Cardiopulmonary Medicine  |   October 2020
A Pilot Study of Jugular Compression (Queckenstedt maneuver) for Cranial Movement Perception
Author Notes
  • From the Italian Academy of Osteopathic Medicine in Saronno, Italy. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Alberto Maggiani, DO, Research Department, Italian Academy of Osteopathic Medicine (AIMO), Piazza Santuario 721047 Saronno (VA), Italy Email: alberto.maggiani@aimoedu.it
     
Article Information
Neuromusculoskeletal Disorders
Cardiopulmonary Medicine   |   October 2020
A Pilot Study of Jugular Compression (Queckenstedt maneuver) for Cranial Movement Perception
The Journal of the American Osteopathic Association, October 2020, Vol. 120, 647-654. doi:https://doi.org/10.7556/jaoa.2020.119
The Journal of the American Osteopathic Association, October 2020, Vol. 120, 647-654. doi:https://doi.org/10.7556/jaoa.2020.119
Abstract

Context: Osteopathy in the cranial field (OCF) is among the most controversial topics of osteopathic practice. The mechanism by which cranial movement (CM) occurs is poorly understood, but includes speculation that intracranial pressure can generate a movement of the cranial bones. If this model is valid, an increase in intracranial pressure produced by bilateral compression of internal jugular veins, or the Queckenstedt maneuver (Q-test), should be detectable.

Objective: To determine whether osteopaths can perceive a palpable change in CM when the Q-test is applied.

Methods: Blindfolded osteopaths experienced in OCF evaluated the CM of volunteers as a trained clinician applied the Q-test. The osteopaths reported any change in CM amplitude during 3 different 1-minute periods. The total number of variations perceived in each period (PV) by all osteopaths on all volunteers was analyzed. The Kruskal Wallis test was used to evaluate the differences between the test periods. The Mann-Whitney test was used for a pairwise comparison. Statistical significance was set at P≤.05.

Results: Eight osteopaths participated in this study and evaluated the CM of 6 volunteers. A Kruskal-Wallis test of the PV between monitoring periods revealed a statistically significant difference (P<.001). A Mann-Whitney Test showed there was a significant increase in PV between the compression period and the 2 other monitoring periods (base P=.003 and expectation P=.009).

Conclusion: Osteopaths could detect a change in the amplitude of CM after the Q-test was applied. Although this was a small-scale pilot study, our data represent a starting point for understanding whether an intracranial or an extracranial mechanism is responsible for the CM.

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