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Depression appears to be resistant to the available pharmacological treatments. Autonomic responses accompanied by any psychological stress are sympathetic nervous system (SNS) and neuroendocrine responses are formed by hypothalamus-pituitary-adrenal (HPA) axis. The purpose of this study is; assessment of effectiveness of osteopathic approach on sympathetic nervous system and HPA axis in adolescents with depression.
Depression diagnosed and volunteer to participate 39 cases who between the ages of 15-21 included. All participants were recruited and randomly assigned into two groups, the osteopathy group (OG) and the placebo group (PG). Stimulation on the sympathetic truncus and prevertebral ganglia were performed in the OG group. The stimulation of the PG group was performed with a lighter touch and a shorter duration in similar areas. Each participant was filled in the demographic data form, Beck Depression Scale and State and Trait Anxiety Inventory (STAI Form - 1 and Form - 2) before the application. Emotional state visual analog scale and STAI Form - 1 was filled and blood pressure and pulse measurement were made and saliva sample was taken before application, immediately after application and 20 minutes after application.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Osteopathy Group | Experimental | Stimulation on the sympathetic truncus and prevertebral ganglia |
|
| Control Group | Sham Comparator | Stimulation on similar areas with lighter touch and shorter duration |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Osteopathic sympathic harmonization | Other | Treatments that harmonize at the sympathetic nerves or plexus, e.g., sympathetic trunk stimulation by means of the rib-raise technique or stimulation of the prevertebral ganglia. |
| Measure | Description | Time Frame |
|---|---|---|
| The Beck Depression Inventory (BDI) | The Beck Depression Inventory (BDI) is a 21-item, self-report rating inventory that measures characteristic attitudes and symptoms of depression. | Before intervention |
| The State-Trait Anxiety Inventory (STAI) Form - 1 | The State-Trait Anxiety Inventory (STAI) is a commonly used measure of trait and state anxiety. It can be used in clinical settings to diagnose anxiety and to distinguish it from depressive syndromes. It also is often used in research as an indicator of caregiver distress. | Before intervention |
| Change from Baseline The State-Trait Anxiety Inventory (STAI) Form - 2 at 20 minutes | The State-Trait Anxiety Inventory (STAI) is a commonly used measure of trait and state anxiety. It can be used in clinical settings to diagnose anxiety and to distinguish it from depressive syndromes. It also is often used in research as an indicator of caregiver distress. | Before intervention, immediately after the intervention, 20 minutes after the intervention |
| Change from Baseline Heart rate and blood pressure measurements at 20 minutes | Heart rate (beats per minute) and blood pressure (mm/Hg) were measured with automatic blood pressure monitor (the Microlife BP 3BT0-A). It is a clinically validated and 1-star automatic blood pressure monitor | Before intervention, immediately after the intervention, 20 minutes after the intervention |
| Change from Baseline Salivary Biomarkers at 20 minutes | Salivary a-amylase and cortisol levels were measured for each sample. These biomarkers were analysed Enzyme-Linked Immunosorbent Assay. | Before intervention, immediately after the intervention, 20 second after the intervention |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Omer Osman PALA, PhD | Cumhuriyet University, Faculty of Health Sciences, Physiotherapy and Rehabilitation | Study Director |
| Seyit CITAKER, Prof | Gazi University, Faculty of Health Sciences, Physiotherapy and Rehabilitation | Principal Investigator |
| Esra GUNEY, Assoc. Prof | Gazi University, Faculty of Medicine, Child and Adolescent Psychiatry | Principal Investigator |
| Aylin SEPICI DINCEL, Prof | Gazi University, Faculty of Medicine, Medical Biochemistry | Principal Investigator |
| Güner Melike GUVELI, MD | Gazi University, Faculty of Medicine, Child and Adolescent Psychiatry | Principal Investigator |
| Burak ARSLAN, MD | Gazi University, Faculty of Medicine, Medical Biochemistry | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sivas Cumhuriyet University | Sivas | 58140 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20606239 | Background | Henderson AT, Fisher JF, Blair J, Shea C, Li TS, Bridges KG. Effects of rib raising on the autonomic nervous system: a pilot study using noninvasive biomarkers. J Am Osteopath Assoc. 2010 Jun;110(6):324-30. | |
| 38414339 | Derived | Pala OO, Citaker S, Guney E, Sepici A, Guveli GM, Arslan B, Guru M. Effectiveness of osteopathic manipulative applications on hypothalamic-pituitary-adrenal (HPA) axis in youth with major depressive disorder: a randomized double-blind, placebo-controlled trial. J Osteopath Med. 2024 Feb 29;124(6):267-275. doi: 10.1515/jom-2023-0056. eCollection 2024 Jun 1. |
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January 1, 2022
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| ID | Term |
|---|---|
| D003863 | Depression |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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A double-blind, placebo-controlled, randomized study
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Double-blind trial
| Sham intervention | Other | Different location, size and time of the rib-raise technique or stimulation of the prevertebral ganglia. |
|
| Demographic data | Sex; male or female | Before intervention |
| Demographic data | Age; years | Before intervention |
| Demographic data | Height (m); weight (kg); body mass index (kg/m2) | Before intervention |