Effects of pressure applied during standardized spinal mobilizations on peripheral skin blood flow: A randomised cross-over study

The acute effects of joint manipulative techniques on markers of autonomic nervous system activity: a systematic review and meta-analysis of randomized sham-controlled trials

“…The vast majority of the included studies (25/29) defined the sham as an ‘inactive’ manual contact (without movement) over the area of intervention, 2/29 studies [57, 58] used a sham, which was mechanically similar to the true intervention without involving joints and surrounding tissues. One study [48] used a sham similar to the true intervention with less pressure, and one study [40] did not describe the sham procedure (Additional file 3). Twelve studies [40–44, 47, 50, 51, 53, 55, 57, 58] assessed, if the participants were well blinded to the interventions delivered, using a post-trial questionnaire, and thus if the sham procedure was likely to produce the same expectations as with the true intervention.…”

“…Very low-certainty evidence (Table 3 B, C) suggests that mobilizations have no acute effect on skin sympathetic nerve activity, as there was no effect on skin temperature during the intervention or during the immediate post intervention period in 5/8 studies [35–37, 45, 48]. Studies could not be pooled in meta-analysis as relevant data were not available.…”

“…Very low-certainty evidence (Table 3 D, E, P) suggests that mobilizations may modulate (increase and decrease) or may have no effect on skin sympathetic nerve activity, as there was no effect on skin blood flow in 1/2 studies [48], while the other study [41], found effects in opposite directions (both increase and decrease). Studies could not be pooled in meta-analysis from lack of relevant data.…”

“…Very low-certainty evidence (Table 3 F, G, P) suggests that mobilizations have no acute effect on cardiovascular autonomic activity, as there was no effect on heart rate in beats per minute (bpm) during the intervention period in 2 pooled studies [46, 49] (mean difference − 0.83 bpm, 95% CI -5.47 to 3.81, I 2 = 0%, p = 0.73; 83 subjects) and during the immediate post intervention period in 3 pooled studies [46, 49, 50] (mean difference − 1.23 bpm, 95% CI -4.47 to 2.02, I 2 = 0%, p = 0.46, 121 subjects). A fourth study [48] also reported no effect during the immediate post intervention period. However, two studies [39, 40] found a statistically significant increase in heart rate from baseline to intervention period, and another study [45] reported a statistically significant increase during the immediate post intervention period.…”

Die akuten Effekte von Gelenkmanipulationstechniken auf Marker der Aktivität des autonomen Nervensystems: Eine Literaturübersicht und Metaanalyse von randomisierten Sham-kontrollierten Studien

“…Es konnten 29 relevante Studien identifiziert werden. 16 Studien führten oszillatorische Mobilisationstechniken [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], eine Studie führte atypische Mobilisationtechniken [30], 5 Studien führten anhaltende "natural apophyseal glides" (SNAGS)/"mobilization with movement" [31][32][33][34][35]…”