Key result
Modified occipitomastoid suture v-spread OMT significantly increased vagal tone, with mean RMSSD increasing from 50.5 ms at baseline to 55.0 ms post-treatment (p=0.013).
Why the study?
Autonomic rehabilitation using OMT to stimulate the vagus nerve may be an adjunct therapy for dysautonomia, but quantitative evidence via HRV on vagal tone was needed.
Does modified occipitomastoid suture v-spread OMT improve heart rate variability and vagal tone in healthy individuals?
Does modified occipitomastoid suture v-spread OMT improve heart rate variability and vagal tone in healthy individuals?
Absolute Event Rate: 55% vs 50.5%
p-value: p=0.013
Modified occipitomastoid suture v-spread osteopathic manipulative treatment may increase vagal tone and decrease sympathetic activity as measured by short-term heart rate variability.
Background Autonomic rehabilitation using osteopathic manipulative treatment (OMT) to stimulate the vagus nerve may be a good adjunct therapy by physiatrists who treat dysautonomia. Heart rate variability (HRV) may provide quantitative evidence for the benefits of OMT on autonomic nervous system function. Elevated HRV indicates optimal health and reduced mortality risk, whereas low HRV is associated with stress, pain, and chronic disease pathology. Objective To analyze the impact of modified occipitomastoid suture v‐spread OMT technique on vagal tone by measuring HRV. Design Within‐participant design with 5‐minute HRV measurement pre‐ and post‐OMT treatment. Setting Clinical examination suites. Participants Thirty healthy osteopathic medical students. Interventions A modified occipitomastoid suture v‐spread treating somatic dysfunction by osteopathic physicians trained in osteopathic neuromusculoskeletal medicine. Main Outcome Measures HRV variables related to vagal tone including root mean square of successive differences (RMSSD), percentage of successive normal sinus RR intervals >50 ms (pNN50), high frequency (HF), Parasympathetic Nervous System Index (PNSI), and Sympathetic Nervous System Index (SNSI). Repeated measures t‐test analyzed the difference in mean HRV values after OMT. Results There were statistically significant increases in each of the HRV measures after OMT. Participants had a mean (95% confidence interval) RMSSD of 50.5 ms (38.3–62.8) at baseline and 55.0 ms (41.2–68.7, p = .013) post‐OMT. pNN50 was 24.5% (17.6–31.3, n = 30) at baseline and 28.2% (20.8–35.6, p = .003) post‐OMT. HF was 1549.6 ms2 (389.8–2709.4) at baseline and 1901.8 ms2 (618.2–3185.4, p = .103) post‐OMT. PNSI was −0.1 (−0.5 to 0.2) at baseline and 0.1 (−0.3 to 1.5, p < .01) post‐OMT, and SNSI was 0.2 (−0.1 to 0.6) at baseline and 0.05 (−0.3 to 0.4, p < .01) post‐OMT. Normalization, due to high baseline variance, results include RMSSD 1.1 ms (1.0 to 1.1, p = .012), pNN50 1.3 (1.1 to 1.4, p = .011), and HF 1.2 ms2 (1.1 to 1.4, p = .018). Conclusions Modified occipitomastoid suture v‐spread may provide clinical benefit through increased vagal tone and decreased sympathetic activity.
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Miller et al. (2024) studied Healthy (n=30). Modified occipitomastoid suture v-spread OMT vs. Baseline (pre-OMT) was evaluated on Root mean square of successive differences (RMSSD) (p=0.013). Modified occipitomastoid suture v-spread OMT significantly increased vagal tone, with mean RMSSD increasing from 50.5 ms at baseline to 55.0 ms post-treatment (p=0.013).
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