Cranio-Sacral Therapy

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The cranio-sacral therapy (from the Latin cranium: skull; sacral: the sacrum (os sacrum) regarding : "skull-sacral therapy", also craniosacral therapy ) is an alternative medical form of treatment that has developed from osteopathy . It is a manual procedure in which hand movements are performed predominantly in the area of ​​the skull , neck , hyoid bone , thorax , spine , sacrum , diaphragm , pelvis and feet . There are only a few studies on cranio-sacral therapy. No efficacy has been scientifically proven.

Emergence

The cranio-sacral therapy arose from the craniosacral osteopathy, which was founded as "Osteopathy in the Cranial Field" by the US osteopathic doctor William Garner Sutherland and which became an integral part of osteopathy as craniosacral osteopathy . Today's expression received Craniosacral therapy mainly by the osteopath John E. Upledger with the book Craniosacral Therapy in 1983, the German translation is titled textbook of Craniosacral Therapy I . Upledger reports in this book that during an operation he discovered the rhythmic movement of the dural membrane ( dura mater ) with a frequency of about eight times a minute and explained this discovery with the basics of craniosacral osteopathy, which he developed further with the cranio-sacral system . His treatment technique was based on palpation (examination by touch).

concept

The cranio-sacral therapy is based, among other things, on the assumption that the rhythmic pulsations of the cerebrospinal fluid ( liquor cerebrospinalis ), the so-called "primary breathing mechanism" PAM (or also primary respiratory mechanism - PRM), affect the outer tissues and Bone transferred and thus can be felt by palpation . In contrast to scientific doctrine ( anatomy ), the individual bones of the skullcap are also seen as mutually movable in adults.

In a typical cranio-sacral therapy session, clients usually lie on their back on a treatment couch, clothed. It takes about an hour on average. The therapist works with his palms or fingers mainly with minimal pulling or pushing forces. This is done either in the direction that is felt to be physiologically sensible, or the perceived tissue tension is pursued in order to reduce it. An essential aspect is to feel and change the craniosacral rhythm.

criticism

Scientific studies show that the movements and pressures of the cerebrospinal fluid react dynamically to the pressure conditions in the body. This leads to characteristic pulse and breath synchronous changes as well as fluctuations in coughing or in the Valsalva maneuver . The existence of a CSF wave effective throughout the body and the effectiveness of cranio-sacral therapy could not be proven. Studies on the effectiveness (see medical effectiveness ) or mode of action of cranio-sacral therapy have so far been rated as inadequate in international medical journals due to methodological deficiencies. A review by Jäkel and Hauenschild from 2012 shows that although there are individual high-quality studies that report pain-relieving and well-being-enhancing effects, the overall study situation does not allow any reliable statement about the clinical effectiveness of cranio-sacral therapy. In a systematic review, Edzard Ernst was also unable to find any evidence of an effect beyond non-specific effects. A review from 2016 came to the conclusion, given the available data, that this form of therapy was neither relevant for diagnosis nor treatment for patients.

In previous studies, there was no significant agreement about an established rhythm between two therapists who were touching the same person at the same time. The movement of the cranial sutures detected by imaging methods in the microscopic range is so small that it clearly falls below the discriminatory capacity of the fine tactile sensors of a human hand.

swell

  1. ↑ John E. Upledger, Jon D. Vredevoogd: Craniosacral Therapy. Eastland Press. 1983. ISBN 0-939616-01-7
  2. ^ John E. Upledger, Jon D. Vredevoogd: Textbook of Craniosacral Therapy I. Karl F. Haug Verlag. Stuttgart 2003. ISBN 3-8304-7168-8
  3. ^ SE Maier et al .: Brain and cerebrospinal fluid motion: real-time quantification with M-mode MR imaging . In: Radiology . tape 193 , no. 2 , November 1994, p. 477-483 , doi : 10.1148 / radiology.193.2.7972766 , PMID 7972766 .
  4. ↑ Steve E. Hartman and James M. Norton: Craniosacral Therapy Is Not Medicine . In: Physical Therapy . tape 82 , no. 11 , November 1, 2002, pp. 1146–1147 , doi : 10.1093 / ptj / 82.11.1146 ( oup.com [accessed November 26, 2019]).
  5. ↑ C. Green et al .: A systematic review of craniosacral therapy: biological plausibility, assessment reliability and clinical effectiveness . In: Complementary Therapies in Medicine . tape 7 , no. 4 , December 1999, pp. 201-207 , doi : 10.1016 / s0965-2299 (99) 80002-8 , PMID 10709302 .
  6. ↑ Steve E. Hartman: Cranial osteopathy: its fate seems clear . In: Chiropractic & Osteopathy . tape 14 , June 8, 2006, p. 10 , doi : 10.1186 / 1746-1340-14-10 , PMID 16762070 , PMC 1564028 (free full text).
  7. ^ Anne Jäkel and Philip von Hauenschild: A systematic review to evaluate the clinical benefits of craniosacral therapy . In: Complementary Therapies in Medicine . tape 20 , no. 6 , December 2012, p. 456-465 , doi : 10.1016 / j.ctim.2012.07.009 , PMID 23131379 .
  8. ↑ Adelaida María Castro-Sánchez et al .: A randomized controlled trial investigating the effects of craniosacral therapy on pain and heart rate variability in fibromyalgia patients . In: Clinical Rehabilitation . tape 25 , no. 1 , January 2011, p. 25-35 , doi : 10.1177 / 0269215510375909 , PMID 20702514 .
  9. ↑ Guillermo A. Matarán-Peñarrocha et al .: Influence of craniosacral therapy on anxiety, depression and quality of life in patients with fibromyalgia . In: Evidence-Based Complementary and Alternative Medicine: eCAM . tape 2011 , 2011, p. 178769 , doi : 10.1093 / ecam / nep125 , PMID 19729492 , PMC 3135864 (free full text).
  10. ↑ Mohammad Reza Nourbakhsh and Frank J. Fearon: The effect of oscillating-energy manual therapy on lateral epicondylitis: a randomized, placebo-control, double-blinded study . In: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists . tape 21 , no. 1 , January 2008, p. 4-13; quiz 14 , doi : 10.1197 / y.yht.2007.09.005 , PMID 18215746 .
  11. ^ Edzard Ernst: Craniosacral therapy: a systematic review of the clinical evidence . In: Focus on Alternative and Complementary Therapies . tape 17 , no. 4 , October 18, 2012, p. 197-201 , doi : 10.1111 / j.2042-7166.2012.01174.x ( wiley.com [accessed November 26, 2019]).
  12. ↑ Albin Guillaud et al .: Reliability of Diagnosis and Clinical Efficacy of Cranial Osteopathy: A Systematic Review . In: PloS One . tape 11 , no. 12 , 2016, p. e0167823 , doi : 10.1371 / journal.pone.0167823 , PMID 27936211 , PMC 5147986 (free full text).
  13. ↑ Wirth-Pattullo V et al. " Interrater reliability of craniosacral rate measurements and their relationship with subjects 'and examiners' heart and respiratory rate measurements ( Memento of the original of September 27, 2007 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. ". Phys Ther. 1994 Oct; 74 (10): 908-16; discussion 917-20. PMID 8090842 ( full text ( memento of the original from September 27, 2007 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this note. ) @1@ 2Template: Webachiv / IABot / www.ptjournal.org @1@ 2Template: Webachiv / IABot / www.ptjournal.org
  14. ^ WP Hanten et al .: Craniosacral rhythm: reliability and relationships with cardiac and respiratory rates . In: The Journal of Orthopedic and Sports Physical Therapy . tape 27 , no. 3 , March 1998, pp. 213-218 , doi : 10.2519 / jospt.1998.27.3.213 , PMID 9513867 .
  15. ↑ Rogers JS et al. " Simultaneous palpation of the craniosacral rate at the head and feet: intrarater and interrater reliability and rate comparisons ( Memento of the original from September 27, 2007 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. ". Phys Ther. 1998 Nov; 78 (11): 1175-85. PMID 9806622 ( full text ( memento of the original from September 27, 2007 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. ) @1@ 2Template: Webachiv / IABot / www.ptjournal.org @1@ 2Template: Webachiv / IABot / www.ptjournal.org
  16. ↑ P. Sommerfeld et al .: Inter- and intraexaminer reliability in palpation of the "primary respiratory mechanism" within the "cranial concept" . In: Manual Therapy . tape 9 , no. 1 , February 2004, p. 22-29 , doi : 10.1016 / s1356-689x (03) 00099-7 , PMID 14723858 .
  17. ↑ RW Moran and P. Gibbons: Intraexaminer and interexaminer reliability for palpation of the cranial rhythmic impulse at the head and sacrum . In: Journal of Manipulative and Physiological Therapeutics . tape 24 , no. 3 , March 2001, p. 183-190 , PMID 11313614 .
  18. ↑ Deutsches Ärzteblatt 2009; 106 (46): A-2325 / B-1997 / C-1941 Scientific evaluation of osteopathic procedures

literature

  • John E. Upledger: Listening to the Inner Doctor - An Introduction to KranioSacral Work. Basel 1994.
  • Torsten Liem: Practice of Craniosacral Osteopathy. Haug, 2010.
  • Daniel Agustoni: Craniosacral Rhythm: Practice book for gentle body therapy. Kösel-Verlag, 2006.

Web links