Acute Effects of Deep-Slow Breathing Exercise and Cranial-Visceral Manual Therapy on ANS Parameters in Healthy Adults
Condition: Autonomic Nervous System
MeSH terms: Hypoventilation
Study type: Interventional

Summary: 
      The purpose of this study is to evaluate the effects of several manual therapy techniques on
      autonomic nervous system and to compare it with other groups in the study such as deep-slow
      breathing group and the control group. The measurements will take place right before and
      after the intervention to evaluate the effects of one single intervention.
    

Detailed description: 
      All the patients will be clearly informed and will be included in the present study after
      their informed consent. The autonomic nervous system (ANS) will be evaluated using
      bio-sensors such as Photoplethysmography (PPG) and Galvanic skin response (GSR). The
      measurements will take place once for an individual. There will be three groups consisted of
      manual therapy, deep-slow breathing, and control groups. Non-invasive cranial and visceral
      techniques will be applied on the manual therapy group. The deep-slow breathing group will
      get an intervention consisting of deep-paced breathing to increase cardiac harmony. The
      control group will rest for the same amount of time as other interventions to distinguish
      whether the changes are related to intervention. After given consent, the participant will be
      assigned randomly to one of three groups. All the participants will be subjected to baseline
      measurement of the abovementioned metrics prior to intervention. All the interventions will
      take place in a controlled setting. After baseline measurement, the participant will take one
      of the three interventions which will take 30 minutes. After the data for each person is
      captured via sensors, it will be stored on a personal computer for further analysis and
      interpretation.

      According to investigator's hypothesis, deep-slow breathing group will show signs of
      sympathetic withdrawal and parasympathetic dominance and that manual therapy group will also
      show same autonomic shift too.
    

Intervention name(s): Manual Therapy; Deep-slow breathing; Control
Intervention type(s): Other; Other; Other
Intervention description(s): This group of patients will receive manual therapy techniques to harmonize vegetative nervous system. PPG and GSR will be recorded during the intervention. The techniques consist of CV-4 technique, suboccipital decompression, lumbo-sacral decompression, release of the transverse diaphragms, frontal lift technique, parietal lift technique, temporal techniques, temporo-mandibular joint myofascial release, deep cervical fasciae technique as described in Upledger's protocol. In addition to the protocol; rib raising technique, larynx and sternocleidomastoid muscle fascial release and occipito-mastoid suture release will be applied. All intervention is planned to take approximately 20 minutes. The group will include forty healthy individuals.; Patients in this group will do slow paced breathing to increase heart rate variability as it can be partially modulated by respiratory effects. The patients will be able to cease the session in case of feeling uncomfortable. The main purpose will be that the individuals should breathe six breaths per minute to increase respiratory sinus arrhythmia which is also reflected at PPG waveforms and in reduction in GSR. The group will include forty healthy individuals.; Control group patients will be attached to the sensors, and they will rest in a quiet and controlled indoor environment without any intervention. The aim of including this group is to to understand whether the parasympathetic effects expected in the manual therapy group were due to the intervention. The group will include forty healthy individuals.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: There are three groups in the study, two of which includes interventions, and one group constitutes the control group. The participants will be randomized into groups with a sealed envelope. There is only one session of the allocated intervention for the particular participant, since the study aims to measure acute effects of cranial and visceral manual therapy on autonomic nervous system parameters.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Deep-slow breathing, manual therapy