The effect of different rates of application of a rib raising technique on cardiovascular and respiratory measures in asymptomatic individuals

Introduction

Articulation or mobilisation is a commonly utilised treatment and diagnostic technique in osteopathic practice.¹ Mobilisation techniques have previously been shown to produce a sympathoexcitation, which can vary due to the rate of application.⁵ The effect of rib raising (RR) has been previously postulated to increase lung function in individuals with and without asthma by stimulation of the sympathetic nervous system.⁶ The aim of the current study was to determine changes in measures of sympathetic markers after the application of a rib raising technique performed at two different rates.

Design

Randomised, controlled, crossover, prospective study.

Methods

Participants: Thirty asymptomatic volunteers recruited from the Victoria University student population.

Intervention: Each participant attended four sessions over four consecutive weeks and received a rapid RR treatment (2Hz), a slow RR treatment (0.5Hz), a control treatment or a placebo treatment in a randomised order.

Outcome Measures: Heart rate (HR) and respiration rate were sampled using PowerLab/8s (ADInstruments) and further analysed using Chart for windows (ADInstruments). Blood pressure both systolic (SBP) and diastolic (DBP) was determined using a calibrated manual sphygmomanometer and stethoscope by a single operator. Measures were calculated as % change from rest.

Results

One-way ANOVA analysis of respiration rate and SBP indicated a significant difference between groups (P=0.00 and P=0.03, respectively). Post hoc analysis indicated that the significant differences were between the fast RR group and placebo (P=0.00), control (P=0.00) and slow (P=0.02) groups for respiration and the fast RR and slow RR (P=0.02) for SBP. ANOVA analysis of the other sympathetic measures revealed that there were no significant changes in HR (P=0.108) or DBP (P=0.581) in any group.

Conclusions

Rapid application of an RR technique produces the greatest significant increase in respiration rate in asymptomatic participants. A significant difference in SBP response is also observed between fast and slow application. A faster application rate appears to elicit a greater sympathetic response in asymptomatic individuals.

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