The effect of rib raising on the autonomic nervous system: measuring heart rate variability in a randomised sham-controlled experiment.
Item
- Title
- The effect of rib raising on the autonomic nervous system: measuring heart rate variability in a randomised sham-controlled experiment.
- Author(s)
- Abdel Tawab, T
- Abstract
- Introduction: There is frequent claim within osteopathic literature that rib raising has an effect on autonomic nervous system (ANS) function. However, there is very little clinically relevant evidence to support this claim. Interventions that have proven significant effects on ANS function offer many possibilities in a clinical setting, including reducing cardiovascular risks such as myocardial infarction and hypertension, and other pathologies including diabetes mellitus. Heart rate variability (HRV) is a leading non-invasive tool used to measure autonomic modulation. This study measures short-term HRV to investigate whether rib raising has a significant effect on ANS function. Method: This sham controlled, randomised trial was conducted on 46 asymptomatic subjects (25 females, 21 males, age range 21-51). 4 subjects (2 males, 2 females) were excluded. HRV was recorded using a Polar RS8OOCX in three intervals: 10 minutes before intervention, 0-5 minutes and 5-10 minutes after intervention. The frequency domain indices that were analysed consisted of normalised values of low frequency band (LF: 0.04-0.15Hz), high frequency band (HF: 0.15-0.4OHz), and the low frequency/high frequency ratio (LF/HF). Both autoregressive (AR) and fast fourier transform (FFT) were analysed using Kubios HRV software. Artifacts were edited using manual linear interpolation. Results: There was no statistically significant change in LF, HF and LF/HF ratio indices in pre and post intervention, in both FFT results and AR results in subjects that received rib raising compared to those in the control or sham group (P> 0.05 in t test, ANOVA, Kruskal Wallis and Wilcoxon). The LF/HF ratio data was not normally distributed (p < 0.05 in f test and Shapiro-wilks) therefore Wilcoxon and Kruskal Wallis was used. However, the individual LF and HF data was normally distributed and parametric tests (t test and ANOVA) were used. The power of the study was 0.06, with Cohen's d effect size 0.14. Discussion: The predicted outcome of this study was to show that rib raising had an immediate increase, followed by an overall decrease in sympathetic modulation, with a corresponding increase in parasympathetic activity. However, this study showed that rib raising does not have a significant change in autonomic modulation. There is debate over the autonomic interpretation of HRV, questioning the simplistic understanding of the ANS, and the validity of HRV as a measuring tool. Many variables that have been shown to affect HRV (including noise, body position, cardiovascular disease, smoking and exercise) were limited in this study. However, the validity of this study would have improved further if other influencing factors such as age, respiration and gender were reduced. Conclusion: Rib raising appears not to have a significant effect on autonomic function (LF, HF or LF/HF ratio). However this is based on a small sample size, and a minimum of 1700 subjects is recommended for future studies.
- presented at
- European School of Osteopathy
- Date Accepted
- 2017
- Date Submitted
- 4.12.2017 17:06:18
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16027
- Inst-Identifier
- 1229
- Keywords
- Visceral osteopathy, visceral manipulation, literature review, outcomes.
- Recommended
- 0
- Item sets
- Thesis
Abdel Tawab, T, “The effect of rib raising on the autonomic nervous system: measuring heart rate variability in a randomised sham-controlled experiment.”, Osteopathic Research Web, accessed May 4, 2025, https://www.osteopathicresearch.org/s/orw/item/503