International Journal of Osteopathic Medicine 10 (2007) 65e79

www.elsevier.com/locate/ijosm

Research report

An observational study of motion induced in the

lumbarepelvic complex during ‘harmonic’ technique:
A preliminary investigation
Jodi L. Waugh*, Robert W. Moran, Clive Standen
School of Health Science, Unitec New Zealand, Private Bag 92025, Auckland, New Zealand
Received 1 December 2006; received in revised form 18 June 2007; accepted 26 June 2007

Abstract

Background: In manual therapy, the ‘harmonic’ approach to inducing cyclical motion in different body regions has been described as
distinct from rhythmic articulation, ‘harmonic’ techniques being further defined as those that bring about a state of resonance in
body tissues. During application of ‘harmonic’ techniques, resonance is proposed to result from the technique operator ‘tuning
in’ to the inherent frequency of the oscillating region. This study provides a quantitative analysis of the motion induced by a ‘har-
monic’ technique and the notion of ‘tuning in’.
Objectives: To provide a quantitative analysis of the oscillatory motion induced in the lumbarepelvic complex by the application of
a ‘harmonic’ technique and to compare the motion induced by two different operators.
Methods: A ‘harmonic’ technique was applied to the lumbarepelvic complex of 26 volunteers and the oscillatory motion filmed. An
additional operator performed the technique on a subgroup (n ¼ 12) of the sample to provide data for the comparisons of two
operators.
Results: The mean (SD) frequency of oscillation across all sessions was 1.17 Hz (0.10). The mean (SD) amplitude was 0.15 m (0.03).
The mean (SD) inter-cycle variability of period was 2.45% (0.47). The mean (SD) inter-cycle variability of amplitude was 6.35%
(2.06). There were no consistent intra-cycle relationship identified between period and amplitude. There was an inverse relationship
between frequency and subject weight (Pearson’s r ¼ 0.66 (95% CI 0.84 to 0.32). The intra-class correlation coefficient (ICC)
for inter-operator reliability of frequency was 0.93 (95% CI ¼ 0.83 to 0.97). The ICC for inter-operator reliability of amplitude was
0.87 (95% CI ¼ 0.69 to 0.94).
Conclusion: The motion induced in the lumbarepelvic complex using a modified harmonic technique displayed properties of har-
monic motion. The inter-operator study demonstrated that two operators of different morphologies ‘tuned in’ to the same frequency
of individual subjects. This supports the theory that motion arising from harmonic techniques is resonant.
Ó 2007 Elsevier Ltd. All rights reserved.

Keywords: Osteopathy; resonance; harmonic technique

1. Introduction cyclical motion in different regions of the body.1e3

Manual therapists from a range of backgrounds and
disciplines use rhythmical application of force to induce
* Corresponding author. Tel.: þ64 9 815 4321x8642; fax: þ64 9 815
4326.
E-mail address: jlwaugh@hotmail.com (J.L. Waugh).
Techniques matching this description have been alluded
to in accounts of early osteopathy but have only re-
cently been identified by the name ‘harmonic’ following
the publication of an instructional manual in 2000.4 In
this paper, ‘harmonic’ techniques are described in paral-
lel with the theory of harmonic motion and resonance
according to classical physics. The ‘harmonic’ approach

1746-0689/$ - see front matter Ó 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ijosm.2007.06.004
66 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
has been asserted as being distinct from rhythmic
articulation:
‘‘During a rhythmic articulation the practitioner is
imposing a rhythm on the patient’s tissues. In
harmonic technique, the practitioner tunes in to and
uses the patient’s own free oscillation frequency to
induce the cyclical motion (p. 2)4’’
Harmonic techniques are also defined as those that
bring about a state of resonance in body tissues.4 Apply-
ing classical physics, ‘tuning in’, described by Leder-
man,4 relates to timing the peak or maximum driving
force so that it coincides (in phase) with the peak veloc-
ity of the oscillating mass or segment; analogous to
a damped harmonic oscillator driven at resonance.
Large amplitude oscillations occur at resonance because
the phase relationship of torque and velocity provide
optimal conditions for transference of the driving force
to the oscillating system.5 Increases in amplitude during
‘harmonic’ techniques have been described in relation to
resonance.4
To date there has been no research of the manual
therapeutic approach employed during ‘harmonic’ tech-
niques. Specifically, the phenomenon of ‘tuning in’, in
which oscillations are induced at the resonant frequency
of the oscillating region, has not been demonstrated ex-
perimentally. Although research about ‘harmonic’ tech-
niques is sparse, a review of related studies reveals
supporting literature for the notions advanced by Leder-
man.4 Resonance has been demonstrated in vivo during
oscillations induced in various joints by mechanical tor-
que generators.6e8 In relation to ‘tuning in’, humans and
terrestrial animals have demonstrated a tendency to
conduct active rhythmic movements such as locomotion
(and quadrupedal motion) at frequencies that corre-
spond with resonant states.9e14 Additionally, humans
have demonstrated a tendency towards oscillation at
the resonant frequency of hand-held pendulums15,16
and bouncing balls.17 Resonance in rhythmic move-
ments has been associated with metabolic minima and
stability of movement patterns compared to other fre-
quencies.9,10,13,15,16 ‘Harmonic’ techniques essentially in-
volve a coordinated rhythmic task adapted to the
resonant frequency of an external mass.
Observational methods were used to consider two
main objectives. The first was to compare apparent
properties of the motion arising from the application
of a ‘harmonic’ technique to properties of harmonic mo-
tion as classically described; and the second, to investi-
gate the ‘tuning in’ process during the application of
a ‘harmonic’ technique.
Harmonic motion demonstrates several properties
which provide a theoretical basis from which to analyse
the oscillations induced by a ‘harmonic’ technique. The
properties of interest were time dependence, amplitude,
displacement and restoring-phases of the total period.
Harmonic oscillations typically display equal displace-
ment (amplitude) about a mean position that coincides
with the position of the mass at restdequilibrium.18
Harmonic motion arises from displacement and from re-
storing forces that are equal in magnitude and opposite in
direction and phase.19 This results in equal time duration
of displacement and equal restoring phases of motion.
The duration of one complete cycle of harmonic motion
(period) is independent of amplitude (time dependence).19
In contrast, anharmonic motion arises from dispro-
portionate displacement and restoring forces. The period
of anharmonic motion is dependent on the amplitude of
oscillation.20
The frequency at which oscillations occur in har-
monic systems is determined by several parameters, de-
pending on the nature of the system. In a spring-mass
system, frequency is determined by the stiffness of the
spring and the mass.18 The frequency of pendulum oscil-
lations is determined by the length of the lever arm (for
small angle oscillations).21
The second objective was to investigate the tendency
of technique operators to ‘tune in’ to a resonant fre-
quency. In previous studies, resonant frequency has
been demonstrated as an increase in amplitude of oscil-
lations over a ‘spectrum’ of frequencies, confirmed by
measures of resistance to mechanically applied tor-
que.22e24 Increases in oscillation amplitude can indicate
resonance if, whilst frequency of driving force varies,
magnitude of the driving force is constant. During
‘harmonic’ techniques the amplitude of oscillations is
largely determined by the force applied by the operator.
Therefore two operators could ‘tune in’ to a resonant
frequency while inducing oscillations of varying ampli-
tude provided the motion is harmonic (time depen-
dence). In the absence of an appropriate resonance
indicator, or method to determine resonant frequency
a priori, an inter-operator reliability design was adopted
to compare oscillations induced by different operators.
If operators demonstrate a tendency to ‘tune in’ and
operate at resonance as described by Lederman,4 the re-
sults would show high inter-operator agreement in the
frequency of oscillations induced in the same subjects.
If the frequency of oscillations was simply determined
by the frequency of the driving force applied by the op-
erator it could be expected that inter-operator agree-
ment would be low and inter-subject variation would
be high. A third possibility has been referred to as the
‘magnet effect’ where the resonant frequencies of two
systems ‘attract each other’ so that the resultant fre-
quency lies in between.25 This situation may be pre-
dicted to result in both inter-operator and inter-subject
variation.
In summary, the aim of this study was to provide
a basic quantitative analysis of oscillatory motion pa-
rameters and to investigate the proposed tendency of
two operators to ‘tune in’ when inducing oscillations
 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
in the lumbarepelvic complex applying the ‘harmonic’
approach.
2. Methods
2.1. Design
A simple observational design was employed using
a video camera to record the motion induced in the lum-
bar pelvic complex of prone subjects during the applica-
tion a modified harmonic technique (Figs. 1 and 2). The
period and amplitude of consecutive oscillations was de-
rived from the video recordings using video digitisation
software. Times at different stages of oscillation were re-
corded so that the restoring and displacement phases
could be compared. The ‘restoring’ or ‘displacement’
phase labelled the half period of motion defined by peak
to peak displacement. The half period associated with
the application of the displacement force was labelled
the ‘displacement’ phase. In the absence of a method to
either measure resonance or determine resonant fre-
quency a priori, an inter-operator reliability design was
employed to compare the motion induced in the same
subjects by two different operators.
A qualitative investigation was undertaken using
video digitisation software to observe anatomical re-
gions involved in the oscillatory motion and apparent
biomechanical causes for intra-subject (left to right) var-
iation in the frequency of induced oscillations.
2.2. Subjects
2.2.1. Recruitment
Twenty seven subjects were recruited via convenience
sampling from the general public as well as a university
population. The data from one subject was lost prior to
analysis due to technical error. Video recordings of the
oscillatory motion induced from the left and rights sides
of 26 subjects was analysed. The mean (SD) age, weight
and height of male subjects (n ¼ 15) was 32 years (9);
mass 79.2 kg (13.6) and height 1.78 m (0.06). The
Fig. 1. Camera view used for data extraction. The fluorescent marker
(M) located over the subject’s lumbaresacral junction is in line with
the plumb line (the plumb line was used as a reference position). In
this frame the operator is ready to apply the modified harmonic tech-
nique using the hand (H) from the right side of the subject.
67
H S
LH RH RH
Fig. 2. Schematic cross section at level of the acetabulum. Oscillatory
motion resulting from a driving force applied via the operator’s hand
(H) to the left side of a subject (S). The diagram presents a schematic
view of the pelvic mass of a subject and an operator applying a driving
force from the left hand side. Observation revealed the hip joints to act
as pivots enabling translation of the pelvic mass. The driving force ap-
plied from the left was observed to translate the pelvis to the right with
resultant external rotation of the left hip (LH) and internal rotation of
the right hip (RH). The rotation was reversed during the restoring
phase.
mean (SD) age, weight and height of female subjects
(n ¼ 11) was 28 years (6), mass 72.4 kg (10.5) and height
1.70 m (0.06). The study was approved by the Unitec
Research Ethics Committee, both operators and sub-
jects gave their written informed consent to participate
in the study.
2.2.2. Exclusion criteria
Volunteers were ineligible to participate if they re-
ported any discomfort or pain in the region of the abdo-
men, spine, knees or pelvis. Volunteers experiencing
pain were excluded because they would be less likely
to relax during the application of the technique and
also potentially exacerbate symptoms. A relaxed state
was important because local muscle contraction has
been shown to increase the resonant frequency of im-
posed oscillations.7,23 Subjects with a history of motion
induced sickness were also excluded.
2.3. Operators
Two operators participated in the study. Operator A
was a qualified osteopath with seven years experience.
Operator A performed the technique on all subjects. Op-
erator B was a postgraduate osteopathy student with
two years supervised clinical experience. For the pur-
poses of the reliability study Operator B performed the
technique on a subset (n ¼ 12) of subjects. The height
and weight measures of Operator A and B were 74 kg,
1.73 m and 104 kg, 1.89 m respectively. Both operators
reported being right hand dominant.
2.4. The modified ‘harmonic’ technique (MHT)
The technique employed in this study was adapted
from ‘Pelvic mass rotation around the longitudinal
axis’ described by Lederman.4 The technique was per-
formed by applying the operator’s (caudad) hand to
68 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
the iliac crest of the prone subject to ‘rock’ the pelvis,
which results in a rotation motion of the lumbar spine
(Fig. 2). When the operator stood on the left side of
the prone subject the driving (caudad) hand was the
right hand and vice versa. Additionally, when using
this technique a practitioner can ‘fix’ vertebrae4 with
the free (cephalad) hand to focus the induced motion
at a target spinal segment. In clinical practice vertebral
‘fixing’ is intended to allow a practitioner to either assess
or improve mobility of a specific region.
Vertebral ‘fixing’ is intended to create an artificial
hinge which results in the same anatomical region being
mobilised via different vector quantities. Because human
body tissues are anisotropic (displaying variable stiffness
depending on the axis to which force is applied26) the os-
cillation characteristics change to reflect the nature of
the structures in line with the direction of force. The ‘fix-
ing’ aspect of the technique increases the likelihood of
inter-operator variation in both locating the segment
to be ‘fixed’, and in modification of the driving force
in response to this hinge point. Vertebral ‘fixing’ was ex-
cluded from this study due to its potential to introduce
further inter and intra-operator variation. The modified
harmonic technique (MHT) was applied with one con-
tact on the lateral aspect of the iliac crest of the pelvis
to initiate and maintain the oscillation. The direction
of force was perpendicular to the long axis of the sub-
ject’s body and approximately parallel with the surface
of the table. The motion was applied within the limits
of the ‘slack’ or toe range, which is described by Leder-
man4 as the range used when movement rather than
stretching is intended.
The anatomical structures in which motion is induced
by the technique adapted for this study are reported to
include the ‘‘lumbar spine, the lower to mid-dorsal
spine, the lower six ribs, the hip joints, the sacroiliac
joints and all the associated surrounding tissues.’’4 The
MHT was verbally described and demonstrated to the
operators prior to data collection; both operators
had previous experience of the technique in a clinical
setting.
2.5. Procedures
2.5.1. Data collection
Height and weight measurements were taken prior to
the subject being positioned on a standard height adjust-
able treatment plinth. When the subject was comfortable
in the prone position a fluorescent plastic marker was
secured by one of the researchers (JW) with adhesive
tape directly to the skin overlying the lumbaresacral junc-
tion (Fig. 1). The position of the lumbaresacral junction
was identified using palpation of standard anatomical
landmarks. A meter rule was positioned horizontally
across the subject’s back in the same plane as the marker
and filmed for calibration purposes. The operator then
entered the room to commence application of the tech-
nique starting from a side determined by coin toss.
2.5.2. Inter-rater reliability study
Operators A and B and a sub-group of 12 subjects (7
males and 5 females) attending one of the data collection
sessions participated in the inter-operator reliability
study. The mean (SD) age, weight and height of subjects
was 32 years (8), mass 77.3 kg (13.4) and height 1.74 m
(0.05). The MHT was applied from both the left and
right sides of each of the 12 subjects by both operators.
Subjects remained prone on the plinth for the duration
of data collection session. Operator A applied the tech-
nique prior to Operator B for the initial 6 subjects and
the order was reversed for the remaining subjects. This
design was adopted to minimise the influence of poten-
tial ‘wash on’ effects.
2.5.3. Video recording
A digital video camera (Sony DV Handycam) was
positioned on a tripod so that the direction of the mo-
tion of the marker was perpendicular to the direction
of the camera view. The camera was aligned with the
long axis of the subject’s body (Fig. 1). Recording
took place at 50 frames s1. Recording commenced
with the first oscillation of the technique and continued
for 30e40 s.
2.6. Data analysis
Oscillation periods and amplitude measures were
derived from video recordings using video analysis soft-
ware (SiliconCOACHÒ Pro. v6.0, Dunedin, New Zea-
land). The first three oscillation cycles of each subject
were unstable and were excluded from data analysis.
2.6.1. Data extraction
Video recordings of motion were imported into Sili-
conCOACH for data extraction. The motion induced
from each side of each subject was represented by the
amplitude and period measures of 15e20 oscillations
(approximately 20 s of video recording). Subject ‘mo-
tion’ data comprised of a left and right set denoting
the side from which the technique was applied.
2.6.2. Period
The analysis software allows a user to manually ad-
vance through frames of video recording (0.02 s per
frame) and features a timer function that can be employed
at any frame. Oscillation time periods were derived from
peak to peak maximum displacement opposite the opera-
tor (see Fig. 3aec). The time at maximum displacement
closest to the operator was labelled as the time at half
period (Fig. 3b). This also divided the motion into restor-
ing and displacement phases.
 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
Fig. 3. One period (T ) is the duration (s) of one complete cycle of motion, in this example T ¼ 0.820 s. These frames illustrate one oscillation cycle
occurring approximately 10 s after commencement of the technique. The time displayed in the frames (a and c) coincide with maximum displacement
of the pelvic mass opposite the operator. Oscillation time periods was calculated as the time interval between maximal displacements.
2.6.3. Amplitude
The analysis software includes a function with which,
based on calibration techniques, distances between
points can be measured. A metre ruler positioned and
recorded in the plane of the marker served to calibrate
this function. Amplitude was measured as ‘contra’
(side of equilibrium opposite the operator) and ‘ipsi’
(side of equilibrium closest to the operator) displace-
ment. The sum of ‘contra’ and ‘ipsi’ is reported as ampli-
tude. Measuring amplitude as a sum of displacement
either side of equilibrium is not standard. Amplitude is
defined in classical physics as ‘‘the maximal displace-
ment of a particular oscillator away from its equilibrium
position’’.20 This measurement was adapted because dis-
placement about equilibrium was not symmetrical.
2.6.4. Statistical analysis
Inter-cycle variability of the frequency and amplitude
parameters was determined using coefficients of varia-
tion. Coefficients of variation (CV) provide a measure
of dispersion for a set of values relative to the mean
and are calculated as (SD/mean)  100.27 Coefficients
of variation were based on parametric data (period or
amplitude) derived from 15e20 oscillations. Separate
CVs were calculated for oscillations induced from each
side of a subject.
Intra-class correlation coefficients (ICC 3,k) were
used to determine the reliability with which two opera-
tors induced oscillations at the same frequency in
individual subjects using the described ‘harmonic’ tech-
nique. Because the correlated data consisted of the
mean frequency (or amplitude) of approximately 15 os-
cillations induced by each operator, the reported values
were for average measures. Intra-class correlation coef-
ficients were calculated using a two-way mixed model
and agreement was defined in terms of absolute agree-
ment rather than consistency. Absolute agreement is ap-
propriate when systematic differences among levels of
ratings are considered relevant.28 An example of system-
atic differences in the context of this study is the finding
69
that Operator B induced oscillations of consistently
shorter periods (higher frequency) than Operator A
with the same variation between subjects. This finding
would indicate that although adjusting to different sub-
jects, the frequency of oscillations was still determined
by particular operators, a relevant finding; thus reliabil-
ity was based on absolute agreement.
Inter-operator reliability for the mean amplitude of
oscillations was also calculated using ICCs but was in-
terpreted as a comparison of the force applied by the dif-
ferent operators rather than an indication of the ‘tuning
in’ process. In classical models, the amplitude of oscilla-
tions at resonance is related to the damping forces acting
on the system.5 In the present investigation, the ampli-
tude of oscillation is dependent in unknown proportions
on both the force applied by the operator and the damp-
ing of the system. As the damping present in the lum-
barepelvic system of a subject is expected to remain
constant, the amplitude of oscillations induced by differ-
ent operators can be interpreted as the level of force
used during the technique. The frequency of oscillations,
however, is classically determined by mass and stiffness
properties,18 both of which are theoretically contingent
on the lumbarepelvic system of the subject. The process
of ‘tuning in’ is related to how an operator adjusts to
these properties and is demonstrated in the frequency
of oscillations.
To classify the oscillatory motion as harmonic or an-
harmonic, the intra-cycle relationship between period
and amplitude from one side of one subject was deter-
mined for approximately 15 consecutive oscillations us-
ing Pearson correlation coefficients. An additional
Pearson correlation between the calculated coefficient
and amplitude was calculated to determine the relation-
ship between time dependence and amplitude (in rela-
tion to pendulum laws). The relationship of weight
and height to mean frequency was also determined using
Pearson correlation coefficients.
All analyses were performed using SPSS v12.0.1
(SPSS Inc., Chicago, IL). Confidence intervals for
70 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
Pearson’s correlation coefficients were calculated using
Fisher’s transformations as described by Hopkins.29
Throughout the text means are presented with standard
deviations in brackets.
2.7. Reliability of the data extraction method
Video analysis software was employed as an aid in
deriving period and amplitude measures from video re-
cordings of lumbarepelvic oscillations induced by a ‘har-
monic’ technique. To establish the reliability of this
method data extraction was repeated twice, several
weeks apart for six randomly selected technique ses-
sions. The video recording of a technique session in-
cluded footage of oscillations induced from both the
left and right sides of a subject. The mean frequencies
of oscillations induced from the left and right sides of
a subject were calculated so each data extraction re-
sulted in twelve representative values. Reliability of the
data extraction method was determined by an ICC
(3,k) ¼ 0.94 (95% CI 0.73e0.99) interpreted as being
nearly perfect.30
3. Results
Fig. 4 depicts the typical behaviour of amplitude as
measured from the initial eight oscillations in a represen-
tative subject (subject 21). The moving averages of am-
plitude appeared to be inconsistent for the initial three
oscillations and were therefore excluded from analysis.
3.1. Variability of oscillation parameters
3.1.1. Frequency
Cycle periods (T ) were extracted from approximately
20 oscillations induced by the modified harmonic tech-
nique applied from both the left and right sides of
each subject. The SI unit for frequency ( f) is Hertz (cy-
cles s1) and can be derived from the inverse of the cycle
0.15
0.1
Amplitude (m)
0.05
0
0 1
-0.05
-0.1
Fig. 4. Amplitude characteristics during the initial oscillations manually induced by a MHT. The x-axis represents the equilibrium position. The
positive y-axis represents the displacement that occurred on the side of equilibrium opposite the operator. The trend line displays the moving average.
The first three oscillation cycles were excluded from data analysis.
period ( f ¼ 1/T ). The total mean (SD) frequency of
manual oscillations for male subjects was 1.15 Hz
(0.11) (n ¼ 15; range 0.97e1.41 Hz). The total mean
(SD) frequency of manual oscillations for female sub-
jects was 1.20 Hz (0.08) (n ¼ 11; range 1.06e1.40 Hz).
3.1.2. Inter-cycle period variability (single sided
intra-subject)
The mean (SD) coefficient of variation for the inter-
cycle oscillation periods was 2.45% (0.47) (Table 1).
3.1.3. Amplitude
Amplitude was measured from peak to peak maximal
displacement. The mean (SD) amplitude of manual os-
cillations was 0.15 m (0.03) (n ¼ 26; range 0.11e0.22 m).
3.1.4. Inter-cycle amplitude variability (single
sidedintra-subject)
The mean (SD) coefficient of variation calculated for
the amplitude parameter was 6.35% (2.06). Amplitude is
relatively inconsistent in comparison to frequency. A de-
gree of independence of oscillation period and ampli-
tude is implied by this finding.
3.1.5. Intra-subject left and right variation
Left and right mean frequency values for each subject
are presented in Fig. 5.
3.2. Correlation between period and amplitude of
manually induced oscillations
A defining characteristic of harmonic motion is that
oscillation periods are independent of amplitude.19 Pear-
son correlations were used to determine relationships
between period and amplitude. Pearson correlation re-
sults are shown in Fig. 6 and Table 1 and demonstrate
no relationship between period and amplitude. The
Pearson’s correlation between coefficients and amplitude
was r ¼ 0.019 (P ¼ 0.895).
2 3 4 5 6 7
Time (s)
 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79 71

Table 1
Summary of oscillation characteristics
Subject Left Right
Mean CV Mean CV Pearson Mean CV Mean CV Pearson
frequency (Hz) amplitude (m) ra frequency (Hz) amplitude (m) ra
1 1.12 (0.02) 2.01 0.16 (0.01) 7.29 0.5 1.11 (0.02) 1.69 0.18 (0.01) 3.39 0.39
3 1.11 (0.03) 2.47 0.16 (0.01) 4.77 0.32 0.97 (0.02) 2.44 0.18 (0.01) 7.70 0.39
4 1.16 (0.03) 2.53 0.14 (0.01) 5.42 0.29 1.14 (0.04) 3.87 0.13 (0.01) 5.44 0.2
5 1.12 (0.02) 1.96 0.15 (0.01) 5.06 0.12 1.17 (0.04) 3.18 0.14 (0.01) 8.17 0.51
6 1.25 (0.03) 2.06 0.16 (0.01) 5.21 0.11 1.21 (0.04) 3.26 0.17 (0.01) 5.53 0.01
7 1.10 (0.02) 1.76 0.22 (0.02) 7.74 0.46 1.15 (0.03) 2.51 0.20 (0.01) 4.83 0.01
8 0.97 (0.02) 2.29 0.22 (0.01) 4.98 0.19 1.00 (0.02) 2.33 0.21 (0.01) 5.36 0.09
9 1.11 (0.03) 3.10 0.15 (0.01) 8.52 0.3 1.14 (0.04) 3.47 0.17 (0.01) 6.22 0.15
10 1.25 (0.03) 2.12 0.14 (0.01) 5.05 0.28 1.26 (0.05) 3.75 0.15 (0.01) 8.78 0.09
11 1.27 (0.03) 2.49 0.12 (0.01) 5.29 0.12 1.16 (0.02) 2.15 0.14 (0.01) 8.48 0.35
12 1.14 (0.03) 2.31 0.15 (0.01) 8.92 0.35 1.19 (0.03) 2.62 0.15 (0.01) 5.37 0.35
13 1.20 (0.03) 2.24 0.14 (0.01) 4.69 0.4 1.18 (0.03) 2.23 0.15 (0.01) 4.94 0.15
14 1.28 (0.02) 1.61 0.13 (0.01) 9.02 0.61 1.24 (0.03) 2.65 0.13 (0.01) 5.69 0.36
15 1.27 (0.03) 2.09 0.16 (0.01) 3.64 0.4 1.23 (0.02) 1.53 0.16 (0.00) 2.67 0.61
16 1.15 (0.04) 3.55 0.15 (0.01) 4.05 0.55 1.06 (0.04) 3.62 0.11 (0.01) 8.86 0.15
17 1.18 (0.02) 1.79 0.18 (0.01) 6.20 0.6 1.15 (0.03) 2.94 0.15 (0.01) 9.00 0.08
18 1.06 (0.02) 1.81 0.20 (0.01) 4.80 0.16 1.07 (0.02) 1.65 0.18 (0.01) 6.25 0.09
19 1.07 (0.02) 2.14 0.18 (0.01) 3.92 0.54 1.01 (0.03) 3.13 0.19 (0.01) 4.81 0.48
20 1.21 (0.03) 2.44 0.12 (0.01) 7.26 0.06 1.25 (0.03) 2.39 0.12 (0.01) 7.29 0.07
21 1.13 (0.03) 2.51 0.16 (0.01) 6.02 0.01 1.11 (0.02) 2.00 0.17 (0.01) 4.81 0.18
22 1.31 (0.04) 3.18 0.12 (0.01) 7.14 0.41 1.40 (0.03) 1.97 0.12 (0.01) 5.58 0.08
23 1.24 (0.04) 3.01 0.14 (0.01) 6.21 0.25 1.23 (0.03) 2.34 0.14 (0.02) 11.52 0.1
24 1.09 (0.02) 2.24 0.18 (0.01) 4.68 0.01 1.03 (0.02) 1.63 0.16 (0.01) 6.23 0.17
25 1.18 (0.02) 1.88 0.16 (0.01) 6.87 0.17 1.19 (0.02) 1.65 0.15 (0.01) 3.58 0.45
26 1.24 (0.04) 3.04 0.12 (0.01) 5.49 0.03 1.19 (0.03) 2.68 0.12 (0.01) 7.38 0.08
27 1.36 (0.04) 2.88 0.12 (0.01) 5.96 0.13 1.41 (0.03) 2.36 0.11 (0.02) 14.25 0.17
Figures in parentheses are SD.
a
Pearson’s r is the correlation coefficient between amplitude and period.

3.3. Correlation between morphology and the
frequency of oscillations
Pearson correlations were used to determine the rela-
tionships of height and weight with the mean frequency
of oscillations induced from the left and right of each
subject. Subjects 3, 11, 16 and 22 were excluded because
of the clear difference shown in oscillations induced
from either sides (see Fig. 5), therefore a mean frequency
was not considered representative. The Pearson correla-
tion between height and frequency (males and females
combined n ¼ 22) was r ¼ 0.10 (95% CI 0.50 to

1.50
LEFT RIGHT

1.40
Mean frequency (Hz)

1.30

1.20

1.10

1.00

0.90
1 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
Subject

Fig. 5. Mean intra-subject frequency variation (left and right). Error bars represent SD. Note that four subjects (subjects 3, 11, 16 and 22) display
a clear discrepancy in mean frequency between left and right sides.
72 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79

0.8 Left Right

Linear (Right) Linear (Left) R2 = 0.0945(R)
0.6
R2 = 0.0273(L)
0.4
Pearson correlation
0.2

0
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
-0.2

-0.4

-0.6

-0.8
Subject

Fig. 6. Pearson correlations of intra-cycle period with amplitude measures during a ‘harmonic’ technique across all subjects.

0.34). For female subjects (n ¼ 10) r ¼ 0.42 (95% CI 3.5. The period of displacement and restoring
0.28 to 0.83); for male subjects (n ¼ 12) r ¼ 0.15 phases of oscillations
(95% CI 0.67 to 0.47). The Pearson correlation be-
tween weight and frequency (males and females com- The total period of a harmonic cycle can be divided
bined n ¼ 22) was r ¼ 0.66 (95% CI 0.84 to 0.32) into two phases depending on the forces driving the mo-
for female subjects (n ¼ 10) r ¼ 0.60 (95% CI 0.89 tion of the system. The displacement phase occurs when
to 0.05) and for male subjects (n ¼ 13) r ¼ 0.69 the mass is being driven (refer to Fig. 3c); the restoring
(95% CI 0.91 to 0.19). phase when the mass recoils from its displaced position.
The restoring and displacement time periods represent
3.4. Displacement about equilibrium during the balance of forces that deform (or displace) and
manually induced oscillations forces that restore the system to the equilibrium position
(elastic energy). The mean (SD) period of manually in-
The mean (SD) percentage of the total trajectory of duced oscillations was 0.86 s. The mean (SD) time taken
each cycle that occurred on the side of equilibrium op- for the displacement and restoring phases of motion
posite the operator was 81.5% (8.5). Classical models were 0.43 s (0.04) and 0.43 s (0.04) respectively. Equal
of harmonic motion show equal displacement about time duration of the displacement and restoring phases
the equilibrium position. during oscillations indicates a balance between the

Table 2
Inter-operator reliability
Subject Left-side technique application Right-side technique application
Operator A Operator B Operator A Operator B
Freq. (Hz) Amp. (m) Freq. (Hz) Amp. (m) Freq. (Hz) Amp. (m) Freq. (Hz) Amp. (m)
16 1.15 0.15 1.15 0.10 1.06 0.11 1.17 0.12
17 1.18 0.18 1.09 0.15 1.20 0.15 1.15 0.15
18 1.06 0.20 1.09 0.15 1.07 0.18 1.08 0.15
19 1.07 0.18 1.08 0.14 1.01 0.19 1.04 0.13
20 1.21 0.12 1.25 0.08 1.25 0.12 1.26 0.09
21 1.13 0.16 1.16 0.13 1.11 0.17 1.16 0.13
22 1.31 0.12 1.29 0.10 1.40 0.12 1.32 0.10
23 1.24 0.14 1.23 0.10 1.23 0.14 1.23 0.12
24 1.09 0.18 1.17 0.11 1.03 0.16 1.15 0.12
25 1.18 0.16 1.19 0.11 1.19 0.15 1.17 0.11
26 1.24 0.12 1.27 0.09 1.19 0.12 1.29 0.09
27 1.36 0.12 1.43 0.09 1.41 0.11 1.41 0.09

Mean (SD) 1.19 (0.09) 0.15 (0.03) 1.20 (0.10) 0.11 (0.02) 1.18 (0.13) 0.14 (0.03) 1.20 (0.10) 0.12 (0.02)
Freq., mean frequency of induced oscillations; Amp. (m), mean amplitude of induced oscillations.
 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
driving and elastic forces of the system, which indicates
that harmonic rather than anharmonic motion is taking
place.
3.6. Inter-operator agreement
3.6.1. Frequency
The mean frequency of oscillations induced from
each side of each subject for both operators is reported
in Table 2. An ICC (3,k) calculated for the relationship
between operators was ICC ¼ 0.93 (95% CI ¼ 0.83e
0.97) representing nearly perfect agreement between
operators.30
3.6.2. Amplitude
The mean amplitude of oscillations induced from
each side of each subject for both operators is reported
in Table 2. An ICC (3,k) calculated for the relationship
between operators was ICC ¼ 0.87 (95% CI ¼ 0.69e
0.94) representing nearly perfect agreement between
operators.30
3.7. Qualitative analysis of motion
Hip function (capacity to rotate) may influence the
frequency of oscillations via damping. This hypothesis
is modelled on a ‘damped harmonic oscillator’, in which
damping provides a drag on the system that reduces an-
gular frequency resulting in longer oscillation periods.31
To further investigate this hypothesis the raw data from
four subjects was selected based on variation demon-
strated in the mean frequency of oscillations induced
from different sides. The aim was to observe the influ-
ence of hip rotation on the frequency of induced motion.
The findings from three of the four selected subjects sup-
ported the proposed role of hip function in determining
frequency; in two subjects ...we were... able to predict
the side of lower frequency based on the nature of the
apparent restriction (i.e. internally restricted rotation
motion bearing more influence on the frequency of oscil-
lations induced from the opposite side). Subject 3 dem-
onstrated notably less movement of the right hip with
both positions of the operator but the effects were em-
phasised when the technique was applied from the right.
The right hip showed less ability to externally rota-
tedthe first movement imposed by the displacement
force applied from the right side. Subject 16 presented
similarly but the left hip was implicated and displayed
less ability for internal rotation. Thus, the periods of os-
cillations induced from the right side of the subject were
longer, resulting in a lower frequency. Successful predic-
tions were made for these two subjects. Subject 11 dis-
played less obvious motion asymmetry of both hip
joints. In this case we predicted incorrectly. There are
likely to be other sources of damping not visible from
the camera view.
73
Observation of raw video indicated that motion in-
duced by the harmonic technique resulted in a transla-
tional movement of the pelvis, a movement dependent
on the pivoting motion available at the hip joints (see
Fig. 2), and that the position of the operator resulted
in greater displacement of the pelvis towards the side op-
posite to equilibrium (as previously discussed). During
the displacement force applied to the iliac crest, the
hip joint closest to the operator rotated externally and
the opposite hip joint underwent increasing internal ro-
tation with the advance of the pelvic mass. During the
restoring phase this pattern was reversed. In all phases
of motion greatest mobility demands appeared to be
placed on the hip joint in closest proximity to the oper-
ator, a finding consistent with greater displacement of
the pelvic mass away from the operator.
4. Discussion
This paper reports the findings from a basic analysis
of motion induced in the lumbarepelvic complex during
the application of a ‘harmonic’ technique. An inter-
operator design was used to investigate the tendency
of two practitioners to induce oscillations at the reso-
nant frequency. ‘Harmonic’ techniques have been
described as those that bring about a state of resonance
in body tissues.4 An instructional text for ‘harmonic’
techniques describes a ‘tuning in’ process where manual
oscillations are adjusted to the resonant frequency of
the oscillating segment or mass.4 Applying classical
physics theory, the ‘tuning in’ process is synonymous
with a resonant state and amounts to timing the peak
driving force to coincide with peak velocity of the oscil-
lating system.5 The phase relationship of torque and
velocity results in optimal conditions for force transfer
which gives rise to resonance phenomena, demonstrated
by an increase in amplitude.5 Several studies have dem-
onstrated resonance in human joints during oscillations
induced by mechanical torque generators.6,7,23,24,32
Resistance to the imposed oscillations was found to be
lowest when induced at the resonant frequency of the
joint.7,23 Authors have related this finding to the effects
of elasticity and inertia being equal in magnitude and
opposite in phase7da dynamic state consistent with
harmonic motion.20 Observational studies of rhythmic
tasks performed by humans have shown a tendency
towards operating at resonance.9,13,15,16 This has been
attributed to the metabolic efficiency of resonant motion
due to the maximum use of forces generated9 and also
to the stability and predictability of motion conducted
at resonance therefore requiring less control input
from the central nervous system.15 In the context of
manual therapy, descriptions of ‘harmonic’ techniques
and the process of ‘tuning in’ are consistent with both
classical descriptions of resonance and research of this
phenomenon in vivo.
74 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
4.1. Harmonic motion
4.1.1. Displacement
The pendulum model of harmonic motion demon-
strates equal amplitude either side of equilibrium.18 In
the current study, manually induced oscillations dis-
played a tendency to oscillate about a mean position
that did not correspond with the resting position of
the pelvic mass; a finding inconsistent with pendulum
analogies but consistent with other studies of oscilla-
tions in vivo. Both Lakie et al.23 and Goodman et al.11
reported oscillations of the wrist joint to occur about
a fixed mean position.15,23 Lakie et al.23 attributed this
phenomenon to the passive elastic tension exerted by
the wrist flexor and extensor muscles. The mean position
about which oscillations occurred corresponded with the
range where resistance from these muscles was least.23
With respect to the motion induced in the lumbare
pelvic complex, the mean position about which oscilla-
tions occurred appeared to approximate the hip joint
opposite the operator. A possible explanation for this
position is that oscillations occur through a range of
least resistance and, typically, hip joints are more mobile
in comparison to the lumbar spine. The mean position
of oscillations may have also been influenced by the
position adopted by the operator and the direction of
force applied during the technique. Oscillations occur-
ring about a mean position resulted in approximately
80% of motion occurring on the side of equilibrium
opposite the operator.
4.1.2. Time dependence
Harmonic oscillations result from a proportionate
balance between displacement and restoring forces acting
on a system and typically display time-dependence: oscil-
lation periods that are independent of amplitude.20 Strict
time dependence applies to simple harmonic motion. The
current analysis modelled the motion induced by the har-
monic technique as a spring-mass system or an inverted
pendulum. Pendulums display time-dependence if oscilla-
tions occur through angles less than 15 . The period of
larger pendulum oscillations show some dependence on
amplitude.18 If the pelvic mass of subjects behaved like
an inverted pendulum, some amplitude dependence might
have been expected for the period of large amplitude oscil-
lations. However, if the motion induced by a modified
harmonic technique was anharmonic, a result of dispro-
portionate displacement and restoring forces,20 oscilla-
tion periods would show a linear relationship with
amplitude. Fig. 6 displays a scatter plot depicting correla-
tion coefficients between intra-oscillation period and
amplitude measures for the ‘harmonic’ technique applied
from the left and right of each subject. Intra-subject and
inter-subject correlation coefficients were both negative
and positive, ranging from trivial to large in magnitude.30
In addition, correlation coefficients did not show any
relationship with amplitude as might have been predicted
by laws that apply to physical pendulums. A linear rela-
tionship between amplitude and period was not identified
from this analysis indicating that the oscillatory motion
induced by the modified ‘harmonic’ technique is not
anharmonic.
The time duration of restoring and displacement
phases of induced oscillations were found to be equal.
This property is related to Hooke’s force law which de-
scribes a linear relationship between the restoring force
and displacement provided the elastic limit is not ex-
ceeded.19 Equal duration of displacement and restoring
phases of induced motion indicate a balance between
displacement and restoring forcesda characteristic of
harmonic motion.18
4.1.3. Critically damped harmonic motion
The mean oscillation period was calculated to be 75%
of the theoretical un-damped period which indicates
25% damping, and near critically damped motion of
the lumbar pelvic complex. A critically damped system
is defined as one that will cross equilibrium only once
following the original displacement force.32 Observation
of critically damped motion is consistent with other
studies where oscillations have been induced in passive
human tissues.6,23,24,32 During data collection, it was
noted that the oscillatory behaviour of different subjects
following cessation of the periodic force was variable.
The oscillatory motion in some subjects stopped almost
immediately (critically damped) and in others continued
for one or two oscillations; marginally less than critically
damped.
4.1.4. Morphology
When properties of harmonic motion are described in
relation to spring-mass systems the period of oscillations
is stated to be dependent on the stiffness of the spring
and the mass, but not amplitude.18 When described in
relation to pendular systems, the oscillation period is
stated to be dependent on the length of the lever arm
and independent of mass and amplitude (provided am-
plitude is not large).18 Weight and height of subjects
were taken as approximate indicators for mass and pen-
dulum length. Pearson correlation coefficients were cal-
culated to determine any relationships between weight
and height with frequency of induced oscillations. A
strong negative correlation, where frequency decreased
with greater subject body weight, demonstrated the rela-
tionship of inertia (mass) and acceleration. In classical
physics, the mass of a body determines inertia; the
greater the mass the less acceleration when a given net
force acts on it.19 Thus, the investigated scenario dis-
plays properties described in relation to spring-mass sys-
tems. ‘Mass’ was considered to be the mass of the pelvis
which has been estimated to be 10.7% of total body
weight,33 thus weight was a reasonable raw measure to
 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
represent the pelvic mass. Height, however, was consid-
ered a poor representative value for lever arm length.
This is discussed further in Section 4.6.
4.2. The variability of manually induced oscillations
The period of oscillations were found to be highly
consistent; the mean coefficient of variation (SD) for
consecutive oscillation periods was 2.45% (0.47). Pro-
viding some context: in a session of harmonic technique
where the mean frequency of oscillations was 1.25 Hz
(75.12 oscillations min1) and the corresponding period;
0.8 s, a slightly higher variation of 2.59% would repre-
sent a scenario where the mean period varied by just
0.02 s (e.g. change of period from 0.80 to 0.82 s). In
some experimental sessions mean variation of oscillation
periods was equal to the duration of one frame of re-
cording. Low tape speed may have partially contributed
to the reported variation. Despite this limitation, vari-
ability of oscillation periods was minimal.
Low variability of oscillation periods was surprising
in that the accepted relationship between damping and
resonance is that damped systems display minor reso-
nance phenomena over a wide range of frequencies.21
If it is assumed that Operator A was inducing oscilla-
tions at resonance, the stability of oscillation periods
suggests that despite the expected level of damping of
the lumbarepelvic complex the ‘window’ of resonant
frequencies was relatively specific. More likely though,
is that low variability of oscillations periods was a prod-
uct of co-ordination strategies employed by the operator
when performing the technique. The findings of period
to period stability are consistent with the findings of
other studies of rhythmic movements performed at res-
onance. Goodman et al. found that oscillations of
a hand-held pendulum at the resonant frequency (deter-
mined by the length of the pendulum) showed higher cy-
cle to cycle stability and therefore predictability than
oscillations of a lower or higher frequency.15 Goodman
et al. proposed that when assembling rhythmic move-
ments it is advantageous to the central nervous system
to tune to the resonant frequency because, during the
study, motion at resonance displayed stability and the
most predictable trajectories.15 It is feasible that, in per-
forming a ‘harmonic’ technique, operators found the
‘window’ of resonant frequencies and then tuned to
a more specific periodic attractor that coincided with ex-
ecution of the technique at their metabolic minima. The
stability of motion demonstrated by the data is consis-
tent with the proposed notion of operating with minimal
central nervous system input.15 The reported variation
in oscillation cycles found in this study are also consis-
tent with the findings of 3e4% variation in the stride in-
terval of humans during walking described by West and
Scafetta.34
75
4.3. Inter-operator agreement
The intra-class correlation coefficient for inter-opera-
tor reliability indicated ‘nearly perfect’ agreement be-
tween operators for both frequency and amplitude
(Table 2). The confidence limits for amplitude, however,
were much wider than those for frequency. This may be
explained on the basis that amplitude is determined by
the magnitude of force administered by the operator,
within the elastic limits posed by the tissues of the lum-
barepelvic complex. The period of an oscillation, how-
ever, is determined by mass and stiffness; both of which
are contingent on the lumbarepelvic tissues and are rel-
atively stable compared to the force administered to in-
duce motion. Greater variability in oscillation amplitude
is consistent with the expected variation in force applied
during the technique. In the current study, two indepen-
dent operators were observed to induce oscillations in
the same subjects at similar frequencies despite varia-
tions in amplitude. Based on the relative similarities of
oscillation parameters it is considered likely that both
operators ‘tuned in’ to the same ‘window’ of resonance
as determined by mass and stiffness properties of the
lumbarepelvic complex. These results support the hy-
pothesis that in performing harmonic techniques, practi-
tioners ‘tune in’ to resonant frequency.
As part of the inter-operator design, potential ‘wash on’
effects were minimised by reversing the order of practi-
tioners during the study. ‘Wash on’ effects may have arisen
due to the thixotropic properties of muscle tissue. Docu-
mented changes in stiffness have been attributed to thixot-
ropy as demonstrated during experimental oscillations
mechanically induced in human joints.7,23,32,35 Reduced
stiffness has been associated with a lower resonant fre-
quency.23 Thixotropic ‘memory time’ was investigated
by Lakie et al.23 who found that changes attributed to thix-
otropy persisted only with continued motion. If motion
was interrupted for longer than two seconds imposed os-
cillations resumed characteristics displayed prior to thixo-
tropic changes.23 Based on the time duration between
technique sessions it is unlikely that oscillations induced
by one operator would have been influenced by those in-
duced previously. Additionally, the duration of technique
application was short, therefore potential for change in the
properties of lumbarepelvic tissues was limited.
Lakie et al.23 noted that on occasion the oscillating
wrist system would spontaneously ‘loosen’ as demon-
strated by a sudden increase in amplitude. This phenom-
enon was attributed to thixotropy and the change in
amplitude was noted to persist whilst the system was
kept in motion. To experimentally induce thixotropic ef-
fects, Lakie et al.23 applied a range of perturbations con-
sisting of different wave forms at varying levels of force.
The response of an oscillating system was found to de-
pend on the magnitude of perturbation force; spontane-
ous loosening also only occurred with large torques.
76 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
‘Loosening’, described by Lakie et al.,23 has been re-
ported to result from a reduction in system stiffness
which corresponds with a lower frequency of oscilla-
tion.18 Operator A consistently induced oscillations of
larger amplitude than Operator B (Table 2) demonstrat-
ing greater force applied during the technique. Based on
the findings of Lakie et al.,23 it was considered likely that
thixotropic changes would occur but more likely during
oscillations induced by Operator A. During oscillations
induced from the left side of subject 24, Operator A in-
duced oscillations of a mean amplitude of 0.18 m at a fre-
quency of 1.09 Hz. Operator B induced oscillations of
0.11 m amplitude at a frequency of 1.17 Hz from the
same side of the same subject. There was a comparatively
large discrepancy between the amplitude of oscillations
induced by each operator in subject 24 compared with
other subjects. Based on the findings of Lakie et al.,23
this discrepancy may be explained by proposing that
Operator A employed a sufficient driving force to evoke
a ‘spontaneous loosening’ response, associated with
thixotropy. Operator B, using less force than Operator
A, did not evoke such a response and the system re-
mained stiff as implied by the higher frequency of
oscillations.
The pattern attributed to thixotropy, oscillations of
larger amplitude and lower frequency, was consistent
with the inter-operator findings to a lesser extent for
a number of subjects. A further explanation for this pat-
tern relates to pendulum laws, in which the period of
large amplitude oscillations is slightly dependent on am-
plitude. Frequency was commonly found to be slightly
lower in large amplitude oscillations induced by Opera-
tor A which supports the pendulum analogy. However,
oscillation characteristics from several technique ses-
sions are not explained by either thixotropic properties
or pendulum laws. For example, oscillations induced
by both operators from the left of subject 16 were calcu-
lated to be of exactly the same frequency with system-
atic differences in amplitude measures. Conversely,
oscillations induced from the right side of subject 17
were measured to have exactly the same amplitude but
different frequency. Oscillations induced from the left
side of subject 17 were also atypical with oscillations in-
duced by Operator A being both larger in amplitude
and higher in frequency than those induced by Operator
B. Influence from individual subjects is possible and is
discussed in the Section 4.4. Otherwise, inter-operator
discrepancy may be explained by classical descriptions
of resonance phenomena in damped systems (previously
discussed). Although the findings of this study have
demonstrated oscillation frequency to be determined
in part by subject weight, damping of the lumbare
pelvic system and the associated large ‘window’ for
resonance allows some variation. In the context of inter-
operator reliability; ‘tuning in’ is proposed to involve
modifying the frequency of driving force so that the
technique is performed within the ‘window’ of reso-
nance at a frequency metabolically optimal for the
operator.
The variation in morphology of two operators was
predicted to determine oscillation characteristics if the
‘magnet effect’ applied to the process of ‘tuning in’ dur-
ing ‘harmonic’ techniques. The ‘magnet effect’, in the
context of this study, would relate to a merging of the
natural eigenfrequency (determined by mass and length
properties) of the operator’s upper limb with the reso-
nant frequency of the ‘pelvic’ mass. Due to the variation
in operator morphology it was expected that this effect
might be demonstrated by inter-operator variation of
oscillation frequency. Because the eigenfrequency of
the respective limbs of both operators was not deter-
mined, the relevance of the ‘magnet’ theory to small in-
ter-operator variation in frequency can not be
accurately predicted. It is, however, considered likely,
that during the application of the driving force, the
weight of the subject’s pelvic mass and necessary con-
traction of the operator’s upper limb muscles change
the resonant frequency of the upper limb so much that
the eigenfrequency calculated from properties of the
passive limb is irrelevant. Muscular contraction of the
operator’s limb is probably used to tune the peak driv-
ing force to the peak velocity of the pelvic mass in order
to perform the rhythmic task at resonance. Because the
lumbarepelvic complex is damped, the ‘window’ of
resonance is large and therefore inter-operator variation
is likely to follow the theory proposed by Goodman
et al. of honing to stable movements for metabolic
efficiency.15
A time frame for the ‘tuning in’ process has not been
discussed in the literature. The findings from this study
showed cycle periods of oscillations to be consistent
within the first three or four oscillations or within two
or three seconds of commencing the technique (see
Fig. 4). Goodman et al.15 found that in terms of finding
stable motion patterns in a rhythmic activity most sub-
jects adapted oscillation frequency of a hand-held pen-
dulum to coincide with auditory cues within 10 s;
a comparable result considering different mechanisms
involved in haptic and auditory pathways.
4.4. Qualitative analysis of motion
Previous studies have found that oscillations occur
within the confines of elastic limits.23 This observation
has given rise to a theory that bounds of resistance form
an ‘attractor’ within which trajectories of rhythmic mo-
tion evolve.15 In the present study, oscillations occurred
about a mean position that approximated to the hip joint
opposite the operator. A discrepancy in the frequency of
oscillations induced from the left and right sides of several
subjects lead to descriptive observations regarding the
influence of hip mobility. Hip mobility may have been
 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
exaggerated in this study because vertebral fixing was
excluded in the application of the technique.
During motion induced in the lumbarepelvic com-
plex, additional oscillatory motion typically developed
in the ankle joints that, whilst slightly out of phase, fol-
lowed motion of the hip joints. Subject 22 appeared to
be tensing the muscles of the lower limbs during the first
three sessions as there was no movement occurring in
the legs or ankle joints. During the fourth session of
harmonic technique small inconsistent movements of
the ankle joints were visible. Of the motion observed,
no asymmetries were detected. Voluntary muscle con-
traction has the effect of stiffening joints, and has been
shown to increase the resonant frequency.23 The obser-
vation of a decrease of mean frequency in consecutive
sessions from 1.4 to 1.29 Hz may indicate that this
subject had been tense in earlier sessions and perhaps
relaxed over the course of the experiment.
4.5. Limitations
4.5.1. Correlation coefficients
The use of Pearson correlations to determine the rela-
tionship between oscillation period and amplitude mea-
sures was limited by low variance in both sets of data.
Correlation coefficients work optimally in the presence
of adequate variance and become unstable when there
is low variance in the data.36 This may have exaggerated
the range and inconsistency of correlation coefficients
seen in Fig. 5.
4.5.2. Video analysis software
No independent validity studies for the distance
function offered by SiliconCOACH software have been
published in the literature. The reliability and validity for
use of SiliconCOACH to measure the amplitude of oscilla-
tions during this study was not determined as the ampli-
tude measure was considered of minor importance
compared with measuring oscillation periods with respect
to the stated objectives. Slight variations of focus due to
use of auto-focus during filming of different subjects is
likely to have negligibly influenced the reliability of the dis-
tance function in determining amplitude because of the
change in real space represented by single pixels. Variation
of focus did not affect oscillation period measures as the
timer was accurate to the duration of one frame and the
researcher only had to identify the frame illustrating maxi-
mum displacement. The calculation of period was limited
by the frame speed used. The use of high speed videogra-
phy would further enhance the accuracy of measures.
4.6. Further research
A similar study employing a subject population with
lower back or hip symptoms would be useful to identify
any relationship between pain and observed harmonic
77
frequency. Such a study could also include a longitudinal
analysis of frequency as symptoms changed over time.
Mass and length properties can predict the inherent
or eigenfrequency of different limbs as passive limbs
are reasonably modelled by pendulums.11,12,37,38 A sim-
ilar model to predict the behaviour of oscillatory motion
in the lumbarepelvic complex of a prone individual is
not yet established. Frequency was strongly correlated
to the weight of subjects, implying that physical effects
of inertia on acceleration may partially explain the fre-
quency of oscillations. Although weight was likely to
be a representative value for the pelvic mass (pelvic
mass has been predicted to be 10.7% of the total body
weight33), height was considered an inadequate predic-
tor for any structures that may have been acting as pen-
dulum lever arms during the motion. It is difficult to
predict, during oscillations induced in the lumbare
pelvic complex, the anatomical length that is analogous
to a pendulum lever arm. The rotation motion arising
from the technique adapted for this study, ‘pelvic mass
rotation about a longitudinal axis’, has been described
by Lederman as being analogous to a torsional pendu-
lum.4 During analysis of video recordings, it appeared
that the pelvic mass pivoted freely over the hip joints.
Therefore, the pivoting motion at the hip joints may
be modelled as two inverted pendulums; the analogous
lever arm being the anterioreposterior diameter in line
with the axis of rotation of the hip joint. The position
and angle of the camera during data collection resulted
in motion of the lumbar spine and lower ribs being ob-
scured by the pelvic mass. Despite this limitation, an anal-
ogous length for a torsional pendulum model may be
assumed to be the length of the lumbar spine and sacrum;
the relatively fixed thoracic spine acting as a pivot. Fur-
ther investigation into these ideas is warranted. Visual
identification of anatomical regions that both contribute
and restrain the motion induced using these techniques is
necessary to develop the clinical utility of the harmonic
approach in both assessment and treatment.
Further to this, in several cases the frequency of man-
ually induced oscillations was found to be dependent on
the side from which the technique was applied. This find-
ing and subsequent observations of the video recordings
of particular subjects revealed the role of hip mobility in
determining the frequency of oscillations induced in the
lumbarepelvic complex. Specifically, the frequency of
oscillations induced from one side was lower depending
on the direction of the restriction (internal or external ro-
tation) and the proximity of the hip to the operator.
Based on observations of the raw video, more rotation
occurs in the hip closest to the application of the driving
force, so an inability of this hip to externally rotate hin-
ders the translation of the pelvic mass and resists the
driving force applied by the operator. Rather than con-
tributing to stiffness, which has been shown to increase
frequency and be influenced by muscular contraction10,23
78 J.L. Waugh et al. / International Journal of Osteopathic Medicine 10 (2007) 65e79
it is hypothesised that apparent restrictions to hip rota-
tion influence the frequency of passive oscillatory motion
via damping. A group of subjects with minor, unilateral
musculoskeletal pathology, such as the early stages of
hip osteoarthrosis may provide an interesting sample
for an osteopathic manipulative intervention applied to
the hip joints. Such a study could utilise a harmonic os-
cillation applied to the lumbarepelvic complex as a pre
and post measure of hip function.
The corollary to identifying dysfunction as a contribu-
tor to damping in passive tissues is to predict the role of
dysfunction in damping active movements. As muscle
stiffness has been found to be a property readily manipu-
lated by the central nervous system,10 it is postulated that
muscular contraction provides a compensatory mecha-
nism for damping arising from dysfunctional joints and
tissues so that the desired frequency of rhythmic move-
ments may still be performed at resonance. Further
research into harmonic techniques from the perspective
of osteopathic manual therapy is warranted.
5. Conclusion
The lumbarepelvic complex set in motion via a mod-
ified harmonic technique can be modelled as an autono-
mous nonlinear system. The defining feature of such
a system is that the timing of the forcing function is in-
trinsically determined, contingent on the state of the sys-
tem itself.13 The timing function of the lumbarepelvic
complex or ‘window’ of resonant frequencies has been
found to be partially determined by subject body weight,
but also influenced in some subjects by the rotation ca-
pacity of the hip joints. The autonomous model applied
in the context of harmonic technique is dually supported
by the findings of inter-subject variation and inter-oper-
ator reliability demonstrated by frequency of induced
oscillations. Oscillation amplitude, however, was found
to be determined by the operator and during one session
of large amplitude oscillations clearly demonstrated
findings consistent with a reduction in stiffness attrib-
uted to thixotropy. The inter-operator study demon-
strated a tendency of two morphologically distinct
operators to induce oscillations at similar frequencies
in the same subjects. The ‘magnet theory’, in which
the natural frequencies of two different biological struc-
tures merge to result in a frequency that lies somewhere
between, is considered unlikely to relate to the harmonic
approach investigated in this study.
Acknowledgment
We would like to thank Dr Eyal Lederman for his
contribution to the development of the initial idea for
this project.
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