“…Dividing extension rates by 2 yielded CRI rates (i.e., a complete cycle of extension and flexion) in the LF band between 0.06 and 0.07 Hz (≡ 3.6–4.2 cpm). Such rates are in agreement with rates reported in the literature for experienced examiners 10 , 24 . Figure 3 Exemplary section from cranial vault hold of participant A14.…”
Section: Resultssupporting
confidence: 92%
“…3 ). Mean palpated CRI rates (extension interval × 2) at 0.066 Hz for LF-responders and at 0.068 Hz for IM-responders were in line with our first hypothesis that observed CRI rates would be comparable with those previously reported for experienced osteopathic practitioners (0.08 Hz; 24 ).…”
Section: Discussionsupporting
confidence: 90%
“…A previous study demonstrated a poor interrater reliability, which put the validity of OMT further into question 23 . Also, the observation that CRI rates palpated by unexperienced examiners were found to be consistently above those palpated by more experienced examiners put the entire concept further into question 24 . Yet another questionable concept concerns the current OMT model used to describe palpated events as ‘flexion’ and ‘extension’ events, supposed to account for one complete CRI cycle.…”
Intermediate (IM) band physiology in skin blood flow exhibits parallels with the primary respiratory mechanism (PRM) or cranial rhythmic impulse (CRI), controversial concepts of osteopathy in the cranial field (OCF). Owing to inconsistent manual palpation results, validity of evidence of PRM/CRI activity has been questionable. We therefore tried to validate manual palpation combining instrumented tracking and algorithmic objectivation of frequencies, amplitudes, and phases. Using a standard OCF intervention, cranial vault hold (CVH), two OCF experts palpated and digitally marked CRI frequencies in 25 healthy adults. Autonomic nervous system (ANS) activity in low frequency (LF) and IM band in photoplethysmographic (PPG) forehead skin recordings was probed with momentary frequency of highest amplitude (MFHA) and wavelet amplitude spectra (WAS) in examiners and participants. Palpation errors and frequency expectation bias during CVH were analyzed for phases of MFHA and CRI. Palpated CRI frequencies (0.05–0.08 Hz) correlated highly with mean MFHA frequencies with 1:1 ratio in 77% of participants (LF-responders; 0.072 Hz) and with 2:1 ratio in 23% of participants (IM-responders; 0.147 Hz). WAS analysis in both groups revealed integer number (harmonic) waves in (very) low and IM bands in > 98% of palpated intervals. Phase analyses in participants and examiners suggested synchronization between MFHA and CRI in a subset of LF-responders. IM band physiology in forehead PPG may offer a sensible physiological correlate of palpated CRI activity. Possible coordination or synchronization effects with additional physiological signals and between examiners and participants should be investigated in future studies.
“…Dividing extension rates by 2 yielded CRI rates (i.e., a complete cycle of extension and flexion) in the LF band between 0.06 and 0.07 Hz (≡ 3.6–4.2 cpm). Such rates are in agreement with rates reported in the literature for experienced examiners 10 , 24 . Figure 3 Exemplary section from cranial vault hold of participant A14.…”
Section: Resultssupporting
confidence: 92%
“…3 ). Mean palpated CRI rates (extension interval × 2) at 0.066 Hz for LF-responders and at 0.068 Hz for IM-responders were in line with our first hypothesis that observed CRI rates would be comparable with those previously reported for experienced osteopathic practitioners (0.08 Hz; 24 ).…”
Section: Discussionsupporting
confidence: 90%
“…A previous study demonstrated a poor interrater reliability, which put the validity of OMT further into question 23 . Also, the observation that CRI rates palpated by unexperienced examiners were found to be consistently above those palpated by more experienced examiners put the entire concept further into question 24 . Yet another questionable concept concerns the current OMT model used to describe palpated events as ‘flexion’ and ‘extension’ events, supposed to account for one complete CRI cycle.…”
Intermediate (IM) band physiology in skin blood flow exhibits parallels with the primary respiratory mechanism (PRM) or cranial rhythmic impulse (CRI), controversial concepts of osteopathy in the cranial field (OCF). Owing to inconsistent manual palpation results, validity of evidence of PRM/CRI activity has been questionable. We therefore tried to validate manual palpation combining instrumented tracking and algorithmic objectivation of frequencies, amplitudes, and phases. Using a standard OCF intervention, cranial vault hold (CVH), two OCF experts palpated and digitally marked CRI frequencies in 25 healthy adults. Autonomic nervous system (ANS) activity in low frequency (LF) and IM band in photoplethysmographic (PPG) forehead skin recordings was probed with momentary frequency of highest amplitude (MFHA) and wavelet amplitude spectra (WAS) in examiners and participants. Palpation errors and frequency expectation bias during CVH were analyzed for phases of MFHA and CRI. Palpated CRI frequencies (0.05–0.08 Hz) correlated highly with mean MFHA frequencies with 1:1 ratio in 77% of participants (LF-responders; 0.072 Hz) and with 2:1 ratio in 23% of participants (IM-responders; 0.147 Hz). WAS analysis in both groups revealed integer number (harmonic) waves in (very) low and IM bands in > 98% of palpated intervals. Phase analyses in participants and examiners suggested synchronization between MFHA and CRI in a subset of LF-responders. IM band physiology in forehead PPG may offer a sensible physiological correlate of palpated CRI activity. Possible coordination or synchronization effects with additional physiological signals and between examiners and participants should be investigated in future studies.
“…Sutherland some 90 years ago has at the center a palpable physiological phenomenon, the primary respiratory mechanism (PRM), termed also as “breath of life”, “tide” or, as of 1961, referred to as “cranial rhythmic impulse” (CRI) (Woods & Woods, 1961 ), which is supposed to represent a manifestation of the PRM. The CRI has been recorded successfully using various protocols with traditional palpation (for a review on this literature, see Sergueef et al., 2011 ) and despite some inconsistent results, several studies on immediate and long‐term effects of OCF/CST on ANS functioning have reported an increase of HF‐HRV parameters as modulation of parasympathetic activity (Arienti et al., 2020 ; Carnevali et al., 2020 ; Cerritelli et al., 2020 ; Henley et al., 2008 ; Rechberger et al., 2019 ; Ruffini et al., 2015 ).…”
Cardiovascular rhythms representing functional states of the autonomic nervous system (ANS) are insufficiently reflected by the current physiological model based on low and high frequency bands (LF, HF, resp.). An intermediate (IM) frequency band generated by a brainstem pacemaker was included in systemic physiological ANS analyses of forehead skin perfusion (SP), ECG, and respiration. Data of 38 healthy participants at T0 and T1 (+1 week) before, during, and following osteopathic cranial vault hold (CVH) stimulation were analyzed including momentary frequencies of highest amplitude, amplitudes in low (0.05–0.12 Hz), IM (0.12–0.18 Hz), and high (0.18–0.4 Hz) frequency bands, and established heart rate variability (HRV) metrics. During CVH, LF interval durations increased, whereas IM/HF band durations decreased significantly. Amplitudes increased significantly in all frequency bands. A cluster analysis found one response pattern dominated by IM activity (47% of participants) with highly stable 0.08 Hz oscillation to CVH, and one dominated by LF activity (0.10 Hz) at T0, increasing to IM activity at T1. Showing frequency ratios at ≈3:1, respiration was not responsible for oscillations in PPG during CVH. HRV revealed no significant responses. Rhythmic patterns in SP and respiration matched previous findings on a reticular “0.15 Hz rhythm”. Involvement of baroreflex pathways is discussed as alternative explanation.
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