Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | https://ri.ufs.br/jspui/handle/riufs/18528 |
Resumo: | Among physiotherapeutic modalities, it has been proposed that some techniques of manual therapy may influence Autonomic Nervous System (ANS). For that, there is an anatomical justification, where stimulation of spinal or paravertebral structures may lead to influence reflex responses of ANS, which in turn may alter visceral function. Such intervention methods are poorly understood as to their form of application, evaluation method, physiological justification, and there is no consensus about results found. Therefore, the main objective of this work is to determine whether the effects of the chosen manual therapy techniques, applied to healthy subjects, influence autonomic modulation and / or cerebral blood flow. To this end, the present project has already been approved by the Human Research Ethics Committee (CAAE: 47522315.2.0000.5546). Subjects between 18 and 30 years old, of both sexes, were recruited randomly into 4 groups: Intervention Group 1 (atlanto-occipital joint decompression technique) Intervention Group 2 (fourth ventricle decompression technique); Intervention Group 3 (stretch-relax technique of the suboccipital muscles) and Group 4 (placebo). All subjects went through an adaptation phase, during 10 minutes, in the supine position. After that, they received the techniques or the placebo for 05 minutes, and the data were collected again for another 10 minutes. During the entire collection, the subjects were attached to the Finapres device, where heart rate and blood pressure are recorded beat by beat. Before and after the application of the techniques, in the 10 minutes before and after the intervention, the individuals were also evaluated using transcranial Doppler, which measures the speed of cerebral blood flow, analyzing the middle cerebral artery. It was observed that, regarding the SNA variables analyzed in the frequency domain, there was no statistically significant difference in any of the groups analyzed. Regarding the speed of cerebral blood flow, there was a statistically significant difference for the stretching groups to contract relax and decompression of the atlanto-occipital joint, with an increase in speed in Group 3 and a decrease in Group 4. Apparently, the techniques applied in this study, did not interfere with cardiac autonomic modulation; the cerebral blood flow, on the other hand, obtained changes in its speed in two techniques, those that, in fact, alter and sustain the change in the positioning of vertebral structures that can cause stenosis or release of the region. Thus, it is believed that manual therapy techniques do not have systemic autonomic effects, but small local changes in terms of blood flow. |
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Santana, Mylena Maria SalgueiroFilho, Valter Joviniano de SantanaNeto, Jader Pereira de Farias2023-10-19T12:28:46Z2023-10-19T12:28:46Z2022SANTANA, Mylena Maria Salgueiro. Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis. 2022. 51f. Tese (doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2022.https://ri.ufs.br/jspui/handle/riufs/18528Among physiotherapeutic modalities, it has been proposed that some techniques of manual therapy may influence Autonomic Nervous System (ANS). For that, there is an anatomical justification, where stimulation of spinal or paravertebral structures may lead to influence reflex responses of ANS, which in turn may alter visceral function. Such intervention methods are poorly understood as to their form of application, evaluation method, physiological justification, and there is no consensus about results found. Therefore, the main objective of this work is to determine whether the effects of the chosen manual therapy techniques, applied to healthy subjects, influence autonomic modulation and / or cerebral blood flow. To this end, the present project has already been approved by the Human Research Ethics Committee (CAAE: 47522315.2.0000.5546). Subjects between 18 and 30 years old, of both sexes, were recruited randomly into 4 groups: Intervention Group 1 (atlanto-occipital joint decompression technique) Intervention Group 2 (fourth ventricle decompression technique); Intervention Group 3 (stretch-relax technique of the suboccipital muscles) and Group 4 (placebo). All subjects went through an adaptation phase, during 10 minutes, in the supine position. After that, they received the techniques or the placebo for 05 minutes, and the data were collected again for another 10 minutes. During the entire collection, the subjects were attached to the Finapres device, where heart rate and blood pressure are recorded beat by beat. Before and after the application of the techniques, in the 10 minutes before and after the intervention, the individuals were also evaluated using transcranial Doppler, which measures the speed of cerebral blood flow, analyzing the middle cerebral artery. It was observed that, regarding the SNA variables analyzed in the frequency domain, there was no statistically significant difference in any of the groups analyzed. Regarding the speed of cerebral blood flow, there was a statistically significant difference for the stretching groups to contract relax and decompression of the atlanto-occipital joint, with an increase in speed in Group 3 and a decrease in Group 4. Apparently, the techniques applied in this study, did not interfere with cardiac autonomic modulation; the cerebral blood flow, on the other hand, obtained changes in its speed in two techniques, those that, in fact, alter and sustain the change in the positioning of vertebral structures that can cause stenosis or release of the region. Thus, it is believed that manual therapy techniques do not have systemic autonomic effects, but small local changes in terms of blood flow.A terapia manual é um recurso terapêutico muito utilizado no tratamento fisioterapêutico. Dentre os benefícios desta modalidade terapêutica, a literatura sugere um efeito positivo no Sistema Nervoso Autônomo (SNA). Os efeitos positivos do tratamento são relacionados a estimulação de estruturas da coluna vertebral ou paravertebrais que podem levar a respostas segmentares reflexas organizadas do SNA, que por sua vez podem alterar a função visceral. Tais métodos de intervenção são pouco esclarecidos quanto à sua forma de aplicação, método de avaliação, sua justificativa fisiológica, além de não haver consenso sobre os resultados encontrados. Sendo assim, o objetivo principal deste trabalho é determinar se os efeitos de técnicas de terapia manual, aplicadas em sujeitos saudáveis, influenciam a modulação autonômica e/ou o fluxo sanguíneo cerebral. Para isto, o presente trabalho teve aprovação no Comitê de ética em Pesquisa com Seres Humanos (CAAE: 47522315.2.0000.5546). Foram recrutados sujeitos com idade entre 18 e 34 anos, de ambos os sexos, alocados de forma randômica em 4 grupos: Grupo 1 (placebo); Grupo Intervenção 2 (técnica de compressão-descompressão); Grupo Intervenção 3 (técnica de alongamento contrair-relaxar dos músculos suboccipitais) e Grupo 4 (descompressão da articulação atlanto-occipital). Todos os sujeitos passaram por uma fase de adaptação, durante 10 minutos, em decúbito dorsal. Após isso, receberam as técnicas ou o placebo por 10 minutos, sendo novamente coletados os dados por mais 10 minutos. Durante toda a coleta os sujeitos ficaram acoplados ao aparelho Finapres, onde são registradas a Frequência Cardíaca e a Pressão Sanguínea Arterial batimento-a- batimento. Antes e depois da aplicação das técnicas, nos 10 minutos pré e pós- intervenção, os indivíduos também foram avaliados através do Doppler transcraniano, que mede a velocidade do fluxo sanguíneo cerebral, analisando-se a artéria vertebral. Observou-se que, quanto às variáveis do SNA analisadas no domínio da frequência, não houve diferença estatisticamente significante em nenhum dos grupos analisados. Já com relação à velocidade do fluxo sanguíneo cerebral, houve diferença estatisticamente significante para os grupos de alongamento contrair relaxar e descompressão da articulação atlanto-occipital, com aumento da velocidade no grupo Grupo 3 e diminuição no Grupo 4. Aparentemente, as técnicas aplicadas neste estudo, não interferiram na modulação autonômica cardíaca; já o fluxo sanguíneo cerebral obteve mudanças em sua velocidade em duas técnicas, sendo elas as que, de fato, alteram e sustentam a mudança no posicionamento de estruturas vertebrais que podem causar a estenose ou a liberação da região. Sendo assim, acredita-se que, as técnicas de terapia manual não têm efeitos autonômicos sistêmicos, mas sim pequenas mudanças locais em termos de fluxo sanguíneo.AracajuporManipulações musculoesqueléticasSistema nervoso autônomoUltrassonografia doppler transcranianaMusculoskeletal manipulationsAutonomic nervous systemUltrasonography doppler transcranialCIENCIAS DA SAUDEEfeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisPós-Graduação em Ciências da SaúdeUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessORIGINALMylena_Santana.pdfMylena_Santana.pdfapplication/pdf812820https://ri.ufs.br/jspui/bitstream/riufs/18528/2/Mylena_Santana.pdfb98703a13853fb81db4a6f27ffd11c8eMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/18528/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51riufs/185282023-10-19 09:28:51.186oai:ufs.br:riufs/18528TElDRU7Dh0EgREUgRElTVFJJQlVJw4fDg08gTsODTy1FWENMVVNJVkEKCkNvbSBhIGFwcmVzZW50YcOnw6NvIGRlc3RhIGxpY2Vuw6dhLCB2b2PDqiAobyBhdXRvcihlcykgb3UgbyB0aXR1bGFyIGRvcyBkaXJlaXRvcyBkZSBhdXRvcikgY29uY2VkZSDDoCBVbml2ZXJzaWRhZGUgRmVkZXJhbCBkZSBTZXJnaXBlIG8gZGlyZWl0byBuw6NvLWV4Y2x1c2l2byBkZSByZXByb2R1emlyIHNldSB0cmFiYWxobyBubyBmb3JtYXRvIGVsZXRyw7RuaWNvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3Mgw6F1ZGlvIG91IHbDrWRlby4KClZvY8OqIGNvbmNvcmRhIHF1ZSBhIFVuaXZlcnNpZGFkZSBGZWRlcmFsIGRlIFNlcmdpcGUgcG9kZSwgc2VtIGFsdGVyYXIgbyBjb250ZcO6ZG8sIHRyYW5zcG9yIHNldSB0cmFiYWxobyBwYXJhIHF1YWxxdWVyIG1laW8gb3UgZm9ybWF0byBwYXJhIGZpbnMgZGUgcHJlc2VydmHDp8Ojby4KClZvY8OqIHRhbWLDqW0gY29uY29yZGEgcXVlIGEgVW5pdmVyc2lkYWRlIEZlZGVyYWwgZGUgU2VyZ2lwZSBwb2RlIG1hbnRlciBtYWlzIGRlIHVtYSBjw7NwaWEgZGUgc2V1IHRyYWJhbGhvIHBhcmEgZmlucyBkZSBzZWd1cmFuw6dhLCBiYWNrLXVwIGUgcHJlc2VydmHDp8Ojby4KClZvY8OqIGRlY2xhcmEgcXVlIHNldSB0cmFiYWxobyDDqSBvcmlnaW5hbCBlIHF1ZSB2b2PDqiB0ZW0gbyBwb2RlciBkZSBjb25jZWRlciBvcyBkaXJlaXRvcyBjb250aWRvcyBuZXN0YSBsaWNlbsOnYS4gVm9jw6ogdGFtYsOpbSBkZWNsYXJhIHF1ZSBvIGRlcMOzc2l0bywgcXVlIHNlamEgZGUgc2V1IGNvbmhlY2ltZW50bywgbsOjbyBpbmZyaW5nZSBkaXJlaXRvcyBhdXRvcmFpcyBkZSBuaW5ndcOpbS4KCkNhc28gbyB0cmFiYWxobyBjb250ZW5oYSBtYXRlcmlhbCBxdWUgdm9jw6ogbsOjbyBwb3NzdWkgYSB0aXR1bGFyaWRhZGUgZG9zIGRpcmVpdG9zIGF1dG9yYWlzLCB2b2PDqiBkZWNsYXJhIHF1ZSBvYnRldmUgYSBwZXJtaXNzw6NvIGlycmVzdHJpdGEgZG8gZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIHBhcmEgY29uY2VkZXIgw6AgVW5pdmVyc2lkYWRlIEZlZGVyYWwgZGUgU2VyZ2lwZSBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7Dp2EsIGUgcXVlIGVzc2UgbWF0ZXJpYWwgZGUgcHJvcHJpZWRhZGUgZGUgdGVyY2Vpcm9zIGVzdMOhIGNsYXJhbWVudGUgaWRlbnRpZmljYWRvIGUgcmVjb25oZWNpZG8gbm8gdGV4dG8gb3Ugbm8gY29udGXDumRvLgoKQSBVbml2ZXJzaWRhZGUgRmVkZXJhbCBkZSBTZXJnaXBlIHNlIGNvbXByb21ldGUgYSBpZGVudGlmaWNhciBjbGFyYW1lbnRlIG8gc2V1IG5vbWUocykgb3UgbyhzKSBub21lKHMpIGRvKHMpIApkZXRlbnRvcihlcykgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIGRvIHRyYWJhbGhvLCBlIG7Do28gZmFyw6EgcXVhbHF1ZXIgYWx0ZXJhw6fDo28sIGFsw6ltIGRhcXVlbGFzIGNvbmNlZGlkYXMgcG9yIGVzdGEgbGljZW7Dp2EuIAo=Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2023-10-19T12:28:51Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis |
title |
Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis |
spellingShingle |
Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis Santana, Mylena Maria Salgueiro Manipulações musculoesqueléticas Sistema nervoso autônomo Ultrassonografia doppler transcraniana Musculoskeletal manipulations Autonomic nervous system Ultrasonography doppler transcranial CIENCIAS DA SAUDE |
title_short |
Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis |
title_full |
Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis |
title_fullStr |
Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis |
title_full_unstemmed |
Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis |
title_sort |
Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis |
author |
Santana, Mylena Maria Salgueiro |
author_facet |
Santana, Mylena Maria Salgueiro |
author_role |
author |
dc.contributor.author.fl_str_mv |
Santana, Mylena Maria Salgueiro |
dc.contributor.advisor1.fl_str_mv |
Filho, Valter Joviniano de Santana |
dc.contributor.advisor-co1.fl_str_mv |
Neto, Jader Pereira de Farias |
contributor_str_mv |
Filho, Valter Joviniano de Santana Neto, Jader Pereira de Farias |
dc.subject.por.fl_str_mv |
Manipulações musculoesqueléticas Sistema nervoso autônomo Ultrassonografia doppler transcraniana |
topic |
Manipulações musculoesqueléticas Sistema nervoso autônomo Ultrassonografia doppler transcraniana Musculoskeletal manipulations Autonomic nervous system Ultrasonography doppler transcranial CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Musculoskeletal manipulations Autonomic nervous system Ultrasonography doppler transcranial |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Among physiotherapeutic modalities, it has been proposed that some techniques of manual therapy may influence Autonomic Nervous System (ANS). For that, there is an anatomical justification, where stimulation of spinal or paravertebral structures may lead to influence reflex responses of ANS, which in turn may alter visceral function. Such intervention methods are poorly understood as to their form of application, evaluation method, physiological justification, and there is no consensus about results found. Therefore, the main objective of this work is to determine whether the effects of the chosen manual therapy techniques, applied to healthy subjects, influence autonomic modulation and / or cerebral blood flow. To this end, the present project has already been approved by the Human Research Ethics Committee (CAAE: 47522315.2.0000.5546). Subjects between 18 and 30 years old, of both sexes, were recruited randomly into 4 groups: Intervention Group 1 (atlanto-occipital joint decompression technique) Intervention Group 2 (fourth ventricle decompression technique); Intervention Group 3 (stretch-relax technique of the suboccipital muscles) and Group 4 (placebo). All subjects went through an adaptation phase, during 10 minutes, in the supine position. After that, they received the techniques or the placebo for 05 minutes, and the data were collected again for another 10 minutes. During the entire collection, the subjects were attached to the Finapres device, where heart rate and blood pressure are recorded beat by beat. Before and after the application of the techniques, in the 10 minutes before and after the intervention, the individuals were also evaluated using transcranial Doppler, which measures the speed of cerebral blood flow, analyzing the middle cerebral artery. It was observed that, regarding the SNA variables analyzed in the frequency domain, there was no statistically significant difference in any of the groups analyzed. Regarding the speed of cerebral blood flow, there was a statistically significant difference for the stretching groups to contract relax and decompression of the atlanto-occipital joint, with an increase in speed in Group 3 and a decrease in Group 4. Apparently, the techniques applied in this study, did not interfere with cardiac autonomic modulation; the cerebral blood flow, on the other hand, obtained changes in its speed in two techniques, those that, in fact, alter and sustain the change in the positioning of vertebral structures that can cause stenosis or release of the region. Thus, it is believed that manual therapy techniques do not have systemic autonomic effects, but small local changes in terms of blood flow. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022 |
dc.date.accessioned.fl_str_mv |
2023-10-19T12:28:46Z |
dc.date.available.fl_str_mv |
2023-10-19T12:28:46Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
SANTANA, Mylena Maria Salgueiro. Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis. 2022. 51f. Tese (doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2022. |
dc.identifier.uri.fl_str_mv |
https://ri.ufs.br/jspui/handle/riufs/18528 |
identifier_str_mv |
SANTANA, Mylena Maria Salgueiro. Efeito de técnicas da terapia manual sobre a modulação autonômica cardiovascular e o fluxo sanguíneo cerebral comparado a método placebo em saudáveis. 2022. 51f. Tese (doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2022. |
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https://ri.ufs.br/jspui/handle/riufs/18528 |
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Pós-Graduação em Ciências da Saúde |
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Universidade Federal de Sergipe |
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