The effects of multiregional fascial mobilization on heart rate and physiological parameters in patients with obstructive sleep apnea

Background: Obstructive sleep apnea (OSA) is associated with increased sympathetic activity and an elevated cardiovascular risk. Noninvasive interventions targeting autonomic regulation may offer complementary therapeutic strategies. Methods: This randomized controlled trial aimed to investigate the acute effects of multiregional fascial mobilization on the physiological parameters of patients with OSA. Patients with polysomnography-confirmed moderate-to-severe OSA (apnea-hypopnea index ≥ 15 events/hour) were randomly assigned to an intervention group that received a standardized 16-minute multiregional fascial mobilization protocol or a control group that rested quietly in the supine position for the corresponding period without receiving manual or tactile intervention. The intervention targeted the cervical, thoracic, and abdominal regions, under controlled conditions. The primary outcomes included heart rate, systolic and diastolic blood pressure, and peripheral oxygen saturation. Measurements were obtained at baseline, immediately post-intervention, and 5 and 15 minutes post-intervention. Results: A total of 95 male patients (mean age: 48.12 ± 10.21 years) completed the study. Baseline characteristics were comparable between the groups, except for heart rate. After adjustment for baseline heart rate using mixed analysis of covariance, no significant group × time interaction was observed for heart rate ( P = .476, partial ηp 2 = .008). Similarly, no significant group × time interactions were observed for systolic blood pressure, diastolic blood pressure, or peripheral oxygen saturation (all P > .05). Although significant time effects were observed for some physiological parameters, the magnitude of these effects varied across outcomes, and none was accompanied by a significant group × time interaction. Therefore, these temporal changes were not interpreted as intervention-specific effects. No adverse events were reported. Conclusion: Heart rate changed significantly over time following the interventions; however, after adjustment for baseline heart rate, the pattern of change did not differ significantly between the fascial mobilization and control groups. Similarly, no significant between-group differences in changes over time were observed for blood pressure or oxygen saturation. These findings do not demonstrate a specific acute effect of multiregional fascial mobilization on the physiological parameters assessed. Further studies using advanced measures of autonomic function and longer follow-up periods are warranted.