Spinal and sacroiliac joint assessment and treatment within the American osteopathic profession

Abstract

Introduction: One of the most important notions in osteopathy is that our body structures possess a certain freedom of motion, which is necessary to function properly. We also know that respiration influences the motion of the heart. This study proposes a method to quantify this motion of the heart. Design: Observational study Methods: A Gyroscan T10-NT (magnetic resonance) has been used. In order to obtain a good three-dimensional image, localizer images were made in the three orthogonal planes (axial, sagittal and frontal). After this images were made in the long axis (two-chamber view), short axis and four-chamber view. Images were made in expiration, inspiration and in neutral position using ECG-triggering. The research group for this study consisted of 10 healthy subjects (5 men, 5 woman). A total of 5021 images were made and all results were analysed with the Friedman test, with significant results if p p<0.1. Results: The position of the apex cordis showed a significant (p<0.01) movement in the three orthogonal planes. The apex moved caudally (20.3mm, SD. 8.59mm). anteriorly (17.1mm, SD. 4.70mm) an to the right (13.9mm, SD. 8.46mm) during inhalation (meaning the difference between maximal exhalation and maximal inhalation). The axis changes measured on the long axis did not achieve statistical significance. Although, at sight, a clear verticalization was observed in all subjects, measurements only showed a tendency (p1⁄40.067) to verticalization during inhalation. No axis changes have been observed in the short axis. Conclusions: Despite the small group of subjects, this study clearly shows a change in position of the heart under influence of breathing. The apex moves caudal, anterior and to the right. The heart tends to verticalize and so to say stand on his apex. During expiration the opposite movement has been found.