HARMONIC TECHNIQUE

that of compartment syndromes. The harmonic pump technique can be complemented by a harmonic movement technique to stimulate tissue repair.

There is currently an osteopathic study in progress looking at the effect of intermittent compression on oedema in post exercise muscle pain (Osteopathic School, Unitec, New Zealand).

have significant therapeutic effects on connective tissue, muscle and joints. The significant therapeutic effects of passive motion on tissue repair have been shown in connective tissue, muscle and joints and the research suggests that patients should receive move- ment stimulation immediately after injury (7-20). The physiological effects of HT include improving the quality of tissue repair, improv- ing circulation, reducing oedema, improving the rate of recovery and reducing the hospital stay (7-24). It is also likely that passive movement techniques such as HT will also have an effect on the transsynovial pump - a physiological system in joints responsible for stimulating fluid flow through the joint space (25).

BOX 1: RESEARCH HAS SHOWN THAT WHERE EARLY PASSIVE MOTION WAS INTRODUCED, THE FOLLOWING BENEFITS WERE SEEN (18-20,22,26-32):

■ Increases in range of movement ■ Reduction in joint stiffness,

■ Improvement in quality of repair (including quality of repair in articular cartilage)

■ Diminished pain levels and use of pain medication ■ Increased return to normal activity.

These changes were observed in a variety of joint conditions such as joint sprains, osteoarthritic joints and post-operative joints. We are currently developing a UK study to examine the effect of HT on repair in frozen shoulder.

Fluid flow effects Reducing tissue adhesion and improving fluid flow are fundamental principles in manual therapy. Intermittent compres- sion applied postoperatively using mechanical machines has been shown to stimulate blood and lymph flow (33-36) and there is some evidence that a similar effect can be applied using manual compression (37). The harmonic pump technique applied by a therapist’s hands, is a method of applying localised intermittent compression and is indicated in situations where there is tissue swelling and inflammation or in an ischaemic condition such as

Length adaptation Stretch techniques based on a harmonic approach could add another dimension to the treatment process. Where there is a reduction in range of movement, these techniques can be employed to encourage tissue elongation.

Research has shown that the physical stresses imposed on a tissue by stretching, stimulate cells in the tissue (myocytes and fibroblasts) to produce muscle contractile proteins and connective tissue elements, a mechanism known as mechanotransduction. Effectively a physical signal is converted to a biochemical signal (38,39). Evidence suggests that this mechanism is more responsive to dynamic rather than static loading of tissues (40- 42) and it has therefore been hypothesised that rhythmic cyclical stimulation at the end elastic range of the tissue may be a more effective way to achieve long-term length changes. Stretching using a harmonic approach of small oscillations would be ideal for delivering this form of mechanical stress.

THE NEUROLOGICAL DIMENSION Studies into the effect of passive manual therapy techniques originally suggested that these were likely to have little effect on motor control of skeletal muscle. As a consequence of these studies a new area has emerged known as osteopathic neuro- muscular re-abilitation (6) but the question still remains as to whether HT has any role to play in the neurological dimension. One potential area where passive, rhythmic or oscilliatory techniques may play a role is on their influence on pain mechanisms (43-49). The ‘pain-gate’ theory is based on a neuro- logical process in which the processing and perception of one sensory stimulus may be reduced by simultaneous stimulation of another (50-54).

THE PSYCHOLOGICAL DIMENSION The movement effect of oscillation and rocking is widely acknowledged as having a positive health benefit for example rocking a baby and these psychological and psychophysiological responses should certainly be explored in future research.

THE FUTURE The future of the harmonic technique is based around requiring

www.sportex.net

17