Evidence map›Paper›PMID 38904298›Full record

Trial reportThe Journal of manual & manipulative therapy2024

Autonomic nervous system and endocrine system response to upper or lower cervical spine mobilization in males with persistent post-concussion symptoms: a proof-of-concept trial.

Gerard Farrell, Cathy Chapple, Ewan Kennedy, Matthew Reily-Bell, Kesava Sampath, Angela Spontelli Gisselman, Chad Cook, Rajesh Katare, Steve Tumilty

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Journal of manual & manipulative therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
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

9 authors.

Gerard FarrellCentre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand.ORCID 0000-0002-3189-6546
Cathy ChappleCentre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand.ORCID 0000-0001-5141-8376
Ewan KennedyCentre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand.ORCID 0000-0002-7341-5309
Matthew Reily-BellDepartment of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.ORCID 0000-0002-9082-2766
Kesava SampathCentre for Health and Social Practice, Waikato Institute of Technology-Rotokauri Campus, Hamilton, Waikato, New Zealand.ORCID 0000-0001-9908-3659
Angela Spontelli GisselmanSchool of Medicine, Doctor of Physical Therapy Program, Tufts University, Phoenix, AZ, USA.ORCID 0000-0002-3218-5869
Chad CookDoctor of Physical Therapy Program, Duke University, Durham, NC, USA.ORCID 0000-0001-8622-8361
Rajesh KatareDepartment of Physiology, HeartOtago, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand.ORCID 0000-0001-5419-7935
Steve TumiltyCentre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, Dunedin, New Zealand.ORCID 0000-0003-2456-7055

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe peripheral stress response, consisting of the autonomic nervous system (ANS) and hypothalamic pituitary adrenal-axis (HPA-axis), functions to maintain homeostasis in response to stressors. Cervical spine manual therapy has been shown to differentially modulate the stress response in healthy populations. No study has investigated whether cervical spine mobilizations can differentially modulate the stress response in individuals with persistent post-concussion symptoms (PPCS), a population characterized by a dysfunctional stress response.

methodsA randomized, controlled, parallel design trial was performed to investigate whether upper or lower cervical spine mobilization can differentially modulate components of the stress response in individuals with PPCS. The outcomes were salivary cortisol (sCOR) concentration (primary) and the HRV metric, rMSSD, measured with a smartphone application (secondary). Nineteen males diagnosed with PPCS, aged 19-35, were included. Participants were randomly assigned into either intervention group, upper (

resultsThere was a statistically significant within-group reduction in sCOR concentration 30 minutes following lower cervical spine mobilizations and statistically significant within-group increase in rMSSD 30 minutes following upper cervical spine mobilizations.

conclusionThe results of this trial provide preliminary evidence for cervical spine mobilizations to differentially modulate components of the stress response at specific time points. Understanding the mechanisms of the effect of cervical spine mobilizations on the stress response provides a novel rationale for selecting cervical spine mobilizations to rehabilitate individuals with PPCS.

Indexed as

Autonomic Nervous SystemCervical VertebraeHydrocortisoneManipulation, SpinalPost-Concussion SyndromeAdultHumansMaleProof of Concept StudySalivaYoung AdultHydrocortisoneautonomic nervous systemcortisolHypothalamic pituitary adrenal-axismanual therapypersistent post-concussion symptomsstress response

Identifiers

PMID38904298
PMCPMC11578419

What OpenQuestion holds

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Registered trials

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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 OpenQuestion graph.