The Neurophysiological Effects of Craniosacral Treatment on Heart Rate Variability: A Systematic Review of Literature and Meta-Analysis


Author: Andrew C Cook1, Anna E Egli2, Nathan E Cohen1, Kyrie Bernardi1, Min Y Chae1, Brandon A Kapalko2, Sunni A Coyne3, Randy Scott4

Affiliation: <sup>1</sup> College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine - Bradenton, Jacksonville, USA.

<sup>2</sup> College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine - Bradenton, St. Augustine, USA.

<sup>3</sup> College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine - Bradenton, Daytona Beach, USA.

<sup>4</sup> Regional Dean, Lake Erie College of Osteopathic Medicine - Bradenton, Jacksonville, USA.
Conference/Journal: Cureus
Date published: 2024 Jul 18
Other:
 Volume ID: 16   ,  Issue ID: 7   ,  Pages: e64807   ,  Special Notes: doi: 10.7759/cureus.64807.   ,  Word Count: 264  
    Craniosacral treatment (CST) is an osteopathic technique grounded in the assumption that there is an intrinsic, fine movement of the cerebrospinal fluid. This rhythmic movement can be utilized for diagnostic and therapeutic purposes by palpation and manipulation of the skull, spine, and associated connective tissues. Therapeutic benefit is likely due to action on the autonomic nervous system (ANS), specifically through the vagus nerve. Current literature on the neurophysiological effects of CST is limited, which has contributed to controversy regarding its effectiveness. Heart rate variability (HRV) as a measure of cardiovascular stress and autonomic system activity is thus proposed as a tool to evaluate the neurophysiologic effects of CST. HRV can be analyzed in two different bands, high-frequency (HF) and low-frequency (LF) power associated with a parasympathetic and sympathetic response. In this meta-analysis, we provide a brief introduction to CST, analyze three primary studies, and summarize the therapeutic benefits and pitfalls of this alternative treatment on the ANS. A significant negative HF standardized mean difference after CST was observed; standardized mean difference = -0.46; 95% CI (-0.79,-0.14). No significant effect on LF power was observed. We conclude that CST does provide a moderate short-term increase in parasympathetic activity. These findings suggest that CST may be used to treat patients with an overactive sympathetic state. Further studies should be conducted for comparison against a control group to eliminate the possibility of a placebo effect and to elucidate long-term effects.



Keywords: autonomic nervous system dysfunction; craniosacral therapy; cv4; heartrate variability; high-frequency power; low-frequency power; neurophysiology; osteopathic cranial manipulative medicine; parasympathetic stimulation; sympathetic overactivity.



PMID: 39156412 PMCID: PMC11329942 DOI: 10.7759/cureus.64807