Highlights
- •Intracranial pressure was evaluated with ultrasonography of the optic nerve.
- •Inversion caused an increase in intracranial pressure.
- •Cerebral circulation was evaluated using Doppler ultrasonography.
- •Inversion decreased blood flow in the internal carotid and middle cerebral arteries.
- •Inversion lowered heart rate but had no effect on blood pressure.
Abstract
Context
Inversion tables are used as treatment for back pain, but there is a lack of agreement
on systemic effects of inversion.
Objective
To assess intracranial pressure (ICP) and cerebral blood flow using ultrasonography
during inversion table tilt.
Methods
Optic nerve sheath diameter (ONSD), heart rate (HR), blood pressure, internal carotid
artery (ICA) and middle cerebral artery (MCA) blood flow of participants were measured
in 3 positions: supine before inversion, during inversion with head down, and supine
post-inversion. ONSD was evaluated with ocular ultrasonography and blood flow (ICA
and MCA) with Doppler ultrasonography.
Results
The ONSD changed significantly between the supine position, at 3 min of inversion,
and after returning to supine position (all P < .001). The post-inversion HR was less than pre-inversion (P = .03) and 3-min inversion HR (P = .003). There were significant changes in ICA and MCA flow caused by inversion,
which affected blood flow velocity, resistance, and pulsatility index (all P ≤ .005).
Conclusion
Inversion caused significant changes in ICP and blood flow. Thus, increased chance
of complications may exist when using inversion as a therapeutic tool or during surgical
procedures in patients with previous history of elevated ICP. These results demonstrate
that inversion therapy should be used with caution.
Keywords
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Article info
Publication history
Published online: July 31, 2019
Accepted:
July 30,
2019
Received in revised form:
July 11,
2019
Received:
May 22,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
