Cranial Rhythm Generation in Osteopathic Diagnosis: Modern Concepts and Evidence

Cranial rhythm had long been viewed within a classical concept, implying micromovements of cranial bones and sutures. However, recent research into neurophysiology, vascular physiology, and suture morphology does not suggest their physiologically significant mobility in adults. The emphasis is currently on the hypothesis of vegetovascular origin of cranial rhythm. According to this hypothesis, slow oscillations of blood pressure and blood flow (Traube–Hering–Mayer waves) and baroreflex modulation aligned with respiratory and cardiac rhythms may generate a multilayered rhythmic structure of changes in tissue turgor, which can be detected on palpation. The interobserver reproducibility of palpated cranial rhythm remains low, and research into the clinical efficacy of cranial techniques is limited due to methodological drawbacks. This review assesses contending concepts, summarizes evidence supporting the vegetovascular origin of this phenomenon, and defines the limits of its interpretation. The practical relevance of this work is determined by the shift from the concept of cranial suture mobility to measurable autonomic regulation parameters (heart rate variability, baroreflex, cardiorespiratory coherence) and standardized research protocols. The presented synthesis defines the cranial rhythm concept from a neurophysiological perspective in order to examine its potential use in clinical practice.