Complementary Therapies in Medicine

Objectives: The physiological changes that occur during pregnancy, including increased bloodvolume and cardiac output, can affect hemodynamic control, most profoundly with positionalchanges that affect venous return to the heart. By using Osteopathic Manipulative Treatment(OMT), a body-based modality theorized to affect somatic structures related to nervous andcirculatory systems, we hypothesized that OMT acutely improves both autonomic and hemody-namic control during head-up tilt and heel raise in women at 30 weeks gestation.

Design: One hundred subjects were recruited at 30 weeks gestation.

Setting: The obstetric clinics of UNTHealth in Fort Worth, TX.

Intervention: Subjects were randomized into one of three treatment groups: OMT, placeboultrasound, or time control. Ninety subjects had complete data (N = 25, 31 and 34 in each grouprespectively).

Main outcome measures: Blood pressure and heart rate were recorded during 5 min of head-uptilt followed by 4 min of intermittent heel raising.

Results: No significant differences in blood pressure, heart rate or heart rate variability wereobserved between groups with tilt before or after treatment (p > 0.36), and heart rate variabil-ity was not different between treatment groups (p > 0.55). However, blood pressure increased significantly (p = 0.02) and heart rate decreased (p < 0.01) during heel raise after OMT comparedto placebo or time control.

Conclusions: These data suggest that OMT can acutely improve hemodynamic control during engagement of the skeletal muscle pump and this was most likely due to improvement ofstructural restrictions to venous return.

 

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