The individualization of estimation of changes in the reaction of the cardiovascular system to the procedure of manual therapy of the thoracic spine in men with a vertebral thoracalgia in the sanatorium-resort treatment’ course

Authors

DOI:

https://doi.org/10.15391/prrht.2024-9(5).10

Keywords:

thoracic spine manual therapy, thoracalgia, cardiovascular system, double product, kerdo index, types of reactions, individual estimation.

Abstract

Purpose

The purpose of this study was to evaluate the reaction of the cardiovascular system of men with vertebral thoracalgia to manual therapy procedures on the chest during the course of sanatorium-resort treatment of spinal osteochondrosis.

Material and methods

Under supervision were 26 men aged 32.3 (27.9; 42.9) years who underwent a course of sanatorium-resort treatment for vertebral thoracalgia in the clinical sanatorium named after V.P. Chkalov (Odesa, Ukraine) in 2010-2011. The treatment complex included of 4 thoracic spine manual therapy (TSMT) procedures, which were performed every 5-7 days of sanatorium-resort treatment. The indicators of the cardiovascular system were recorded using the Omron M1 Classic device (Japan) in a supine position before and after every procedure TSMT.

Results

The results obtained in this study indicated sufficiently characteristic significant changes in heart rate (min-1), which mainly decreases, DBP (mm Hg), which mainly increases, PBP (mm Hg), which mainly decreases in each of the procedures TSMT in men with vertebral thoracalgia.

Separately, according to the data of the rank evaluation of changes in indicators, the types of response of the contractile function of the heart (Δ Double product) and autonomic support of hemodynamics (Δ Index Kerdo) in men were characterized. They showed that there are individual differences in response to the TSMT procedure in the course of sanatorium-resort treatment.

Conclusion.

Determining the changes in Δ Double product and Δ Index Kerdo for the procedure of manual therapy of the thoracic spine made it possible to develop criteria for evaluating the types of response of the contractile function of the heart and autonomic support of hemodynamics. Their analysis in the course of sanatorium treatment of patients with thoracalgia showed that there are individual characteristics of reactions that should be taken into account in order to prevent the occurrence of negative effects of the TSMT procedure.

References

Amatuzzi, F., Gervazoni Balbuena de Lima, AC, Da Silva, ML, Cipriano, GFB, Catai, AM, Cahalin, LP, Chiappa, G., & Cipriano, G. (2021). Acute and Time-Course Effects of Osteopathic Manipulative Treatment on Vascular and Autonomic Function in Patients With Heart Failure: A Randomized Trial. Journal of Manipulative and Physiological Therapeutics , 44 (6), 455–466. https://doi.org/10.1016/j.jmpt.2021.06.003

Araujo, FX, Ferreira, GE, Angellos, RF, Stieven, FF, Plentz , RDM, & Silva, MF (2019). Autonomic Effects of Spinal Manipulative Therapy: Systematic Review of Randomized Controlled Trials. Journal of Manipulative and Physiological Therapeutics, 42 (8), 623–634. https://doi.org/10.1016/j.jmpt.2018.12.005

Audette, I., Dumas, JP, Côté, JN, & De Serres, SJ (2010). Validity and between-day reliability of the cervical range of motion (CROM) device. Journal of Orthopedic and Sports Physical Therapy, 40 (5), 318–323. https://doi.org/10.2519/jospt.2010.3180

Berglund, KM, Persson , BH, & Denison, E. (2008). Prevalence of pain and dysfunction in the cervical and thoracic spine in persons with and without lateral elbow pain. Manual Therapy, 13 (4), 295–299. https://doi.org/10.1016/j.math.2007.01.015

Beyer, L., Vinzelberg, S., & Loudovici -Krug, D. (2022). Evidence (-based medicine) in manual medicine/manual therapy—a summary review. Manuelle Medicine, 60(4), 203–223. https://doi.org/10.1007/s00337-022-00913-y

Bialosky , JE, Bishop, MD, Price, DD, Robinson, ME, & George, SZ (2009). The mechanisms of manual therapy in the treatment of musculoskeletal pain: A comprehensive model. Manual Therapy , 14 (5), 531–538. https://doi.org/10.1016/j.math.2008.09.001

Briggs, AM, Bragge , P., Smith, AJ, Govil , D., & Straker , LM (2009). Prevalence and associated factors for thoracic spine pain in the adult working population: A literature review. Journal of Occupational Health, 51 (3), 177–192. https://doi.org/10.1539/joh.K8007

Cagnie , B., Danneels , L., Van Tiggelen , D., De Loose, V., & Cambier , D. (2007). Individual and work-related risk factors for neck pain among office workers: A cross-sectional study. European Spine Journal, 16 (5), 679–686. https://doi.org/10.1007/s00586-006-0269-7

Casanova-Méndez, A., Oliva- Pascual - Vaca, Á., Rodriguez-Blanco, C., Heredia- Rizo, AM, Gogorza-Arroitaonandia, K., & Almazán-Campos, G. (2014). Comparative short-term effects of two thoracic spinal manipulation techniques in subjects with chronic mechanical neck pain: A randomized controlled trial. Manual Therapy , 19 (4), 331–337. https://doi.org/10.1016/j.math.2014.03.002

Cleland, JA, Childs, JD, Fritz, JM, Whitman, JM, & Eberhart , SL (2007). Development of a clinical prediction rule for guiding treatment of a subgroup of patients with neck pain: Use of thoracic spine manipulation, exercise, and patient education. Physical Therapy , 87 (1), 9–23. https://doi.org/10.2522/ptj.20060155

Chow, N., Hogg-Johnson, S., Mior , S., Cancelliere , C., Injeyan , S., Teodorczyk-Injeyan , J., Cassidy, JD, Taylor-Vaisey, A., & Côté , P . (2021). Assessment of Studies Evaluating Spinal Manipulative Therapy and Infectious Disease and Immune System Outcomes. JAMA Network Open , 4 (4), e215493. https://doi.org/10.1001/jamanetworkopen.2021.5493

Edmondston, S., Ferguson, A., Ippersiel, P., Ronningen, L., Sodeland, S., & Barclay, L. (2012). Clinical and radiological investigation of thoracic spine extension motion during bilateral arm elevation. Journal of Orthopedic and Sports Physical Therapy , 42 (10), 861–869. https://doi.org/10.2519/jospt.2012.4164

Engel, RM, Vemulpad , SR, & Beath , K. (2013). Short-term effects of a course of manual therapy and exercise in people with moderate chronic obstructive pulmonary disease: A preliminary clinical trial. Journal of Manipulative and Physiological Therapeutics , 36 (8), 490–496. https://doi.org/10.1016/j.jmpt.2013.05.028

Fernandez, M., Moore, C., Tan, J., Lian , D., Nguyen, J., Bacon, A., Christie, B., Shen, I., Waldie , T., Simonet , D., & Bussières , A. (2020). Spinal manipulation for the management of cervicogenic headache: A systematic review and meta-analysis. European Journal of Pain (London, England), 24(9), 1687–1702. https://doi.org/10.1002/ejp.1632

Fernández-López, I., Peña-Otero, D., Atín-Arratibel, M. de los Á., & Eguillor-Mutiloa, M. (2021). Effects of Manual Therapy on the Diaphragm in the Musculoskeletal System: A Systematic Review. Archives of Physical Medicine and Rehabilitation , 102 (12), 2402–2415. https://doi.org/10.1016/j.apmr.2021.03.031

Funabashi, M., Son, J., Pecora, CG, Tran, S., Lee, J., Howarth, SJ, Kawchuk, G., & de Luca, K. (2021). Characterization of thoracic spinal manipulation and mobilization forces in older adults. Clinical Biomechanics, 89, 105450. https://doi.org/10.1016/j.clinbiomech.2021.105450

Gera, C., Malik, M., Kaur, J., & Saini, M. (2020). A systematic review and meta-analysis on the effect of spinal mobilization and manipulation on cardiovascular responses. Hong Kong Physiotherapy Journal , 40 (2), 75–87. https://doi.org/10.1142/S1013702520500122

Goertz , CM, Salsbury , SA, Vining, RD, Long, CR, Pohlman , KA, Weeks, WB, & Lamas, GA (2016). Effect of Spinal Manipulation of Upper Cervical Vertebrae on Blood Pressure: Results of a Pilot Sham-Controlled Trial. Journal of Manipulative and Physiological Therapeutics , 39 (5), 369–380. https://doi.org/10.1016/j.jmpt.2016.04.002

Guyatt, GH, Oxman, AD, Vist, G., Kunz, R., Brozek, J., Alonso- Coello, P., Montori, V., Akl, EA, Djulbegovic, B., Falck-Ytter, Y. , Norris, SL, Williams, JW, Atkins, D., Meerpohl, J., & Schünemann, HJ (2011). GRADE guidelines: 4. Rating the quality of evidence - Study limitations (risk of bias). Journal of Clinical Epidemiology , 64 (4), 407–415. https://doi.org/10.1016/j.jclinepi.2010.07.017

Haas, A., Chung, J., Kent, C., Mills, B., & McCoy, M. (2024). Vertebral Subluxation and Systems Biology: An Integrative Review Exploring the Salutogenic Influence of Chiropractic Care on the Neuroendocrine-Immune System. Cureus . https://doi.org/10.7759/cureus.56223

Henderson, AT, Fisher, JF, Blair, J., Shea, C., Li, TS, & Bridges, KG (2010). Effects of rib raising on the autonomic nervous system: A pilot study using noninvasive biomarkers. Journal of the American Osteopathic Association, 110 (6), 324–330. http://www.ncbi.nlm.nih.gov/pubmed/20606239

Heneghan, NR, & Rushton, A. (2016). Understanding why the thoracic region is the “Cinderella” region of the spine. Manual Therapy , 21 , 274–276. https://doi.org/10.1016/j.math.2015.06.010

Hinkeldey, N., Okamoto, C., & Khan, J. (2020). Spinal Manipulation and Select Manual Therapies: Current Perspectives. Physical Medicine and Rehabilitation Clinics of North America , 31 (4), 593–608. https://doi.org/10.1016/j.pmr.2020.07.007

Huisman, PA, Speksnijder, CM, & De Wijer, A. (2013). The effect of thoracic spine manipulation on pain and disability in patients with non-specific neck pain: A systematic review. Disability and Rehabilitation , 35 (20), 1677–1685. https://doi.org/10.3109/09638288.2012.750689

Joshi, S., Balthillaya, G., & Raghava Neelapala, YV (2019). Thoracic posture and mobility in mechanical neck pain population: A review of the literature. Asian Spine Journal , 13 (5), 849–860. https://doi.org/10.31616/asj.2018.0302

Kim, SY, An, CM, Cha, YS, & Kim, DH (2021). Effects of sling-based manual therapy on cervicothoracic junction in patients with neck pain and forward head posture: A randomized clinical trial. Journal of Bodywork and Movement Therapies, 27, 447–454. https://doi.org/10.1016/j.jbmt.2021.03.007

Koziolkin, O. A., Miedviedkova, S. O., Liakhova, І. М., Malakhovа, S. M., Lisova, O. O., & Cherepok, О. O. (2019). Complex treatment of patients with vertebral thoracalgia using manual therapy and physical rehabilitation. Zaporozhye Medical Journal, 0(5). https://doi.org/10.14739/2310-1210.2019.5.179421

Kovanur Sampath, K., Mani, R., Katare, R., Neale, J., Cotter, J., & Tumilty, S. (2021). Thoracic Spinal Manipulation Effect on Neuroendocrine Response in People With Achilles Tendinopathy: A Randomized Crossover Trial. Journal of Manipulative and Physiological Therapeutics , 44 (5), 420–431. https://doi.org/10.1016/j.jmpt.2021.06.001

Kovanur Sampath , K., Treffel , L., P. Thomson , O., Rodi , JD, Fleischmann, M., & Tumilty , S. (2024a). Changes in biochemical markers following a spinal manipulation–a systematic review update. Journal of Manual and Manipulative Therapy , 32 (1), 28–50. https://doi.org/10.1080/10669817.2023.2252187

Kovanur Sampath, K., Tumilty, S., Wooten, L., Belcher, S., Farrell, G., & Gisselman, AS (2024b). Effectiveness of spinal manipulation in influencing the autonomic nervous system - a systematic review and meta-analysis. Journal of Manual and Manipulative Therapy , 32 (1), 10–27. https://doi.org/10.1080/10669817.2023.2285196

Leboeuf-Yde, C., Nielsen, J., Kyvik , KO, Fejer , R., & Hartvigsen , J. (2009). Pain in the lumbar, thoracic or cervical regions: Do age and gender matter? A population-based study of 34,902 Danish twins 20-71 years of age. BMC Musculoskeletal Disorders , 10 , 39. https://doi.org/10.1186/1471-2474-10-39

Leonés-Macías, E., Torres-Sánchez, I., Cabrera- Martos, I., Ortiz-Rubio, A., López-López, L., & Valenza, MC (2018). Effects of manual therapy on the diaphragm in asthmatic patients: A randomized pilot study. International Journal of Osteopathic Medicine , 29 , 26–31. https://doi.org/10.1016/j.ijosm.2018.07.006

Liem, T., Bohlen, L., Jung, A.M., Hitsch, S., & Schmidt, T. (2024). Does Osteopathic Heart-Focused Palpation Modify Heart Rate Variability in Stressed Participants with Musculoskeletal Pain? A Randomized Controlled Pilot Study. Healthcare (Switzerland) , 12 (2), 138. https://doi.org/10.3390/healthcare12020138

Locher, H., Bernardotto, M., Beyer, L., Acarkan, T., Barth, F., Borgstrøm, H., Bultman, H., Buzhov, B., Çağlar Okur, S., Caporale, M., di Segni, F., Faldborg, L., Firdin, F., Genov, D., Goss, K., Habring, M., Holck, P., Jensen, N., Jorritsma, W., … Vinzelberg, S. (2022). ESSOMM European core curriculum and principles of manual medicine. Manuelle Medicine , 60(S1), 3–40. https://doi.org/10.1007/s00337-022-00886-y

Minarini, G., Ford, M., & Esteves, J. (2018). Immediate effect of T2, T5, T11 thoracic spine manipulation of asymptomatic patients on autonomic nervous system response: Single-blind, parallel-arm controlled-group experiment. International Journal of Osteopathic Medicine , 30 , 12–17. https://doi.org/10.1016/j.ijosm.2018.10.002

Mintken, PE, DeRosa, C., Little, T., & Smith, B. (2008). A model for standardizing manipulation terminology in physical therapy practice. Journal of Manual and Manipulative Therapy , 16 (1), 50–56. https://doi.org/10.1179/106698108790818567

Muth, S., Barbe, MF, Lauer, R., & McClure, P. (2012). The effects of thoracic spine manipulation in subjects with signs of rotator cuff tendinopathy. Journal of Orthopedic and Sports Physical Therapy , 42 (12), 1005–1016. https://doi.org/10.2519/jospt.2012.4142

Núñez -Cortés, R., Alvarez, G., Pérez- Bracchiglione, J., Cabanas-Valdés, R., Calvo-Sanz, J., Bonfill, X., & Urrutia, G. (2021). Reporting results in manual therapy clinical trials: A need for improvement. International Journal of Osteopathic Medicine , 42 , 92–99. https://doi.org/10.1016/j.ijosm.2021.06.002

Page, MJ, Green, S., Kramer, S., Johnston, R. V, McBain, B., Chau, M., & Buchbinder , R. (2014). Manual therapy and exercise for adhesive capsulitis (frozen shoulder). The Cochrane Database of Systematic Reviews, 2014 (8), CD011275. https://doi.org/10.1002/14651858.CD011275

Panenko, A., Noskin, L., & Romanchuk, O. (2004). [Individual health typing as the basis of targeted corrective and rehabilitation measures]. Odesa Medical Journal , 1, 65–68.

Panenko, A., & Romanchuk, O. (2006). [Sanotyping in the determination of morphofunctional determinants of vegetative disorders ]. Medical rehabilitation , balneology , physiotherapy , 4 , 30–34.

Panenko, A., & Romanchuk, O. (2024). Regarding the assessment of the influence of thoracic spine manual therapy on the women’s cardiovascular system in the course of sanatorium treatment. Physical Rehabilitation and Recreational Health Technologies, 9(4), 301–317. https://doi.org/10.15391/prrht.2024-9(4).09

Pecos-Martín, D., de Melo Aroeira, AE, Verás Silva, RL, Martínez de Tejada Pozo, G., Rodríguez Solano, LM, Plaza- Manzano, G., Gallego-Izquierdo, T., & Falla, D. (2017). Immediate effects of thoracic spinal mobilization on erector spinae muscle activity and pain in patients with thoracic spine pain: a preliminary randomized controlled trial. Physiotherapy (United Kingdom), 103 (1), 90–97. https://doi.org/10.1016/j.physio.2015.10.016

Rechberger, V., Biberschick, M., & Porthun, J. (2019). Effectiveness of an osteopathic treatment on the autonomic nervous system: a systematic review of the literature. European Journal of Medical Research, 24(1), 36. https://doi.org/10.1186/s40001-019-0394-5

Roquelaure, Y., Petit, A., Fouquet, B., & Descatha, A. (2014). Pathologies professionnels musculo-squelettiques : priority à la prevention et à la coordination des prises en charge [Work-related musculoskeletal disorders: priority to prevention and coordination of the interventions]. La Revue du praticien , 64(3), 350–357.

Romanchuk, OP, & Hanitkevych, VI (2022a). [Cardiovascular Effects of the Yumeiho Therapy Procedure and Their Evaluation]. Rehabilitation & Recreation, 12, 73–79. https://doi.org/10.32782/2522-1795.2022.12.10

Romanchuk, O., & Hanitkevych, V. (2022b). The influence of the Yumeiho therapy procedure on central hemodynamics and its assessment. Physical Rehabilitation and Recreational Health Technologies , 7 (3), 96–103. https://doi.org/10.15391/prrht.2022-7.20

Romanchuk, OP, & Hanitkevych, VI (2022c). [The influence of Yumeiho-therapy on the adolescent's respiratory system functional state with posture disorders]. Rehabilitation and Recreation , 11 , 47–57. https://doi.org/10.32782/2522-1795.2022.11.5

Romanchuk, O., & Ganitkevich, V. (2022). Influence of Yumeiho therapy on morphometric parameters of adolescents with postural disorders. Physical Rehabilitation and Recreational Health Technologies, 7(2), 43–47. https://doi.org/10.15391/prrht.2022-7.10

Romanchuk, O. (2022a). Comparative features of the immediate impact of manual therapy traction manipulations on the cardiorespiratory system of men and women. Physical Rehabilitation and Recreational Health Technologies, 7 (4), 130–142. https://doi.org/10.15391/prrht.2022-7(4).24

Romanchuk, O. (2022b). The Immediate Effects of the Manual Therapy Traction Manipulations on Parameters of Cardiorespiratory System Functioning. International Journal of Human Movement and Sports Sciences, 10 (4), 832–840. https://doi.org/10.13189/saj.2022.100424

Roura, S., Álvarez, G., Solà, I., & Cerritelli, F. (2021). Do manual therapies have a specific autonomic effect? An overview of systematic reviews. PloS One, 16(12), e0260642. https://doi.org/10.1371/journal.pone.0260642

Salom-Moreno, J., Ortega-Santiago, R., Cleland, JA, Palacios- Ceña , M., Truyols-Domínguez , S., & Fernández -De-Las- Peñas , C. (2014). Immediate changes in neck pain intensity and widespread pressure pain sensitivity in patients with bilateral chronic mechanical neck pain: A randomized controlled trial of thoracic thrust manipulation vs non-thrust mobilization. Journal of Manipulative and Physiological Therapeutics, 37 (5), 312–319. https://doi.org/10.1016/j.jmpt.2014.03.003

Sillevis, R., Cleland, J., Hellman, M., & Beekhuizen, K. (2010). Immediate effects of a thoracic spine thrust manipulation on the autonomic nervous system: A randomized clinical trial. Journal of Manual and Manipulative Therapy, 18 (4), 181–190. https://doi.org/10.1179/106698110X12804993427126

Simonelli, C., Vitacca, M., Vignoni, M., Ambrosino, N., & Paneroni, M. (2019). Effectiveness of manual therapy in COPD: A systematic review of randomized controlled trials. Pulmonology, 25 (4), 236–247. https://doi.org/10.1016/j.pulmoe.2018.12.008

Stępnik, J., Czaprowski, D., & Kędra, A. (2024). Effect of manual osteopathic techniques on the autonomic nervous system, respiratory system function and head-cervical-shoulder complex—a systematic review. Frontiers in Medicine, 11 . https://doi.org/10.3389/fmed.2024.1358529

Walser, RF, Meserve, BB, & Boucher, TR (2009). The effectiveness of thoracic spine manipulation for the management of musculoskeletal conditions: A systematic review and meta-analysis of randomized clinical trials. Journal of Manual and Manipulative Therapy , 17 (4), 237–246. https://doi.org/10.1179/106698109791352085

Ward, J., Coats, J., Tyer, K., Weigand, S., & Williams, G. (2013). Immediate effects of anterior upper thoracic spine manipulation on cardiovascular response. Journal of Manipulative and Physiological Therapeutics , 36 (2), 101–110. https://doi.org/10.1016/j.jmpt.2013.01.003

Ward, J., Tyer, K., Coats, J., Williams, G., & Kulcak, K. (2015). Immediate effects of upper thoracic spine manipulation on hypertensive individuals. Journal of Manual and Manipulative Therapy , 23 (1), 43–50. https://doi.org/10.1179/1066981714Z.000000000106

Downloads

Published

2024-09-12

Issue

Section

Original research article