How do patients feel post-treatment? pilot study at a UK osteopathic teaching clinic of self-reported adverse events

Abstract

interventions were applied for longer periods than has been studied previously, so that their ability to produce sustained elevations of lymph flow could be evaluated. Experimental Design and Methods: Experiments were conducted in eight conscious dogs surgically instrumented with aortic and inferior vena cava catheters and an ultrasonic flow transducer implanted on the thoracic lymph duct (J Am Osteopath Assoc 105:447-456, 2005). Abdominal LPT (1-2 compressions per sec) and moderate treadmill exercise (3 mi per hr, 0 % grade) were performed on different days for 8 min before and after ECE with normal saline, iv, 4.4 0.3 % of body weight. Data were collected prior to each intervention and at 1-min intervals during LPT and exercise. Results: Before ECE, LPT and exercise increased mean aortic and mean inferior vena cava pressures (P<0.05). ECE increased pretreatment mean aortic pressure, inferior vena cava pressure, and pretreatment lymph flow in the thoracic duct (P<0.05). After ECE, LPT did not further increase aortic pressure but did increase inferior vena caval pressure. After ECE, exercise increased aortic pressure, but not inferior cava pressure. Before ECE, LPT increased lymph flow from 1.7 0.5 to 5.0 1.1 ml/min at 1 min (P<0.05). Following ECE, LPT increased lymph flow from 4.8 0.6 to 9.9 1.1 ml/min at 1 min (P<0.05). Lymph flow remained significantly above pre-treatment baseline for 4 min both before and after ECE. The net increase in lymph flow produced by 8-min LPT was 15.4 1.1 ml before ECE and 18.3 3.8 ml after ECE. Moderate treadmill exercise increased lymph flow from 1.0 0.3 to 8.9 1.9 ml/min at 1 min before ECE (P<0.05) and from 4.0 0.3 to 15.2 3.0 ml/min at 1 min after ECE (P<0.05). Lymph flow during exercise remained significantly above baseline for 4 min before ECE and for 6 min after ECE. The net increase in lymph flow produced by 8 min of exercise was 24.9 5.5 ml before ECE and 39.6 5.1 ml after ECE (P<0.05 vs LPT). Conclusions: Expansion of the extracellular fluid volume produced large increases in thoracic duct lymph flow, which were further augmented by lymphatic pump treatment and by moderate treadmill exercise. (A report of this investigation has been accepted for publication in Lymphatic Research and Biology. This research was supported by NIH grant U19 AT002023.)