[[alternative]]The Influence of Craniosacral Therapy on Heart Rate Variability and Anxiety in Adult Women

[[abstract]] 背景與目的：近來越來越多的成年人會選擇輔助與替代療法(complementary and alternative medicine, CAM)來緩解身心不適。許多研究顯示使用CAM能對女性族群帶來益處，但對於使用顱薦平衡按摩(craniosacral therapy, CST)可帶來何種效益，目前研究尚少。顱薦平衡按摩是一種輕柔、緩和、安全的徒手放鬆技術。研究顯示CST的觸摸會引起副交感神經系統反應，能降低疼痛、提升幸福感。本研究目的在探討CST介入對女性族群的情境焦慮、壓力知覺與心率變異(heart rate variability, HRV)的影響。 材料與方法：本研究於2022年3月到2023年3月期間，在網路公開招募20~60歲成年女性為實驗對象。實驗採抽籤隨機分派為實驗組22人，對照組24人。每週一次，一次30分鐘，連續2週在固定時間介入。介入前與介入後，實驗對象分別填寫簡式健康量表(BSRS-5)、情境與特質焦慮量表的情境焦慮部分（State Anxiety, A-State）、壓力覺知量表(Chinese 14-item PSS) 和量測HRV。介入方式：實驗組在安靜、安全、不受打擾的場所，與研究者分處不同的空間，採用視訊方式，接受研究者以口語引導進行顱薦平衡按摩30分鐘；對照組在安靜、安全、不受打擾的空間休息30鐘。實驗數據以SPSS 29.0 軟體分析。 結果：本研究受試者在2週介入後，在簡式健康量表心理健康部分：第一次介入後，憤怒題項，實驗組相對於對照組，有顯著下降(p=0.047)。第二次介入後，焦慮題項實驗組相對於對照組，有顯著下降(p=0.015)；憂鬱題項實驗組相對於對照組，有顯著下降(p=0.046)。壓力覺知量表部分，兩次介入後兩組間沒有顯著差異。情境焦慮量表部分，第一次介入後，實驗組相對於對照組，有顯著下降(p=0.024)；第二次介入後，實驗組相對於對照組，也有顯著下降(p=0.015)。心率變異的時域(time domain)部分，第二次介入後，實驗組的rMSSD和pNN50後測都顯著高於前測(p=0.005)，而對照組的則是無顯著差異。心率變異的頻域(frequency domain )部分，在兩次介入後，兩組的HF與LF前後測，皆無顯著差異。 結論：口語引導顱薦平衡按摩對成年女性可有效地降低主觀焦慮和提升迷走神經張力。本研究結果可以作為顱薦平衡按摩技術應用的重要參考。[[abstract]] Background and Purpose: Recently, more adults choose complementary and alternative medicine (CAM) to relieve physical and mental discomfort. Studies have shown that the female have benefited from the use of CAM, however, few studies have focused on the benefits of using craniosacral therapy (CST), a gentle, soft, and safe relaxation technique. A number of clinical studies have shown that the use of touch in CST can trigger a response from the parasympathetic nervous system, which can reduce anxiety and improve the sense of well-being. The aim of this study was to investigate the effects of CST on the state anxiety, perceived stress and heart rate variability (HRV) in female participants. Materials and Methods: From March, 2022 to March, 2023, an online recruitment drive targeting adult females aged 20 – 60 was carried out. By drawing lots, participants were assigned to the experimental group and the control group. Once a week at a fixed time for 30 minutes for two consecutive weeks, before and after the intervention, the participants filled out the Brief Symptom Rating Scale (BSRS-5), the State-Trait Anxiety Inventory – State Anxiety, the Perceived Stress Scale (Chinese 14-item PSS) and underwent HRV analysis. Intervention Method: The participants in the experimental group were asked to go to a quiet, safe, undisturbed place, which was in a different location to the author, and were guided verbally by the author via video link the CST technique for 30 minutes. The participants in the control group rested for 30 minutes in a quiet, safe, undisturbed place. SPSS 29.0 software was used to analyze the data. Results: After two weeks of intervention, the participants in the experimental group showed significant decrease (p=0.047) in the anger parameter of the Brief Symptom Rating Scale (BSRS-5) after the first intervention. After the second intervention, the anxiety parameter of the experimental group decreased significantly (p=0.015) compared to the control group; in terms of depression, a significant decrease (p=0.046) was found in the experimental group compared to the control group. As for the Perceived Stress Scale, there was no significant differences between the two groups after two interventions. With regard to the state anxiety, the experimental group after the first intervention had significantly lower anxiety level than that of the control group (p=0.024); similarly, after the second intervention, the experimental group had significantly lower anxiety level than that of the control group (p=0.015). HRV data showed that in terms of time domain, both rMSSD and pNN50 in the experimental group became significantly higher (p=0.005) after the second intervention; However, no significant differences were found in the control group. As for the frequency domain, both groups showed no significant differences between the pre-test and post-test comparison of the HF and LF after two interventions. Conclusion: The verbally guided CST technique is effective in lowering the anxiety levels and elevating the vagal tone of adult female participants. This study can be used as an important reference for the application of craniosacral massage technique