ArticlePloS one2025
The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 6 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Comparative effectiveness of traditional Chinese non-pharmacological therapies for chemotherapy-related symptoms in cancer patients: a systematic review and network meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- Pooled it
- Effects of traditional Chinese medicine nursing techniques combined with music-based interventions on sleep in older adults: a systematic review and meta-analysis.Frontiers in psychiatry · 2026Pooled it
- Global trends and neurobiological frontiers of manual therapy in sleep disorders: integrating bibliometrics with clinical evidence.Frontiers in psychiatry · 2026Pooled it
- Exercise Therapy Versus Manual Therapy for the Management of Pain Intensity, Disability, and Physical Function in People With Chronic Low Back Pain: A Systematic Review With Meta-Analysis and Meta-Regression.European journal of pain (London, England) · 2025Pooled it
- Guideline
- Specific and shared mechanisms mediating pain intensity and functional outcomes in chronic neck pain.Pain management · 2026Trial
- Integrating Chair Yoga and Manual Therapy Into Hypertension Management: Effects on Autonomic Regulation, Muscle Viscoelasticity, and Mental Well-Being.Journal of clinical hypertension (Greenwich, Conn.) · 2026Trial
- Does adding cervical mobilization to shoulder mobilization improve pain, sensation, and function in subacromial impingement syndrome? A three-arm randomized controlled trial.BMC musculoskeletal disorders · 2026Trial
- Effects of thoracic manipulation with trigger point therapy on inflammatory cytokine levels in individuals with multiple sclerosis: a pilot study.Frontiers in rehabilitation sciences · 2026Trial
- Manual therapy treatment mechanisms are complex: Challenges and a call to action.Complementary therapies in medicine · 2026Article
- Appropriate translational designs for determining causal force-based (manual therapy) treatment mechanisms.Musculoskeletal science & practice · 2026Review
- Article
- Visual monitoring in real-time improves consistency of 3D IASTM force applied to humans.Chiropractic & manual therapies · 2026Observational
- Neurophysiological Response of Spinal Mobilization and Manipulation in Individuals With and Without Musculoskeletal Spine Disorders: A Scoping Review.The European journal of neuroscience · 2026Article
- Comparative Effects of Therapeutic Exercise and Manual Therapy Techniques on Self-Reported Disability in Chronic Non-Specific Low Back Pain: A Network Meta-Analysis.Journal of clinical medicine · 2026Review
- The Effectiveness of Cervical Spine and Diaphragm Manual Therapy Combined with Breathing Re-Education Exercises on Musculoskeletal, Respiratory and Psychophysiological Outcomes in Patients with Non-Specific Chronic Neck Pain: A Randomized Controlled Trial.Journal of clinical medicine · 2026Article
- Manual Therapy-Associated Dural Tear Causing Intracranial Hypotension Treated with an Epidural Blood Patch: A Case Report.Journal of clinical medicine · 2026Article
- 'It might help, but it won't fix me': a qualitative study of individuals' beliefs about manual therapy for low back pain.Chiropractic & manual therapies · 2026Article
- Mechanistic Explanations of Manual Therapy Do Not Influence Outcomes in Healthy Individuals: A Randomized Controlled Trial.Health science reports · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTreatment mechanisms are the underlying process or pathway through which a treatment influences the body. This includes molecular, cellular and physiological processes or pathways contributing to treatment effect. Manual therapy (MT) evokes complex mechanistic responses across body systems, interacting with the individual patient and context to promote a treatment response. Challenges arise as mechanistic studies are spread across multiple professions, settings and populations. The purpose of this review is to summarize treatment mechanisms that have been reported to occur with MT application.
methodsFour electronic databases were searched (Medline, CINAHL, Cochrane Library, and PEDro) for reviews investigating mechanistic responses which occur during/post application of MT. This review was registered a priori with PROSPERO (CRD42023444839). Methodological quality (AMSTAR-2) and risk of bias (ROBIS) were assessed for systematic and scoping reviews. Data were synthesized by mechanistic domain.
resultsSixty-two reviews were included. Systematic reviews (n = 35), narrative reviews (n = 24), and scoping reviews (n = 4) of asymptomatic (n = 37), symptomatic (n = 43), non-specified human subjects (n = 7) and animals (n = 7) were included. Reviews of moderate quality supported neurovascular, neurological, and neurotransmitter/neuropeptide changes. Reviews of low quality supported neuroimmunce, neuromuscular, and neuroendocrine changes. Reviews of critically low quality support biomechanical changes.
conclusionsFindings support critically low to moderate quality evidence of complex multisystem mechanistic responses occurring with the application of MT. Results support peripheral, segmental spinal, and supraspinal mechanisms occurring with the application of MT, which can be measured directly or indirectly. The clinical value of these findings has not been well established. While MT has proven to be an effective intervention to treat conditions such as pain, the current body of literature leaves uncertainty as to 'why' MT interventions work, and future research should look to better define which mechanisms (or combinations of mechanisms) are mediators of clinical response.
Indexed as
Identifiers
What Socratic holds
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.