INTRODUCTION

Many people report after a session of Structural Integration that they feel lighter, and that movement is easier. In my experience, when I ask “What do you notice?” without prompting, they often choose the same words: “I feel lighter” or “I feel taller.” This sense of ease has been investigated in several ways. I will report on previous published and unpublished investigations for which I have been able to obtain data, and present detailed information from one case study.

Since breathing is a basic motion important to Structural Integration, the first studies were done in this area. In 1973 Roger Thies reported on changes in lung capacity in basic training classes. Nine practitioners and 24 models in two classes in 1972 agreed to measures of lung function before, after one, and after ten sessions. Vital capacity (total volume, or the amount of air which can be expelled after the largest possible inspiration) and Forced Expiratory Volume (the amount of air which can be forced out in a fixed period of time) were measured at these time periods during each class. A few of the individual subjects showed large increases, but these were balanced by reductions in others such that the group mean did not change. Not only was there no statistically significant change, the data indicate that even with much larger sample sizes there would be little change, and certainly no change of any clinical significance in persons who are otherwise normal. The author concludes, “Since vital capacity does not change significantly in most individuals undergoing Structural Integration, their inner feeling of ease in breathing must have a different origin.” (Thies, R. Increase of Vital Capacity as a Result of Processing in Structural Integration, 1973 ).

There are reports of increase of chest expansion during basic training classes (using a tape measure to calculate the largest minus the smallest chest circumference during maximal breathing), but I have been unable to locate the data. I was encouraged by these reports, however, and included these measures in pilot studies. In two of my patients (one paraplegic after spinal cord injury, one with spasticity after head injury), chest expansion increased from 7 / 8 to 1 1/4 and 1 to 11 / 2 inches respectively; while vital capacity in the first patient decreased from 3000 to 2875 cc and increased in the second 2850 to 3125cc.

A different approach to breathing and sense of ease was taken by Cottingham, who joined with a well-published researcher to conduct two studies which are readily available. [ 1. Cottingham JT, Porges SW, Lyon T, “Effects of Soft Tissue Mobilization (Rolfing Pelvic Lift) on Parasympathetic Tone in Two Age Groups”, Physical Therapy 68: 352-356, 1988; and 2. Cottingham JT, Porges SW, Richmond “Shifts in Pelvic Inclination Angle and Parasympathetic Tone Produced by Rolfing Soft Tissue Manipulation”, Physical Therapy 68:1364-1370,1988]. As a person breathes in and out, the heart rate speeds up and slows down. This is called respiratory sinus rhythm, and is mediated by the vagus nerve. Measuring the change in heart rate with breathing gives an index of parasympathetic tone to the heart. This methodology was employed by Cottingham. They found in younger, but not older males that Rolfing pelvic lift caused an increase in vagal tone during the lift with subsequent return to baseline levels in the first study. In the second study of young men, preselected for anterior pelvic tilt, the increase in parasympathetic tone persisted to the 24-hour follow-up.

There have been numerous studies in the medical literature on parasympathetic tone as measured by change in heart rate with inspiration. It has been found that regular, slow deep breathing will increase parasympathetic tone. Furthermore, an increase in parasympathetic tone is generally associated with a sense of well-being; conversely, individuals with very low parasympathetic tone, as measured by heart rate change with respiration, have been found to have higher medical risk for diseases and complications. Cottingham’s findings could be explained by larger chest excursions during breathing, although this was not measured.

At the same time as the vagal studies by Cottingham, Jim Walker attempted to directly measure this sense of increased ease of motion in his Master’s thesis at the University of Arizona (Walker JA, Wells CL “The Effects of Rolfing on Running Economy and Running Mechanics”) He randomly assigned 18 elite runners to receive ten sessions of Structural Integration, ten sessions of sports massage, or to serve as the control group. He measured ease of running in several ways: 1) running economy at three velocities; 2) perceived exertion; 3) low back hamstring flexibility and 4) biomechanical variables associated with running economy: step length, plantar flexion at toe off, and angle of lower leg at foot contact. He found no change in maximal oxygen consumption, step length, sit and reach, perceived exertion or oxygen consumption at 214, 241, and 268 m /min (corresponding to 60, 70 and 80% of maximum exercise). The biomechanical measures were not statistically significant, but showed a trend in favor of the Rolfing group and would be significant if the same results were found with a larger sample size; for instance, shank angle at foot contact decreased in the Rolfing group from 3.5 to 2.3 degrees, but increased in massage 5.9 to 6.5 and in control 3.7 to 4.7 degrees. Similarly, plantar flexion at toe off increased in the Rolfing group from 62.9 to 66.1, while the massage group showed a smaller increase from 68 to 69.7, and the controls from 68.5 to 71.1 degrees.

He concluded that “each of the subjects in the Rolf Group stated the belief that the treatment had helped their running in one or more ways. Benefits they cited included relief from chronic nagging injuries, a more fluid running style, and a heightened sense of body awareness contributing to better running form, especially when fatigued. In contrast, the subjects who underwent sports massage therapy did not report benefits to their running, and in fact stated that the time spent was more of an inconvenience than it was worth.”

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CASE STUDY

I had a client who had been an avid runner until a serious motorcycle accident. I saw her about two years after the accident, and as we went through a series of Structural Integration sessions she was able to begin running again and then improve her running time. To further investigate the sense of ease of motion during movement, I identified a runner who kept daily running logs. This 50-year old man had a history of left foot deformity since birth, and shooting pains in the left leg since removal of an undescended testicle in his 20’s (diagnosed as severed lateral femoral cutaneous nerve). He had an everted left foot with no motor function in the posterior tibialis muscle, decreased strength in left toe extensors and obvious decrease in calf size both legs. EMG studies suggested a mild peripheral motor disease rather than L5 radiculopathy as the etiology of leg weakness. Most likely is a hereditary form, Charcot-Marie-Tooth, which usually is diagnosed in mid-life and progresses very slowly. He was an amateur racer and wished to improve his race time. He kept daily records of distance and time for four months prior to Structural Integration to provide a baseline. As the distance run each day was not constant, and increased from five to seven miles at day 110, I have presented his data as minutes per mile run. During the period of training there were several races in which he participated, but those times are not included in the chart.

The data are presented in the graph above, with the points representing the minutes per mile, and the solid line the number of miles run that day. The data are divided into day 0-110 (five-mile training), 110-140 (seven mile training) and 140-200 (period of ten sessions of Structural Integration). Separate regression equations for running time are calculated for each of the three periods. This is a statistical procedure that plots a straight line, which best fits the data points.

The data show a great deal of fluctuation in the daily running speed. During the baseline period the average mile time was 11.23 minutes (SD 1.3); during the period of Structural Integration the average time was 9.75 min (SD.86). This difference is statistically significant (<.05). Furthermore, the highest time in the period of treatment was only slightly higher than the average value in the baseline phase. Regression shows that there was only very minimal improvement for the first 30 days after he increased his running distance (the regression line is almost horizontal); however, his average running time started to decrease as soon as he began the Ten Series. His maximum speed (as seen in his race times, not shown on the graph) did NOT change. What did change was that there were fewer days in which he ran slowly. He noted that previously he would have days on which he did not feel well, and he would run slowly on those days. After he started the course of Structural Integration, he found that even when he “coasted” on bad days, his time was not that much prolonged.

DISCUSSION

Clients continue to report a sense of ease of movement after Structural Integration. This is noted by the average sedentary person, amateur athletes, and elite athletes. It does not appear to be associated with measurable change in oxygen consumption, either at maximum exercise capacity or at submaximal work loads. This is not surprising, as oxygen consumption actually varies quite a bit from breath to breath – the reported values are averages across several minutes and would not be sensitive to small changes (less than 5%) in efficiency. There are some data suggesting that postural and biomechanical changes toward greater efficiency do occur even in elite athletes, but in the case of the amateur runner studied there was no increase in his fastest race time. Perceived effort, rated on a 1 to 20 scale, does not show changes after Structural Integration, but again the measure may not be sensitive to small changes in efficiency.

What is clearly noticeable from this case study is that there is much less variation in performance after Structural Integration in this amateur runner – as he reports, it is easy to do an average run on a bad day, whereas previously he would have had a below-average run on a bad day. This may be the perception of movement which is interpreted as “ease.” Future research on mechanical efficiency is best addressed to this variability until we have far more precise measures of posture and movement available.

Autonomic changes after Structural Integration may provide another explanation of the sense of ease of movement. Increase in parasympathetic tone dilates peripheral blood vessels, decreasing the after load on the heart and making it a more efficient pump. This may not be clinically important in persons with normal cardiac function, however. Of more relevance is the sense of well-being which can be associated with rise in parasympathetic tone. Parasympathetic tone is easily measured by portable devices and would be a fruitful avenue for continued research in Structural Integration. I am grateful to John Cottingham for initiating this line of research and persevering despite criticisms, and to the Rolf Institute for financially supporting his project.

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<img src=’https://novo.pedroprado.com.br/imgs/2002/624-3.jpg’>Effect of Structural Integration on Running: A Case Study[:]