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Published on: December 13, 2024
Impact of Physiotherapy on Autonomic Nervous System Function in Spinal Pain: A Systematic Review and Meta-analysis
Hani A Alkhawajah1, Hani Al-Abbad2, Ali M Albarrati3
1Department of Physiotherapy, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi Arabia.
Background:
Spine pain conditions, such as low back pain (LBP) and neck pain, are prevalent musculoskeletal disorders. The autonomic nervous system (ANS) has been implicated as a potential contributor to pain. However, research investigating the impact of physiotherapy interventions on ANS function in patients with spinal pain disorders remains limited.
Objective:
This review aims to examine the influence of physiotherapy interventions on the ANS in patients with spinal pain conditions.
Methods:
A comprehensive literature search was conducted in PubMed, CINAHL, Web of Science, Ovid, and the Cochrane Controlled Trials Register to identify eligible randomized clinical trials. For meta-analysis, a random-effects model was used to compare the effects of physiotherapy interventions on ANS outcomes to comparison interventions.
Results:
A total of 16 studies were included in the systematic review, of which 11 were eligible for meta-analysis. Nine studies focused on participants with LBP, while seven studies focused on neck pain. The included studies investigated a variety of physiotherapy interventions compared to various control interventions. The meta-analysis revealed no statistically significant difference in ANS-related parameters between physiotherapy and comparison groups for LBP (pooled standardized mean difference [SMD] = 0.12; 95% CI: -0.10, 0.32; I2 = 55%) or neck pain (SMD = 0.09; 95% CI: - 0.29, 0.46; I2 = 74%).
Conclusions:
This systematic review and meta-analysis found no evidence that physiotherapy interventions induce ANS modulation compared to other interventions.
Funding:
None.
Registration:
PROSPERO (registration no.: CRD42023460760).