Influence of neural mobilization in the sympathetic slump position on the behavior of the autonomic nervous system
Douglas Roberto da Silva, Rodrigo Alexis Lazo Osório, Adriana Barrinha Fernandes
Abstract
Introduction: The neural mobilization technique in the sympathetic slump position (NMSS) was based on the slump test, whose purpose was to directly influence the sympathetic trunk and thus provide greater analgesia by sympathetic activation and treat pain syndromes caused by peripheral sympathetic changes. Therefore, as the autonomic nervous system (ANS) is responsible for extrinsic regulation of the cardiovascular system through sympathetic and parasympathetic action, the aim of this study was to investigate the influence of the NMSS technique on the systolic and diastolic blood pressure and heart rate variability in athlete and non-athlete men. Methods: Twenty‑eight subjects performed the procedure that was divided into three phases: rest; intervention and recovery, lasting 4 minutes and 30 seconds each, totaling a 13-minute and 30 seconds collection time. Results: The results showed that the NMSS technique significantly influences the action/activity of the ANS, as there was predominant sympathetic activation during the application of the technique, which was observed by the increase in systolic blood pressure, low frequency (LF), LF/HF ratio and decreased values of high frequency (HF). Conclusion: It may be concluded that the neural mobilization technique on the sympathetic slump (NMSS) significantly influences the ANS action/activity. Among the groups, there was no statistically significant difference in heart rate variability. It is worth noting that patients with cardiovascular disorders may be at risk if the NMSS technique is applied since there was an increase in SBP and sympathetic activation during its application in both groups.
Keywords
References
Alderman BL, Olson RL. The relation of aerobic fitness to cognitive control and heart rate variability: a neurovisceral integration study. Biol Psychol. 2014; 99:26-33. http://dx.doi.org/10.1016/j.biopsycho.2014.02.007. PMid:24560874.
Alla F, Briançon S, Juillière Y, Mertes P-M, Villemot J-P, Zannad F. Differential clinical prognostic classifications in dilated and ischemic advanced heart failure: the EPICAL study. Am Heart J. 2000; 139(5):895-904. http://dx.doi.org/10.1016/S0002-8703(00)90023-1. PMid:10783225.
Blumberg H, Hoffmann U, Mohadjer M, Scheremet R. Sympathetic nervous system and pain: a clinical re-appraisal. Behav Brain Sci. 1997; 20(3):426-34, discussion 435-513. http://dx.doi.org/10.1017/S0140525X97271487. PMid:10097005.
Borell EV, Langbein J, Després L, Hansen S, Leterrier C, Marchant-Forde J. et al. Heart rate variability as a measure of autonomic regulation of cardiac activity for assessing stress and welfare in farm animals. Physiol Behav. 2007; 92(3):293-316. http://dx.doi.org/10.1016/j.physbeh.2007.01.007.
Butler DS, Slater H. Neural injury in the thoracic spine: a conceptual basis for manual therapy. In: Grant R, editor. Physical therapy of the cervical and thoracic spines. 2nd ed. New York: Churchill Livingstone; 1994. p. 313-38.
Carlson LK, Watson HK. Treatment of reflex sympathetic dystrophy using the stress-loading program. J Hand Ther. 1998; 1(4):149-53. http://dx.doi.org/10.1016/S0894-1130(88)80022-X.
Casonatto J, Tinucci T, Dourado AC, Polito M. Cardiovascular and autonomic responses after exercise sessions with different intensities and durations. Clinics (Sao Paulo). 2011; 66(3):453-8. http://dx.doi.org/10.1590/S1807-59322011000300016. PMid:21552672.
Chapleau MW, Hajduczok G, Abboud FM. Peripheral and central mechanisms of baroreflex resetting. Clin Exp Pharmacol Physiol Suppl. 1989; 15(s15):31-43. http://dx.doi.org/10.1111/j.1440-1681.1989.tb02994.x. PMid:2680188.
Chiu TW, Wright A. To compare the effects of different rates of application of a cervical mobilisation technique on sympathetic outflow to the upper limb in normal subjects. Man Ther. 1996; 1(4):198-203. http://dx.doi.org/10.1054/math.1996.0269. PMid:11440508.
Chua KC, Chandran V, Acharya UR, Lim CM. Cardiac state diagnosis using higher order spectra of heart rate variability. J Med Eng Technol. 2008; 32(2):145-55. http://dx.doi.org/10.1080/03091900601050862. PMid:18297505.
Cleland J, Durall C, Scott S. Effects of slump long sitting on peripheral sudomotor and vasomotor function: a pilot study. J Manual Manip Ther. 2002; 10(2):67-75. http://dx.doi.org/10.1179/106698102790819292.
Cleland J, McRae M. Complex regional pain syndrome I: management through the use of vertebral and sympathetic trunk mobilization. J Manual Manip Ther. 2002; 10(4):188-99. http://dx.doi.org/10.1179/106698102790819067.
Corazza I, Barletta G, Guaraldi P, Cecere A, Calandra-Buonaura G, Altini E, Zannoli R, Cortelli P. et al. A new integrated instrumental approach to autonomic nervous system assessment. Comput Methods Programs Biomed. 2014; 117(2):267-76. http://dx.doi.org/10.1016/j.cmpb.2014.08.002. PMid:25168777.
Di Rienzo M, Parati A, Radaelli A, Castiglioni P. Baroreflex contribution to blood pressure and heart rate oscillations: time scales, time-variant characteristics and nonlinearities. Phil Trans R Soc A. 2009;367(1892):1301-18. http://dx.doi.org/10.1098/rsta.2008.0274. PMid:19324710.
Essner A, Sjostromc R, Ahlgrenb E, Lindmark B. Validity and reliability of Polar RS800CX heart rate monitor, measuring heart rate in dogs during standing position and at trot on a treadmill. Physiol Behav. 2013; 114-115:1-5. http://dx.doi.org/10.1016/j.physbeh.2013.03.002.
Evans DW. Mechanisms and effects of spinal high-velocity, low-amplitude thrust manipulation: previous theories. J Manipulative Physiol Ther. 2002; 25(4):251-62. http://dx.doi.org/10.1067/mmt.2002.123166. PMid:12021744.
Giri S, Nixdorf D. Sympathetically maintained pain presenting first as temporomandibular disorder, then as parotid dysfunction. Tex Dent J. 2007; 124(8):748-52. PMid:17867545.
Goldstein DS, Bentho O, Park MY, Sharabi Y. LF power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes. Exp Physiol. 2011; 96(12):1255-61. http://dx.doi.org/10.1113/expphysiol.2010.056259. PMid:21890520.
Grassi G, Seravalle G, Brambilla G, Mancia G. The sympathetic nervous system and new nonpharmacologic approaches to treating hypertension: a focus on renal denervation. Can
J Cardiol. 2012; 28(3):311-7. http://dx.doi.org/10.1016/j.cjca.2011.11.005. PMid:22244774.
Hasan W. Autonomic cardiac innervation. Organogenesis. 2013; 99(3):176-93. http://dx.doi.org/10.4161/org.24892.
Hodges GJ, Kiviniemi AM, Mallette MM, Klentrou P, Falk B, Cheung SS. Effect of passive heat exposure on cardiac autonomic function in healthy children. Eur J Appl Physiol. 2018; 118(10):2233-40. http://dx.doi.org/10.1007/s00421-018-3957-1. PMid:30069604.
Irigoyen MC, Consolim-Colombo FM, Krieger EM. Cardiovascular control: role of the sympathetic nervous system. Rev Bras Hipertens. 2001; 8:55-62.
Jowsey P, Perry J. Sympathetic nervous system effects in the hands following a grade III póstero-anterior rotatory mobilization technique applied to T4: a randomised, placebo-controlled trial. Man Ther. 2010; 15(3):248-53. http://dx.doi.org/10.1016/j.math.2009.12.008. PMid:20093065.
Kawaguchi LYA, Nascimento ACP, Lima MS, Frigo L, Paula AR Jr, Tierra-Criollo CJ, Lopes-Martins RAB. Characterization of heart rate variability and baroreflex sensitivity in sedentary individuals and male athletes. Rev Bras Med Esporte. 2007; 13(4):231-6. http://dx.doi.org/10.1590/S1517-86922007000400004.
Kingston L, Claydon L, Tumilty S. The effects of spinal mobilizations on the sympathetic nervous system: a systematic review. Manual Therapy. 2014; 19:281-7. http://dx.doi.org/10.1016/j.math.2014.04.004.
Krygier JR, Heathers JAJ, Shahrestani S, Abbott M, Gross JJ, Kemp AH. Mindfulness meditation, well-being, and heart rate variability: a preliminary investigation into the impact of intensive Vipassana meditation. Int J Psychophysiol. 2013; 89(3):305-13. http://dx.doi.org/10.1016/j.ijpsycho.2013.06.017. PMid:23797150.
Laterza MC, Rondon MUPB, Negrão CE. The anti-hypertensive effect of exercise. Rev Brasi Hipertensão. 2007; 14(2):104-11.
Lopes HF, Silva HB, Consolim-Colombo FM, Barreto JA Fo, Riccio GMG, Giorgi DMA, Krieger EM. Autonomic abnormalities demonstrable in young normotensive subjects who are children of hypertensive parents. Braz J Med Biol Res. 2000; 33:51-4. http://dx.doi.org/10.1590/S0100-879X2000000100007.
Lovick TA. Interactions between descending pathways from the dorsal and ventrolateral periaqueductal gray matter in the rat. In: Depaulis A, Bandler R, editors. The midbrain periaqueductal gray matter. New York: Plenum Press; 1991. p. 101-34. http://dx.doi.org/10.1007/978-1-4615-3302-3_7.
Lovick TA. Ventrolateral medullary lesions block the antinociceptive and cardiovascular responses elicited by stimulating the dorsal periaqueductal grey matter in rats. Pain. 1985; 21(3):241-52. http://dx.doi.org/10.1016/0304-3959(85)90088-0. PMid:3991230.
Maitland G. The slump test: examination and treatment. Aust J Physiother. 1985; 31(6):215-9. http://dx.doi.org/10.1016/S0004-9514(14)60634-6. PMid:25026106.
Malliani A. The pattern of sympathovagal balance explored in the frequency domain. News Physiol Sci. 1999; 14:111-7. PMid:11390833.
McCraty R, Shaffer F. Heart rate variability: new perspectives on physiological mechanisms, assessment of self-regulatory capacity, and health risk. Glob Adv Health Med. 2015; 4(1):46-61. http://dx.doi.org/10.7453/gahmj.2014.073. PMid:25694852.
McGuiness J, Vicenzino B, Wright A. Influence of a cervical mobilization technique on respiratory and cardiovascular function. Man Ther. 1997; 2(4):216-20. http://dx.doi.org/10.1054/math.1997.0302. PMid:11440535.
Middleton N, De Vito G. Cardiovascular autonomic control in endurance-trained and sedentary young women. Clin Physiol Funct Imaging. 2005; 25(2):83-9. http://dx.doi.org/10.1111/j.1475-097X.2004.00594.x. PMid:15725306.
Nathan H. Osteophytes on the spine compressing the sympathetic trunk and splanchnic nerves in the thorax. Spine. 1987; 12(6):527-32. http://dx.doi.org/10.1097/00007632-198707000-00003. PMid:3660077.
Perry J, Green A. An investigation into the effects of a unilaterally applied lumbar mobilisation technique on peripheral sympathetic nervous system activity in the lower limbs. Man Ther. 2008; 13(6):492-9. http://dx.doi.org/10.1016/j.math.2007.05.015. PMid:17643340.
Petersen N, Vicenzino B, Wright A. The effects of a cervical mobilisation technique on sympathetic outflow to the upper limb in normal subjects. Physiother Theory Pract. 1993; 9(3):149-56. http://dx.doi.org/10.3109/09593989309047454.
Polar. Global: support polar - selection Info Analysis for R-R data [Internet]. 2018 [cited 2018 Nov 5]. Available from: https://support.polar.com/en/support/Selection_Info_Analysis_for_R_R_data?product_id=38638&category=faqs
Polito MD, Farinatti PTV. Heart-rate, blood pressure, and rate pressure product during resistive exercises: a review of the literature. Rev Port Cienc Desporto. 2003; 3(1):79-91. http://dx.doi.org/10.5628/rpcd.03.01.79.
Quintana DS, Guastella AJ, McGregor IS, Hickie IB, Kemp AH. Heart rate variability predicts alcohol craving in alcohol dependent outpatients: Further evidence for HRV as a psychophysiological marker of self-regulation. Drug Alcohol Depend. 2013; 132(1-2):395-8. http://dx.doi.org/10.1016/j.drugalcdep.2013.02.025. PMid:23601925.
Raczak G, Daniłowicz-Szymanowicz L, Kobuszewska-Chwirot M, Ratkowski W, Figura-Chmielewska M, Szwoch M. Long-term exercise training improves autonomic nervous system profile in professional runners. Kardiol Pol. 2006; 64(2):135-40, discussion 141-2. PMid:16502362.
Rassi A Jr. Understanding better the measures of variability analysis [Internet]. 2018 [cited 2018 June 10]. Available from: http://www.cardios.com.br/noticias_detalhes.asp?idNoticia=331&IdSecao=24&IdTipoNoticia=7&cientifico=¬icias=&idmenu=
Sata Y, Head GA, Denton K, May CN, Schlaich MP. Role of the sympathetic nervous system and its modulation in renal hypertension. Front Med (Lausanne). 2018; 29(5):82. http://dx.doi.org/10.3389/fmed.2018.00082. PMid:29651418.
Seravalle G, Mancia G, Grassi G. Sympathetic nervous system, sleep, and hypertension. Curr Hypertens Rep. 2018; 20(9):74. http://dx.doi.org/10.1007/s11906-018-0874-y. PMid:29980938.
Shacklock M. Biomechanics of the nervous system: breig revisited. Australia: Neurodynamic Solutions; 2007.
Silveira APC, Silva BS, Almeida MB. Acute responses from heart rate variability to exercise. EFDeportes. [Internet]. 2012 [cited 2018 Feb 10]; 16(164):1. Available from: http://www.efdeportes.com/efd164/variabilidade-da-frequencia-cardiaca-ao-exercicio.htm
Slater H, Vicenzino B, Wright B. Sympathetic slump: the effects of a novel manual therapy technique on peripheral sympathetic nervous system function. J Manual Manip Ther. 1994; 2(4):156-62. http://dx.doi.org/10.1179/jmt.1994.2.4.156.
Sterling M, Jull G, Wright A. Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity. Man Ther. 2001; 6(2):72-81. http://dx.doi.org/10.1054/math.2000.0378. PMid:11414776.
Task Force of the European Society of Cardiology, North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J. 1996; 17(3):354-81. PMID:873721.
Vanderlei LCM, Pastre CM, Hoshi RA, Carvalho TD, Godoy MF. Basic notions of heart rate variability and its clinical applicability. Rev Bras Cir Cardiovasc. 2009; 24(2):205-17. http://dx.doi.org/10.1590/S0102-76382009000200018. PMid:19768301.
Vicenzino B, Cartwright T, Collins D, Wright A. Cardiovascular and respiratory changes produced by lateral glide mobilization of the cervical spine. Man Ther. 1998; 3(2):67-71. http://dx.doi.org/10.1016/S1356-689X(98)80020-9.
Vicenzino B, Collins D, Wright T. Sudomotor changes induced by neural mobilisation techniques in asymptomatic subjects. J Manual Manip Ther. 1994; 2(2):66-74. http://dx.doi.org/10.1179/jmt.1994.2.2.66.
Vieira S, Felix ACS, Quitério RJ. Heart rate variability and maximum workload reached in the dynamic physical exertion test in elderly men. Rev Bras Med Esporte. 2012; 18(6):377-80. http://dx.doi.org/10.1590/S1517-86922012000600006.
Wallen MB, Hasson D, Theorell T, Canlon B, Osika W. Possibilities and limitations of the polar RS800 in measuring heart rate variability at rest. Eur J Appl Physiol. 2012; 112(3):1153-65. http://dx.doi.org/10.1007/s00421-011-2079-9. PMid:21766225.
Wazen GLL, Gregório ML, Kemp AH, Godoy MF. Heart rate variability in patients with bipolar disorder: from mania to euthymia. J Psych Res. 2018; 99:33-8. http://dx.doi.org/10.1016/j.jpsychires.2018.01.008. PMid:29407285.v
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email