title: Clinical response and autonomic modulation as seen in heart rate variability in mechanical intermittent cervical traction: a pilot study.
abstract: OBJECTIVE
  To determine the influence of mechanical intermittent cervical traction on the autonomic system.
  
  
  METHODS
  Prospective, cases series study.
  
  
  METHODS
  Sixteen healthy volunteers without contraindications for cervical traction.
  
  
  METHODS
  Subjects received mechanical intermittent cervical  traction in a sitting position under two traction forces (10% and 20% of total body weight). Electrocardiographic and neck surface electromyographic signals were recorded and analysed from 3 5-min periods (before, during and after traction). Subjective symptoms, heart rate and heart rate variability parameters, including standard deviation of all normal-to-normal beat intervals, very low-frequency power, low-frequency power, high-frequency power, multiscale entropy, slope of multiscale entropy, and root mean square value of electromyography amplitude were statistically compared.
  
  
  RESULTS
  This pilot study showed that using 10% body weight traction force was more comfortable than using 20% body weight. Only subtle perturbation was noted in the autonomic  system when using 20% body weight traction force.
  
  
  CONCLUSIONS
  The response pattern of heart rate variability analysis in this pilot study provides some early information about individual discomfort in cervical traction. The autonomic modulation and the safety of cervical traction with other modality settings or in patients with neck pain require further study.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Yang-Ming University Hospital, Taipei, Taiwan.
authors.forename: Po Jung
authors.initials: PJ
authors.lastname: Pan
authors.forename: Ping Huang
authors.initials: PH
authors.lastname: Tsai
authors.forename: Chih Chun
authors.initials: CC
authors.lastname: Tsai
authors.forename: Chen Liang
authors.initials: CL
authors.lastname: Chou
authors.forename: Men Tzung
authors.initials: MT
authors.lastname: Lo
authors.forename: Jen Hwey
authors.initials: JH
authors.lastname: Chiu
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001835:Body Weight; D002574:Cervical Vertebrae; D004562:Electrocardiography; D004576:Electromyography; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck; D019547:Neck Pain / Q000209:etiology / Q000503:physiopathology*; D010865:Pilot Projects; D011446:Prospective Studies; D012016:Reference Values; D014143:Traction / Q000009:adverse effects* / Q000379:methods