Evidence map›Paper›PMID 34855830›Full record

SynthesisPloS one2021

Do manual therapies have a specific autonomic effect? An overview of systematic reviews.

Sonia Roura, Gerard Álvarez, Ivan Solà, Francesco Cerritelli

Registry-linked trialAbstract readSystematic Review
In one paragraph

Synthesis in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07393815 (Physiological Responses to Graded Manual Pressure in Healthy Adults), which is not on this map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07393815 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Physiological Responses to Graded Manual Pressure in Healthy Adults: a Randomized Experimental Study on Autonomic, Hormonal, Sensory and Vascular Outcomes

TypeinterventionalSponsorUniversidad Europea de MadridRan2026 to 2026Enrolled90ConditionsHealthy ParticipantsArms"Manual Pressure Protocol", Manual Therapy Protocols (DLM, light and moderate-pressure massage), Graded Sustained Pressure
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  17. Time to evolve: the applicability of pain phenotyping in manual therapy.The Journal of manual & manipulative therapy · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sonia RouraSpain National Center, Foundation COME Collaboration, Barcelona, Spain.ORCID 0000-0002-3822-4814
Gerard ÁlvarezSpain National Center, Foundation COME Collaboration, Barcelona, Spain.ORCID 0000-0002-2680-6331
Ivan SolàIberoamerican Cochrane Centre-Biomedical Research Institute Sant Pau, IIB Sant Pau, Barcelona, Spain.ORCID 0000-0003-0078-3706
Francesco CerritelliItalian National Centre, Foundation COME Collaboration, Pescara, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of manual therapy interventions on the autonomic nervous system have been largely assessed, but with heterogeneous findings regarding the direction of these effects. We conducted an overview of systematic reviews to describe if there is a specific autonomic effect elicited by manual therapy interventions, its relation with the type of technique used and the body region where the intervention was applied.

methodsWe conducted an overview according to a publicly registered protocol. We searched the Cochrane Database of Systematic Reviews, MEDLINE, EPISTEMONIKOS and SCOPUS, from their inception to march 2021. We included systematic reviews for which the primary aim of the intervention was to assess the autonomic effect elicited by a manual therapy intervention in either healthy or symptomatic individuals. Two authors independently applied the selection criteria, assessed risk of bias from the included reviews and extracted data. An established model of generalisation guided the data analysis and interpretation.

resultsWe included 12 reviews (5 rated as low risk of bias according the ROBIS tool). The findings showed that manual therapies may have an effect on both sympathetic and parasympathetic systems. However, the results from included reviews were inconsistent due to differences in their methodological rigour and how the effects were measured. The reviews with a lower risk of bias could not discriminate the effects depending on the body region to which the technique was applied.

conclusionThe magnitude of the specific autonomic effect elicited by manual therapies and its clinical relevance is uncertain. We point out some specific recommendations in order to improve the quality and relevance of future research in this field.

Indexed as

Musculoskeletal ManipulationsAutonomic AgentsAutonomic Nervous System DiseasesDatabases, FactualHumansParasympathetic Nervous SystemSympathetic Nervous SystemAutonomic Agents

Identifiers

PMID34855830
PMCPMC8638932

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.