapy researchers in the United Kingdom compared immediate effects of integrated myofascial techniques (IMTs) and kinesiotaping (KT) with a control group who received sham transcutaneous electrical nerve stimulation (TENS) on blood flow changes at L3. Blood flow changes were measured by near-infrared spectroscopy (NIRS). 
Power analysis called for 45 participants who were randomly assigned to IMTs, KT, or sham groups. All were healthy college students. Exclusion criteria included low back pain, a diagnosis of serious infection in the preceding 2 weeks, previous severe back or leg injury, surgical procedure on the back, spinal deformity, and history of tumor or fracture in the back. 
The IMT intervention was provided by a massage therapist. The techniques used were similar to those used in osteopathic manipulative medicine but included direct pressures using knuckles and elbows with the subject in the prone, side lying, and seated positions for 30 minutes. 
Kinesiotaping consisted of 2 I-shaped RockTape elastic bandages attached directly to the participants’ skin over the erector spinae parallel to the spinous processes of the lumbar vertebrae using a light tension with 10% to 15% stretch for 30 minutes. The control group received sham TENS, with the sterile electrodes placed bilaterally at the level of L3, 3 cm from the spinous process, for 30 minutes. 
The outcome measures were pain pressure threshold measured by an algorimeter and blood flow assessments of oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin (which is the sum of oxygenated plus deoxygenated hemoglobin). Integrated myofascial techniques significantly affected oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin (P<.001). When IMTs were compared with KT and sham TENS, the statistical significance was still positive (P<.001). No statistically significant differences were found for the pain pressure threshold. 
The application of IMTs significantly increased tissue blood flow immediately after application, but KT and sham control did not. The authors describe possible mechanisms of action. In my clinical experience, using myofascial release in the lumbar spine area increases blood flow by restoring normal tissue structure and function and possibly activating the autonomic nervous system. The use of NIRS technology should be considered in future osteopathic research.