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This study aims to analyze the influence of the fourth ventricle compression technique in heart rate, respiratory rate, blood pressure, conductivity and thermal variability of the skin in healthy young adults.
The fourth ventricle compression technique (CV-4) is one of the most important techniques in the treatment of cranial osteopathy.
During the present study, the effects of CV-4 technique will be analyzed in the following variables: heart rate, respiratory rate, blood pressure, conductivity and thermal variation of the skin.
According to the literature, CV-4 technique will cause changes in all of the studied variables, except the respiratory rate, through the activation of the brain stem, namely the parasympathetic nerve centers.
Regarding the respiratory rate, it is justified by the fourth ventricle and the respiratory centers proximity.
Concerning heart rate and respiratory rate, during the CV-4 technique the literature describes a decrease in the values of this variables. However, other studies refer that the technique does not produce relevant effects in the heart and respiratory rates variation, probably because there was no stipulated time to finish the technique, ending subjectively compared to previous ones.
When it comes to blood pressure, a decrease in systolic blood pressure values is noticed by some authors.
In which concerns the variation in body temperature, according to the literature, there were no significant results obtained when performing CV-4.
During the performed literature analysis,there were not found any studies concerning the influences of the CV-4 technique in the thermal conductivity variable.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CV-4 group | Experimental | The initial selection will be made through a questionnaire, in order to fulfill the exclusion and inclusion criteria. On the data collection day a more detailed survey is performed and informed consent is signed. The patient waits for 5 minutes in the supine position, after which the baseline evaluation is performed. The CV-4 technique is performed following immediate evaluation. 15 minutes after the technique, a new evaluation of the variables is accomplished. |
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| Control group | Sham Comparator | The initial selection will be made through a questionnaire, in order to fulfill the exclusion and inclusion criteria. On the data collection day a more detailed survey is performed and informed consent is signed. The patient waits for 5 minutes in the supine position, after which the baseline evaluation is performed. The sham technique is performed following immediate evaluation. 15 minutes after the technique, a new evaluation of the variables is accomplished. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fourth ventricle compression technique (CV-4) | Other | The participant is in the supine position and the principal investigator is seated at the patient's head, with elbows resting on the table. The main investigator overlaps his hands with the thenar eminences, contacting the occipital bone squamous part, between the external occipital protuberance and the participant's occipito-mastoid suture. The technique begins with a maintained compression on the occipital squamous part during a deep thorax exhalation. Throughout the compression of the occipital bone and the participant's voluntary inspirations, the principal investigator feels a gradual pressure increase at the thenar eminences. The technique will be performed until reaching the still point, in which the mobility of the occipital bone, respiratory rate and muscle tone decrease, or until 5 minutes elapsed. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline in heart rate variability immediately after the intervention | To obtain the heart rate measurements, a pulse volume sensor (Biosignalsplux researcher) was connected to the third finger of the hand, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | Immediately after the intervention. |
| Change from Baseline in heart rate variability 15 minutes after the intervention | To obtain the heart rate measurements, a pulse volume sensor (Biosignalsplux researcher) was connected to the third finger of the hand, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | 15 minutes after the intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline in respiratory rate variability immediately after the intervention | To obtain the respiratory rate measurements, a respiratory belt transducer (Biopac Systems) was adjusted to the patient's thorax, at the xiphoid process level, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | Immediately after the intervention. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Natália MO Campelo, PhD | Contact | 938674365 | +351 | ncampelo.estsp.ipp.pt@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Natália MO Campelo | Escola Superior de Saúde do Politécnico do Porto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Escola Superior da Saúde do Porto | Porto | 4200-072 | Portugal |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22182954 | Result | Jakel A, von Hauenschild P. Therapeutic effects of cranial osteopathic manipulative medicine: a systematic review. J Am Osteopath Assoc. 2011 Dec;111(12):685-93. | |
| 26199632 | Result | Cardoso-de-Mello-E-Mello-Ribeiro AP, Rodriguez-Blanco C, Riquelme-Agullo I, Heredia-Rizo AM, Ricard F, Oliva-Pascual-Vaca A. Effects of the Fourth Ventricle Compression in the Regulation of the Autonomic Nervous System: A Randomized Control Trial. Evid Based Complement Alternat Med. 2015;2015:148285. doi: 10.1155/2015/148285. Epub 2015 Jun 14. |
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| ID | Term |
|---|---|
| C005703 | salicylhydroxamic acid |
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|
| Sham | Other | The main investigator uses the technique contact but does not perform any type of tissue traction or compression, maintaining this contact for 5 minutes. At the end of the stipulated time, the contact is removed in a subtle way. |
|
| Change from Baseline in respiratory rate variability 15 minutes after the intervention | To obtain the respiratory rate measurements, a respiratory belt transducer (Biopac Systems) was adjusted to the patient's thorax, at the xiphoid process level, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | 15 minutes after the intervention |
| Change from Baseline in blood pressure variability immediately after the intervention | To obtain the blood pressure measurements, a digital sphygmomanometer was applied to the patient's left arm, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | Immediately after the intervention. |
| Change from Baseline in blood pressure variability 15 minutes after the intervention | To obtain the blood pressure measurements, a digital sphygmomanometer was applied to the patient's left arm, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | 15 minutes after the intervention. |
| Change from Baseline in skin conductivity variability immediately after the intervention | To obtain the skin conductivity measurements, 2 electrodermal activity sensors (Biosignalsplux researcher) were connected to the patient's first finger, on the carpometacarpal and metacarpophalangeal joints, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | Immediately after the intervention. |
| Change from Baseline in skin conductivity variability 15 minutes after the intervention | To obtain the skin conductivity measurements, 2 electrodermal activity sensors (Biosignalsplux researcher) were connected to the patient's first finger, on the carpometacarpal and metacarpophalangeal joints, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | 15 minutes after the intervention. |
| Change from Baseline in skin thermal variation immediately after the intervention | To obtain the skin thermal variation measurements, negative temperature coefficient (NTC) thermistor sensors (Biosignalsplux researcher) were connected to the patient's first finger, on the carpometacarpal and metacarpophalangeal joints, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | Immediately after the intervention. |
| Change from Baseline in skin thermal variation 15 minutes after the intervention | To obtain the skin thermal variation measurements, negative temperature coefficient (NTC) thermistor sensors (Biosignalsplux researcher) were connected to the patient's first finger, on the carpometacarpal and metacarpophalangeal joints, with the patient lying supine. The sensor was only removed after completing all the evaluation moments. | 15 minutes after the intervention. |
| Result | Milnes, K., & Moran, R. W. (2007). Physiological effects of a CV4 cranial osteopathic technique on autonomic nervous system function: A preliminary investigation. International Journal of Osteopathic Medicine, 10(1), 8-17. https://doi.org/10.1016/j.ijosm.2007.01.003 |
| 15750368 | Result | Cutler MJ, Holland BS, Stupski BA, Gamber RG, Smith ML. Cranial manipulation can alter sleep latency and sympathetic nerve activity in humans: a pilot study. J Altern Complement Med. 2005 Feb;11(1):103-8. doi: 10.1089/acm.2005.11.103. |
| 23768271 | Result | Miana L, Bastos VH, Machado S, Arias-Carrion O, Nardi AE, Almeida L, Ribeiro P, Machado D, King H, Silva JG. Changes in alpha band activity associated with application of the compression of fourth ventricular (CV-4) osteopathic procedure: a qEEG pilot study. J Bodyw Mov Ther. 2013 Jul;17(3):291-6. doi: 10.1016/j.jbmt.2012.10.002. Epub 2012 Nov 16. |
| 30100295 | Result | Curi ACC, Maior Alves AS, Silva JG. Cardiac autonomic response after cranial technique of the fourth ventricle (cv4) compression in systemic hypertensive subjects. J Bodyw Mov Ther. 2018 Jul;22(3):666-672. doi: 10.1016/j.jbmt.2017.11.013. Epub 2017 Dec 9. |
| 31383430 | Result | Bayo-Tallon V, Esquirol-Caussa J, Pamias-Massana M, Planells-Keller K, Palao-Vidal DJ. Effects of manual cranial therapy on heart rate variability in children without associated disorders: Translation to clinical practice. Complement Ther Clin Pract. 2019 Aug;36:125-141. doi: 10.1016/j.ctcp.2019.06.008. Epub 2019 Jul 2. |