ESCUELA DE DOCTORADO

 
Tesis Doctorales de la Universidad de Alcalá
CONTRIBUCIÓN A UN ENFOQUE NO CONVENCIONAL DE LA FUNCIÓN VASCULAR PERIFÉRICA: ESTUDIO DEL IMPACTO FISIOLÓGICO DEL MASAJE EN LA CIRCULACIÓN DEL MIEMBRO INFERIOR
Autor/aGomes Da Rocha, Clemente Jose
DepartamentoBiología de Sistemas
Director/aMonteiro Rodrígues, Luis
Codirector/aBuján Varela, María Julia Araceli
Fecha de defensa15/03/2022
CalificaciónSobresaliente Cum Laude
ProgramaCiencias de la Salud (RD 99/2011)
Mención internacionalNo
ResumenMassage is a long-known technique, applied with your hands for multiple purposes associated to health and well-being, but the demonstration of its physiological impact and mechanisms is still limited, and sometimes controversial or inconclusive. Some studies suggested a positive contribution of massage in pain modulation fatigue anxiety relief and stress control regardless of other underlying pathologies. Our main objective was to study the physiological impact of massage in the human lower limb and the involved adaptive mechanisms in previously selected and characterized healthy groups. We used well known reliable non-invasive optical techniques to register microcirculation events with total comfort and safety of participants - Laser Doppler flowmetry (LDF) and photoplethysmography (PPG). In addition, we also used the Wavelet transform (WT), applied to the decomposition of these signals. The present project involved 98 participants (32.6 ± 15.5 years) of both sexes, normotensive and without signs of vascular impairment and all procedures followed the principles of the Declaration of Helsinki (institutional Ethics Committee 03/2013.12). The massage protocol was evaluated in two of its variants in terms of the direction of application: ascending and descending, applied to one of the lower limbs previously randomized, with the other limb serving as control. The experimental massage procedure involved three phases of continuous recording with participants lying in supination - Phase I (baseline) for 10 minutes, Phase II, provocation (massage) for 5 minutes and Phase III, recovery for 10 minutes. Our project was structured in four milestones, the first being the definition of the experimental procedure, which allowed us to immediately observe that the perfusion impact of massage was observed in both limbs, despite being applied to only one of the limbs. The second milestone, in which we intended to deepen the data analysis, confirmed by correlation analysis of raw LDF and PPG signals the existence of significant proximity of these signals. In the third milestone, we confirm the adequacy of the chosen non-invasive measurement technologies and we verify that the average spectrum of the LDF and PPG signal profiles have different amplitudes. In the last milestone, we confirmed that massage involves more than a change in the local microcirculation that we named as the Prompt Adaptive Hemodynamic Response (PAHR) impacting the entire systemic cardiocirculatory hemodynamics. This answer was addressed in a complementary way in equally healthy individuals, but older, constituting the last manuscript of this collection. Here we demonstrate that, although responses here obtained are similar to those obtained in young participants, this PAHR is age dependent and therefore less obvious, suggesting its potential interest to be used as a clinical indicator. Based on the results obtained in these four milestones, we were able to substantiate the following main conclusions