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Osteopathic manual therapy in heart failure patients: A randomized clinical trial
Authors:Sergio R. Thomaz  Felipe A. Teixeira  Alexandra C.G.B. de Lima  Gerson Cipriano Júnior  Magno F. Formiga  Lawrence Patrick Cahalin
Affiliation:1. Sciences and Technologies in Health''s Sciences Program, Department of Physical Therapy, University of Brasilia, Brasília, DF, Brazil;2. Physical Education and Rehabilitation Science PhD Program, University of Brasilia, Brasilia, DF, Brazil;3. Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
Abstract:

Background

Heart Failure (HF) patients usually present with increased arterial resistance and reduced blood pressure (BP) leading to an impaired functional capacity. Osteopathic Manual Therapy (OMT) focused on myofascial release techniques (MRT) and in the balancing of diaphragmatic tensions, has been shown to improve blood flow in individuals using the resistive index (RI). However, its effects in HF patients have not been examined.

Purpose

To evaluate the acute response of selected osteopathic techniques on RI, heart rate (HR), and BP in patients with HF.

Methods

Randomized-controlled clinical trial of HF patients assigned to MRT (six different techniques with three aimed at the pelvis, two at the thorax, and one at the neck for 15 min) or Control group (subjects in supine position for 15 min without intervention). The RI of the femoral, brachial and carotid arteries was measured via doppler ultrasound while HR and BP were measured via sphygmomanometry before and after a single MRT or control intervention.

Results

Twenty-two HF patients equally distributed (50% male, mean age 53 years; range 32–69 years) (ejection fraction = 35.6%, VO2peak: 12.9 mL/kg?1 min?1) were evaluated. We found no intra or inter group differences in RI of the carotid (ΔMRT: 0.07% vs Δ Control:11.8%), brachial (ΔMRT:0.17% vs ΔControl: 2.9%), or femoral arteries (ΔMRT:1.65% vs ΔControl: 0.97%) (P > 0.05) and no difference in HR or BP (ΔMRT:0.6% vs ΔControl: 3%), (P > 0.05).

Conclusion

A single MRT session did not significantly change the RI, HR, or BP of HF patients.
Keywords:Osteopathy  Manual therapy  Fascia  Blood flow  Blood pressure femoral  Brachial and carotid artery  Ultrasound  Heart failure
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