SynthesisThe Journal of manual & manipulative therapy2025
Effects of mobilization or manipulation of the thoracic spine on autonomic nervous system markers in symptomatic and asymptomatic participants - a systematic review and meta-analysis.
Synthesis in The Journal of manual & manipulative therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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
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Authors and funding
4 authors.
Funding
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Abstract
objectivesTo identify the effects of thoracic mobilization/manipulation on autonomic nervous system responses.
methodsFour electronic databases were searched for controlled trials published before February 2024. Studies on mobilization/manipulation of the thoracic spine were included evaluating effects on the autonomic nervous system (ANS). Risk of bias was assessed by two independent assessors using the Cochrane risk-of-bias tool 2, the RoB-2 tool for crossover studies or the ROBINS-I tool. Meta-analyses using random-effects models present the overall combined mean effects.
results2139 articles were identified, 20 studies (863 participants) were included in the qualitative data analysis and 15 in meta-analyses. Four studies had a high risk of bias in one or more domains. Meta-analyses indicated no statistically significant effect of mobilization or manipulation on markers of the ANS. The ratio of low-frequency-to-high-frequency power did not significantly decrease after thoracic mobilization/manipulation compared to any type of control intervention (-0.28; 95% CI -0.59 to 0.04; p=0.09). Skin conductance and root mean square of successive RR interval differences as well as LFab (ms^2; absolute power of the low-frequency band) did not significantly increase after thoracic mobilization/manipulation. Subgroup and sensitivity-analyses indicated no significant effects. DISCUSSION: Methodological limitations and heterogeneity (
conclusionNo significant effects of mobilization/manipulation of the thoracic spine on ANS markers were found. The direction of changes towards increased or decreased sympathetic or parasympathetic nervous system activity was ambiguous.
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