Bibliographic record
Abstract
In response to the letter concerning the study mentioned,1Roy RA Boucher JP Comtois AS. Heart rate variability modulation after manipulation in pain-free patients vs patients in pain.J Manipulative Physiol Ther. 2009; 32: 277-286Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar we will respond to each statement. Firstly, the parasympathetic nervous system does have a lumbar output, as Chusid2Chusid JG Correlative neuroanatomy and functional neurology. 19th ed. Lange medical publications; Los Altos, CA: Chusid, 1985: 162-179Google Scholar illustrates. Postganglionic fibers emerge from L-5 and S-3; they merge with a postganglionic fiber originating from L-2 of the inferior mesenteric ganglion to form the hypogastric plexus and innervate the reproductive organs. Concerning the literature on somatoautonomic interactions, Sato et al3Sato A Sato Y Schmidt RF The impact of somatosensory input on autonomic functions..Rev Physiol Biochem Pharmacol. 1997; 130: 135-138Google Scholar stated:Cardiovascular responses are particularly pronounced when the joint receptors are sensitized by inflammation.… Since the response is abolished after severance of medial and posterior articular nerves, it is evident that the response is a reflex that is evoked by excitation of knee joints afferents.… Therefore, the response of the cardiac sympathetic nerve during knee joint stimulation is elicited by knee joint afferent excitation.… The articulo-cardiovascular reflex originating in the knee joint was therefore thought to be a supraspinal reflex.… Stimulation of the thoracic or lumbar region produces … small decreases in heart rate.… In order to confirm that the observed responses were mediated by spinal joints afferents … the lumbar spine was examined while cutting successive dorsal roots.… The observed responses were found to be due to … afferent fiber-mediated reflexes.Therefore, we contend that the autonomic balance could be affected by a lumbar manipulation; and we point out that the differences lie in the grouping, pain vs no pain.Secondly, we agree that changes in respiration can significantly affect the results of heart rate variability (HRV) analysis. We knowingly designed our project in such a fashion as to not disturb the normal breathing pattern of the subject because disturbances could affect their personal HRV. In addition, subjects lying prone may have had difficulties in following a certain rhythm; and the resultant probable anxiety could also affect the HRV.4Cervantes Blásquea JC Rodas Font G Capdevila Ortis L Heart rate variability and precompetitive anxiety in swimmers.Psicothema. 2009; 21: 531-536PubMed Google Scholar For some of them, the increased respiration rate and/or resulting anxiety could have induced a shift toward sympathetic dominance.4Cervantes Blásquea JC Rodas Font G Capdevila Ortis L Heart rate variability and precompetitive anxiety in swimmers.Psicothema. 2009; 21: 531-536PubMed Google Scholar Imposed breathing patterns also modify end-tidal CO2 that has been shown to affect HRV. Thus, we chose to eliminate those possible biases and retain the natural patterns instead. We contend that each subject's heart and respiration rate is personal and natural; to change one is to create a bias toward the other.As you mention, it is a critical issue; and if we would have induced a certain rhythm of respiration, we contend that the effects of the intervention reported would have been erroneous and biased. Maybe our results could have been more spectacular or eloquent if we had induced the subjects in producing an artificial breathing rhythm.In conclusion, we hope that our responses satisfy your concerns. We hope as well that our methodological considerations of allowing spontaneous breathing will be taken into account in future studies on HRV. In response to the letter concerning the study mentioned,1Roy RA Boucher JP Comtois AS. Heart rate variability modulation after manipulation in pain-free patients vs patients in pain.J Manipulative Physiol Ther. 2009; 32: 277-286Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar we will respond to each statement. Firstly, the parasympathetic nervous system does have a lumbar output, as Chusid2Chusid JG Correlative neuroanatomy and functional neurology. 19th ed. Lange medical publications; Los Altos, CA: Chusid, 1985: 162-179Google Scholar illustrates. Postganglionic fibers emerge from L-5 and S-3; they merge with a postganglionic fiber originating from L-2 of the inferior mesenteric ganglion to form the hypogastric plexus and innervate the reproductive organs. Concerning the literature on somatoautonomic interactions, Sato et al3Sato A Sato Y Schmidt RF The impact of somatosensory input on autonomic functions..Rev Physiol Biochem Pharmacol. 1997; 130: 135-138Google Scholar stated:Cardiovascular responses are particularly pronounced when the joint receptors are sensitized by inflammation.… Since the response is abolished after severance of medial and posterior articular nerves, it is evident that the response is a reflex that is evoked by excitation of knee joints afferents.… Therefore, the response of the cardiac sympathetic nerve during knee joint stimulation is elicited by knee joint afferent excitation.… The articulo-cardiovascular reflex originating in the knee joint was therefore thought to be a supraspinal reflex.… Stimulation of the thoracic or lumbar region produces … small decreases in heart rate.… In order to confirm that the observed responses were mediated by spinal joints afferents … the lumbar spine was examined while cutting successive dorsal roots.… The observed responses were found to be due to … afferent fiber-mediated reflexes. Therefore, we contend that the autonomic balance could be affected by a lumbar manipulation; and we point out that the differences lie in the grouping, pain vs no pain. Secondly, we agree that changes in respiration can significantly affect the results of heart rate variability (HRV) analysis. We knowingly designed our project in such a fashion as to not disturb the normal breathing pattern of the subject because disturbances could affect their personal HRV. In addition, subjects lying prone may have had difficulties in following a certain rhythm; and the resultant probable anxiety could also affect the HRV.4Cervantes Blásquea JC Rodas Font G Capdevila Ortis L Heart rate variability and precompetitive anxiety in swimmers.Psicothema. 2009; 21: 531-536PubMed Google Scholar For some of them, the increased respiration rate and/or resulting anxiety could have induced a shift toward sympathetic dominance.4Cervantes Blásquea JC Rodas Font G Capdevila Ortis L Heart rate variability and precompetitive anxiety in swimmers.Psicothema. 2009; 21: 531-536PubMed Google Scholar Imposed breathing patterns also modify end-tidal CO2 that has been shown to affect HRV. Thus, we chose to eliminate those possible biases and retain the natural patterns instead. We contend that each subject's heart and respiration rate is personal and natural; to change one is to create a bias toward the other. As you mention, it is a critical issue; and if we would have induced a certain rhythm of respiration, we contend that the effects of the intervention reported would have been erroneous and biased. Maybe our results could have been more spectacular or eloquent if we had induced the subjects in producing an artificial breathing rhythm. In conclusion, we hope that our responses satisfy your concerns. We hope as well that our methodological considerations of allowing spontaneous breathing will be taken into account in future studies on HRV. Heart Rate Variability Modulation After Manipulation in Pain-Free Patients vs Patients in PainJournal of Manipulative & Physiological TherapeuticsVol. 33Issue 4PreviewIn May 2009, the Journal of Manipulative and Physiological Therapeutics published a study on the modulation of heart rate variability (HRV) by lumbar spinal manipulation.1 In this letter, we would like to raise several issues with this study. We argue that it cannot be concluded that lumbar spinal manipulation affects HRV or that the response of the autonomic nervous system may be specific to its effectors organs based on that study. Rather, we suggest that the reported results reflect nonspecific effects that were not measured or controlled for. Full-Text PDF
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.036 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.026 | 0.032 |
| Insufficient payload (model declined to judge) | 0.030 | 0.025 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".