Effects of an Osteopathic Manual Therapy Protocol on Heart Rate Variability, Stress, and Anxiety in Young Adults

Summary

Anxiety is characterized by excessive worry and anticipation of future threats, often accompanied by physiological and behavioral manifestations. Anxiety disorders are among the most prevalent mental health conditions worldwide and represent a significant public health concern, particularly among young adults and university students, who frequently experience academic, social, and financial stressors. The aim of this randomized clinical trial is to evaluate the effect of a protocol, consisting of 4 manual techniques, compared to a placebo group, in heart rate variability immediately after the intervention and in anxiety after one week in young adults. The main questions it aims to answer are:

Does the osteopathic intervention protocol influence the parasympathetic nervous system? Does the osteopathic intervention protocol influence anxiety and stress?

The researchers will compare the osteopathic protocol to a placebo (simulation technique), in order to see if the protocol influences anxiety and stress. Participants will:

Prior to the intervention, complete the EADS questionnaire and undergo measurement of heart rate variability; Undergo the protocol or placebo; Immediately after the intervention, they will undergo the measurement of heart rate variability; After one week in the intervention, complete the questionnaire EADS.

Conditions

• Stress
• Anxiety

Interventions

OTHER

Fourth Ventricle Technique

This technique is performed with the patient in the supine position and lower limbs straight. The technique, according to Sutherland consists of a slight compression performed with the thenar eminence of the Osteopath in the supraoccipital region, precisely on the scale of the patient's occipital bone with compression initiated by the expiration phase of the primary respiratory mechanism and maintaining the compression for 5 min.

OTHER

Suboccipital Decompression

The patient is in the supine position, in maximum comfort. The Osteopath is located at the bedside of the table seated. Place both hands inferior to the occiput, and apply pressure to the area located between the occiput and axis, with the distal phalanges of your fingers. Then, apply a force in the anterior and cranial direction. The application of force should be maintained for 5 minutes.

OTHER

Diaphragm Myofascial Release Technique

The patient must position himself in the supine position with the lower limbs relaxed, the Osteopath must be at the head of the table and make a manual contact on the lower edge of the last costal arch, in the phase of inspiration the hands of the Osteopath bring laterally and cephalically the diaphragm, following the elevation of the ribs. During expiration, the Osteopath increases contact with the internal costal margin, maintaining resistance. The technique should be performed in a set of 10 deep breaths on each side, with a one-minute interval between them.

OTHER

Sacral Rock

The patient is in the prone position. The therapist is positioned laterally at the level of the patient's hip and places the palm of the cephalic hand over the spinous of the first spiny of the sacrum and allows his fingers to rest on the rest of the sacrum. The therapist's caudal hand is placed on the other hand with the thenar and hypothenar zone on the fourth and fifth spinous of the sacrum and the fingers of that same hand towards the patient's head. The therapist instructs the patient to inhale deeply, and the therapist follows the natural movement of the sacral base afterwards. At the end of inspiration, the therapist applies light pressure with the caudal hand to exaggerate sacral extension. The therapist then instructs the patient to exhale and follows the sacrum in flexion. At the end of exhalation, the therapist applies and maintains light pressure with the cephalic hand to exaggerate sacral flexion. This process is repeated for 3 minutes.

OTHER

Sham Cranial Listening

The patient is in the supine position and the Osteopath is seated at the head of the table, contacting the patient's skull with both hands as follows: 2nd finger on the greater wings of the sphenoid, 3rd finger on the temporal bone in front of the ears, 4th finger on the temporal bone behind the ears and 5th finger on the occipital bone, while the 1st finger rests on the head, and if possible in contact with each other to act as an external fixed point. To carry out this, the Osteopath only used the contacts, as described, in a period of 5 minutes, without any therapeutic intent.

Sponsors & Collaborators

• Escola Superior de Tecnologia da Saúde do Porto

  lead OTHER

Principal Investigators

• Natália MO Campelo · ESS

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

35 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-06-30

Primary Completion

2026-08-31

Completion

2026-09-30

Countries

• Portugal

Study Locations