Validation of subjective manual palpation using objective physiological recordings of the cranial rhythmic impulse during osteopathic manipulative intervention

Research Square

Abstract

Abstract ObjectiveReticular brain activity described by intermediate (IM) band physiology exhibits parallels to controversial concepts of cranial osteopathy (CO), the primary respiratory mechanism or cranial rhythmic impulse (CRI). Interestingly, evidence for PRM/CRI activity has been reported using manual palpation, yet with questionable validity. Validation is tested combining manual palpation, instrumented tracking, and algorithmic objectivation of frequencies and phases.MethodsUsing a standard CO intervention, Vault Hold (VH), two CO experts palpated and digitally marked CRI frequencies in 25 healthy adults. IM band autonomic nervous system activity was examined as momentary frequency of highest amplitude (MFHA) in examiner and participant forehead photoplethysmography (PPG). Palpation errors and frequency expectation bias during VH were examined using MFHA and CRI phases.FindingsPalpated CRI frequencies matched those reported in the literature. Mean MFHA and CRI frequencies were highly correlated and showed constant low deviating 1:1 coupling in 77% of participants (responders), and high deviating 1:2 coupling in 23% of participants (non-responders). Both groups showed harmonic waves in (very) low and IM bands in >98% of palpated intervals. Phase analyses suggested synchronization between MFHA and CRI in responders but not in non-responders confirming that examiners palpated CRI activity in participants.ConclusionsDecreases in forehead PPG of responders from IM activity (~0.14 Hz) to LF activity (0.072 Hz) suggest successful palpation may be explained by IM and LF activity, whereas CRI in non-responders was not associated with PPG activity.

Authors 7

1. Holger Pelz Aachen

   University of Žilina · RWTH Aachen University

   Affiliation as printed

   Deutsche Gesellschaft für Osteopathische Medizin e.V

   RWTH Aachen University

   University of Zilina

2. Gero Müller
   Affiliation as printed

   Herstaler Str. 14, 52074 Aachen, Germany

3. Micha Keller corresponding Aachen

   University of Žilina · RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University

   University of Zilina

4. Klaus Mathiak Aachen

   University of Žilina · RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University

   University of Zilina

5. Johannes Mayer Aachen

   University of Žilina · RWTH Aachen University

   Affiliation as printed

   Deutsche Gesellschaft für Osteopathische Medizin e.V

   RWTH Aachen University

   University of Zilina

6. Štefan Borik Aachen

   University of Žilina · RWTH Aachen University

   Affiliation as printed

   University of Zilina

   RWTH Aachen University

7. Volker Perlitz Aachen

   University of Žilina · RWTH Aachen University

   Affiliation as printed

   Simplana GmbH

   RWTH Aachen University

   University of Zilina