Autonomic nervous system and endocrine system response to upper or lower cervical spine mobilization in males with persistent post-concussion symptoms: a proof-of-concept trial.
| Autor: | Farrell G; Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand., Chapple C; Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand., Kennedy E; Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand., Reily-Bell M; Department of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand., Sampath K; Centre for Health and Social Practice, Waikato Institute of Technology-Rotokauri Campus, Hamilton, Waikato, New Zealand., Gisselman AS; School of Medicine, Doctor of Physical Therapy Program, Tufts University, Phoenix, AZ, USA., Cook C; Doctor of Physical Therapy Program, Duke University, Durham, NC, USA., Katare R; Department of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand., Tumilty S; Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand. |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of manual & manipulative therapy [J Man Manip Ther] 2024 Dec; Vol. 32 (6), pp. 602-618. Date of Electronic Publication: 2024 Jun 21. |
| DOI: | 10.1080/10669817.2024.2363018 |
| Abstrakt: | Introduction: The peripheral stress response, consisting of the autonomic nervous system (ANS) and hypothalamic pituitary adrenal-axis (HPA-axis), functions to maintain homeostasis in response to stressors. Cervical spine manual therapy has been shown to differentially modulate the stress response in healthy populations. No study has investigated whether cervical spine mobilizations can differentially modulate the stress response in individuals with persistent post-concussion symptoms (PPCS), a population characterized by a dysfunctional stress response. Methods: A randomized, controlled, parallel design trial was performed to investigate whether upper or lower cervical spine mobilization can differentially modulate components of the stress response in individuals with PPCS. The outcomes were salivary cortisol (sCOR) concentration (primary) and the HRV metric, rMSSD, measured with a smartphone application (secondary). Nineteen males diagnosed with PPCS, aged 19-35, were included. Participants were randomly assigned into either intervention group, upper ( n = 10) or lower ( n = 9) cervical spine mobilization. Each outcome was collected at different time points, pre- and post-intervention. Statistical analyses were performed using the Friedman's Two-Way ANOVA, Mann-Whitney U test, and Wilcoxon Signed Rank Test. Results: There was a statistically significant within-group reduction in sCOR concentration 30 minutes following lower cervical spine mobilizations and statistically significant within-group increase in rMSSD 30 minutes following upper cervical spine mobilizations. Conclusion: The results of this trial provide preliminary evidence for cervical spine mobilizations to differentially modulate components of the stress response at specific time points. Understanding the mechanisms of the effect of cervical spine mobilizations on the stress response provides a novel rationale for selecting cervical spine mobilizations to rehabilitate individuals with PPCS. |
| Databáze: | MEDLINE |
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