Effect of Cranial Osteopathic Manipulative Medicine on Cerebral Tissue Oxygenation

Context: The use of cranial osteopathic manipulative medicine (OMM) to alter cerebral tissue oxygen saturation could play a role in the maintenance of cerebral homeostasis. Objective: To examine the effects of cranial OMM on cerebral tissue oxygen saturation (S CT O2) and cardiac autonomic func tion in healthy adults. Methods: Cranial OMM augmentation and suppression tech niques and sham therapy were randomly applied to healthy adults. During cranial OMM and sham therapy, S CT O2of the prefrontal cortex was determined bilaterally by using nearinfrared spectroscopy. Heart rate, blood pressure, and systemic arterial blood oxygen saturation (SaO 2) were also measured. Power spectral analysis was applied to continuous 4-minute R-R intervals. Measurements were made during 2-minute baseline periods, during 4-minute applications of the tech niques, and during 5-minute recovery periods. Results: Twenty-one adults (age range, 23-32 y) participated in the present study. Differences in mean baseline measure ments for the augmentation technique, suppression tech nique, and sham therapy were not statistically significant for heart rate, blood pressure, SaO 2, left S CT O2, or right S CT O2. During the suppression technique, there was a statistically significant decrease in both left (slope [standard deviation]= -0.33 [0.08] %/min, R2=0.85, P=.026) and right (slope [standard deviation]=-0.37 [0.06] %/min, R 2=0.94, P=.007) S CT O2 with increased cranial OMM time. However, neither the augmen tation technique nor the sham therapy had a statistically sig nificant effect on S CT O2. Decreases in normalized low-fre quency power of R-R interval variability and enhancements of its high-frequency power were statistically significant (P=.05) during cranial OMM and sham therapy, indicating a decrease in cardiac sympathetic influence and an enhanced parasympathetic modulation. Conclusion: The cranial OMM suppression technique effec tively and progressively reduced S CT O2 in both prefrontal lobes with the treatment time.