Quantitative evaluation of skeletal muscle blood flow by diffuse correlation spectroscopy : application to manipulative therapy

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  • 手技療法による骨格筋血流変化の定量評価 : 拡散相関分光法による検討
  • シュギ リョウホウ ニ ヨル コッカクキン ケツリュウ ヘンカ ノ テイリョウ ヒョウカ : カクサン ソウカン ブンコウホウ ニ ヨル ケントウ

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Abstract

Manipulative therapy (MT) is a typical treatment applied to the motor organ with a therapeutic objective in various medical fields. In a current clinical practice, however, the effectiveness of MT is subjectively evaluated by a therapist and/or a patient. MT has been expected to increase local blood flow and decrease edema and pain. However, these physiological changes have not been fully clarified due to the lack of non-invasive and cost-effective methodology to evaluate muscle blood flow. We here used diffuse correlation spectroscopy (DCS), a novel technique to non-invasively measure blood flow velocity, to quantitatively evaluate the effect of MT on the blood flow of the target muscle. Healthy participants (3 men/3 women, age: 22.5±0.7) took part in the study. Participants took a supine position on the treatment table to have a hip joint flexion test. The right leg was elevated to the maximum hip joint flection, and the hip flexion angle and the subjective pain intensity (evaluated by visual analog scale: VAS) were measured. Subsequently, the blood flow of the posterior surface of the femoral region was measured for 5 minutes at rest as a baseline. The blood flow of the same site was measured again after 5 minutes of MT. Finally, we measured a post-MT VAS under the hip joint flexion to the same angle as in the first flexion. Participant received two sessions of MT and control conditions, in which they received MT and no treatment (quiet rest for 5 minutes) between the two hip joint flexion measurements, respectively, in a random and counterbalanced order. Subjective pain intensity with hip joint flexion tended to decrease after MT (p=0.08) while no change was observed in case of control condition (p=0.41). The blood flow velocity of the treated muscle was significantly increased after MT relative to that of the pre-treatment state (p<0.05). There was no change in the blood flow velocity throughout the measurement in case of control condition. These results suggest that MT-induced mechanical pressure to the skin and muscle tissues promote venous return and increase local blood flow.

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