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Journal of Integrative Medicine ›› 2014, Vol. 12 ›› Issue (3): 156-161.doi: 10.1016/S2095-4964(14)60021-2

• Research Article • Previous Articles     Next Articles

Heart rate variability and the influence of craniosacral therapy on autonomous nervous system regulation in persons with subjective discomforts: A pilot study

Wanda Girsbergera,b, Ulricke BanzigeraGerhard Lingga, Harald Lothallera, Peter-Christian Endlera   

  1. Interuniversity College for Health and Development, Castle of Seggau, 8042 Graz, Austria
    Practice for Craniosacral Therapy, Kronenstrasse 48, 8006 Zurich, Switzerland
  • Received:2014-01-21 Accepted:2014-02-24 Online:2014-05-10 Published:2014-05-15


Subjective discomforts in a preclinical range are often due to imbalanced autonomic nervous system activity, which is a focus of craniosacral therapy. 


The aim of this work was to determine any changes in heart rate variability (HRV) in a study on craniosacral therapy. 

Design, Setting, Participants and Interventions

This is a quasi-experimental (controlled) study with cross-over design. In a private practice, measurements were performed on 31 patients with subjective discomforts before and after a control and an intervention period. HRV was determined using a device that requires a measuring time of 140 s and electrode contact only with the fingertips. 

Main Primary Outcome Measures

HRV change under the influence of a defined one-time intervention (test intervention) with craniosacral therapy versus control (defined rest period). 


Standard deviation of all RR-intervals (ms) and total power of RR-interval variability in the frequency range (ms2) were together interpreted as an indicator of test subjects’ autonomic nervous activity and as a measure of their ability to cope with demands on their health. Neither of these parameters increased during the control period (P>0.05), whereas during the test intervention period there was an increase in both (P<0.05, P<0.01). Nevertheless, interactions between treatment and the increase were statistically not significant (P>0.05). No changes were observed in the low frequency/high frequency ratio (sympathetic-vagal balance) in the course of the control or the test intervention period (P>0.05). 


Craniosacral treatment had a favourable effect on autonomic nervous activity. This in itself is an interesting result, but further research will be needed to distinguish specific effects of craniosacral therapy technique from less specific therapist-client interaction effects.

Key words: Massage, Autonomic nervous system, Electrocardiography, Adult, Complementary therapies, Pilot projects

Figure 1

Flow of participants of the study2.4 Intervention and control restA trained Swiss craniosacral therapist, with 20 years of professional experience, gave 30-minute sessions in CST following the 10-step protocol developed by Upledger et al[5], proceeding in each case according to her observations in the individual subject. The treatment involved gentle touch of different parts of the fully clothed patient’s body with the intent of resolving structural or energy restrictions. This included techniques on the patient’s feet, sacrum, thoracic inlet, occiput (CV4) and parietal bones (parietal lift)[2,5]. The expectation was that these treatments would have an influence on HRV."

Figure 2

Sequence of heart rate variability measurements (dark-shaded arrows) and control or test period (light-shaded arrows) on day 1 (t1_1 and t1_2) and day 2 (t2_1 and t2_2)"


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