A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses Spinal manipulations and mobilizations showed significant reduction in SBP, but the heterogeneity was moderate. On sensitivity analysis, there was a significant decrease in both systolic as well as diastolic blood pressure and heterogeneity was also very low. Results were insignificant for heart rate. Therefore, within the limitations of the present systematic review and meta-analysis, it can be concluded that spinal manipulations and mobilizations may result in decrease of systolic as well as diastolic blood pressure. However, given the distinct kinematics, biomechanics and site of application of these techniques, more precise reviews can be performed to evaluate the efficacy of different types of manual therapy techniques applied at different regions of spine for progressing from generalized to specific conclusions.

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