Evaluation of Local Skeletal Muscle Blood Flow in Manipulative Therapy by Diffuse Correlation Spectroscopy.

Yasuhiro Matsuda,Mikie Nakabayashi,Sinan Zhang,Tatsuya Suzuki,Masashi Ichinose,Yumie Ono

doi:10.3389/fbioe.2021.800051

Abstract

Manipulative therapy (MT) is applied to motor organs through a therapist’s hands. Although MT has been utilized in various medical treatments based on its potential role for increasing the blood flow to the local muscle, a quantitative validation of local muscle blood flow in MT remains challenging due to the lack of appropriate bedside evaluation techniques. Therefore, we investigated changes in the local blood flow to the muscle undergoing MT by employing diffuse correlation spectroscopy, a portable and emerging optical measurement technology that non-invasively measures blood flow in deep tissues. This study investigated the changes in blood flow, heart rate, blood pressure, and autonomic nervous activity in the trapezius muscle through MT application in 30 volunteers without neck and shoulder injury. Five minutes of MT significantly increased the median local blood flow relative to that of the pre-MT period (p < 0.05). The post-MT local blood flow increase was significantly higher in the MT condition than in the control condition, where participants remained still without receiving MT for the same time (p < 0.05). However, MT did not affect the heart rate, blood pressure, or cardiac autonomic nervous activity. The post-MT increase in muscle blood flow was significantly higher in the participants with muscle stiffness in the neck and shoulder regions than in those without (p < 0.05). These results suggest that MT could increase the local blood flow to the target skeletal muscle, with minimal effects on systemic circulatory function.

Highlights

Manipulative therapy (MT) is a traditional procedure applied to the musculoskeletal system as part of a medical treatment, sports conditioning, and health promotion
There were no significant differences in blood pressure, heart rate (HR), and cardiac autonomic indices between the pre-and post-periods in the same conditions and between the corresponding periods of the two conditions (CT and MT)
By adopting a diffuse optical technique with sufficient sensitivity for blood flow measurement in deep tissues (Shang et al, 2013; Yu et al, 2007), we confirmed the effect of MT in increasing the local muscular blood flow

Summary

Introduction

Manipulative therapy (MT) is a traditional procedure applied to the musculoskeletal system as part of a medical treatment, sports conditioning, and health promotion. The lack of accurate and practical bedside techniques to quantify deep-tissue blood flow could explain this inconsistency Several techniques, such as the thermodilution method (Reuter et al, 2010), Xenon clearance method (Thomas et al, 1979), and positron emission tomography (Grafton et al, 1992) have been utilized to quantitatively measure tissue blood flow. These invasive and semi-invasive techniques are inappropriate for investigating the therapeutic effect of MT, which mainly targets patients and/or elderly individuals with physical decline. There are reports of locally increased blood flow, which could explain the elevated cutaneous and/or intramuscular temperature at the site of MT application (Drust et al, 2003; Sefton et al, 2010; Portillo-Soto et al, 2014; Monteiro Rodrigues et al, 2020)

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Results

Conclusion