{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:25:40Z","timestamp":1793042740300,"version":"4.5.0"},"reference-count":51,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T00:00:00Z","timestamp":1693699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2017\/26447\u20102"],"award-info":[{"award-number":["2017\/26447\u20102"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this review was to compare the heart rate variability (HRV) responses at rest of adults with chronic musculoskeletal pain against healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PubMed, Scopus, Web of Science (Science and Social Science Citation Index), and CINAHL databases were searched, with no date restrictions. Two independent reviewers selected observational studies that characterized the HRV responses at rest in adults with chronic musculoskeletal pain compared with those of healthy controls. Methodological quality was assessed using the Downs and Black checklist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study followed the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses statement. HRV in adults with chronic musculoskeletal pain was evaluated systematically. Of the 4893 studies screened, 20 of poor\u2010to\u2010moderate quality met the inclusion criteria. Most studies used electrocardiography and at least one time and\/or frequency domain index. Studies were found that investigated HRV in adults with temporomandibular disorders, neck pain, whiplash, low back pain, and fibromyalgia. The heterogeneity of the studies in relation to painful conditions, parameters or position for HRV analysis precluded a meta\u2010analysis. In general, these studies seem to show increased sympathetic and decreased parasympathetic modulation in adults with musculoskeletal pain when compared to controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adults with musculoskeletal pain exhibited a decline in HRV compared to controls. However, definitive conclusions cannot be drawn since the evidence is heterogeneous and of moderate quality. Further high\u2010quality research with standardized measurements is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.13294","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T04:26:26Z","timestamp":1693801586000},"page":"211-230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Heart rate variability in adults with chronic musculoskeletal pain: A systematic review"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2984-6902","authenticated-orcid":false,"given":"\u00c9rika P.","family":"Rampazo","sequence":"first","affiliation":[{"name":"Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy Federal University of S\u00e3o Carlos (UFSCar)  Rod Washington Luiz, km 235 S\u00e3o Carlos 13565\u2010905 S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia","family":"Rehder\u2010Santos","sequence":"additional","affiliation":[{"name":"Cardiovascular Physiotherapy Laboratory, Department of Physical Therapy Federal University of S\u00e3o Carlos (UFSCar)  Rod Washington Luiz, km 235 S\u00e3o Carlos 13565\u2010905 S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparecida M.","family":"Catai","sequence":"additional","affiliation":[{"name":"Cardiovascular Physiotherapy Laboratory, Department of Physical Therapy Federal University of S\u00e3o Carlos (UFSCar)  Rod Washington Luiz, km 235 S\u00e3o Carlos 13565\u2010905 S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"Liebano","sequence":"additional","affiliation":[{"name":"Physiotherapeutic Resources Research Laboratory, Department of Physical Therapy Federal University of S\u00e3o Carlos (UFSCar)  Rod Washington Luiz, km 235 S\u00e3o Carlos 13565\u2010905 S\u00e3o Paulo Brazil"},{"name":"Department of Rehabilitation Sciences University of Hartford  West Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/J.PAIN.0000000000001939"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000160"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215517732820"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/PAPR.12357"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000360"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JURO.2007.01.144"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/NAU.24532"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102415576724"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102415583989"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.SEMARTHRIT.2013.03.004"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.NEUBIOREV.2020.02.007"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0B013E31823BBFB0"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00420\u2010013\u20100917\u20102"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2018.11.010"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-010-1813-z"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2486\/indhealth.2017\u20100190"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195166"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10484\u2010017\u20109364\u20102"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291718001988"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2019.00710"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_11_24_1","doi-asserted-by":"crossref","unstructured":"FabbriS SilvaC HernandesE OctavianoF Di ThommazoA BelgamoA.Improvements in the StArt tool to better support the systematic review process. 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