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Table 1 Standard treatment protocol OstinCaRe study

From: Effects of osteopathic treatment on pulmonary function and chronic thoracic pain after coronary artery bypass graft surgery (OstinCaRe): study protocol for a randomised controlled trial

Osteopathic technique

Description

Rationale for use

Doming/stretching of the abdominal diaphragm [31–33]

Direct release of the respiratory diaphragm: the patient is supine and the osteopath stands on the homolateral side of the patient. The osteopath places the cubital side of the heterolateral hand under the anterior costal margin and the fingers of the homolateral hand under the posterior costal margin. During inspiration, the hands follow the expansion of the ribs and during expiration, the osteopath holds the expansion of the ribs. This is repeated 3–4 times on each side.

Improves motion of diaphragm

Releases connective tissue tension within structures of the thorax

Myofascial release of the thorax [33]

One hand is placed posterior on one hemi thorax, the other hand anterior of the same hemi thorax (according to the anatomy of the ribs). Determine the direction of free movement with passive motion testing. Maintain either indirect or direct position until release. The osteopath stimulates the expression of the fasciae after the release.

Releases tissue restriction

Promotes improved lymphatic and venous drainage

Improves pulmonary function and lymphatic circulation

Suboccipital inhibition [31, 33, 34]

Fingertips are placed on occipital condyles. The osteopath applies an outward and cephalad traction to decompress the occipital joint

Improves parasympathetic function

Releases restricted tissues around vagus nerves

Equilibration anterior-posterior [35]

One hand is placed under the sacrum and one hand on the sternum. The osteopath follows and synchronizes the expression of the primary respiration between sacrum and sternum. The same is done between the occiput and the sternum.

Improves lymphatic and venous circulation