{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:18:11Z","timestamp":1760145491852,"version":"build-2065373602"},"reference-count":54,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Objectives: To compare the acute effects of upper cervical manipulation (CM) and manual massage (MM) to simulated CM (Sham) and Control conditions (Control) on heart rate variability (HRV) and blood pressure (BP) responses in women with non-elevated BP. Methods: A single-blind, four-arm, parallel-group, randomized, crossover, placebo-controlled trial recruited 15 apparently healthy women with non-elevated BP who visited the lab on four occasions with 48 h intervals to ensure adequate washout between interventions. A Latin square randomization approach was employed to assign participants to one of four experimental conditions: (1) Control: Rest without intervention; (2) CM: Bilateral high-velocity, low-amplitude manipulation of the upper cervical spine (C0\u2013C2); (3) MM: A single 120 s session of MM release applied unilaterally to the anterior and posterior thigh, posterior lower leg, and lumbar musculature; or (4) Sham: Mimicking the positioning used in CM without the application of thrust manipulation. In each experiment, HRV, systolic and diastolic BP were measured at rest (Baseline) and every 15 min for 60 min after each intervention. All procedures were performed in the morning to avoid any confounding circadian rhythm effect on HRV and BP. Results: We found significant increases within conditions for RMSSDms (Control: Post-0 (p = 0.032), Post-15 (p = 0.023); Sham: Post-15 (p = 0.014); CM: Post-15 (p = 0.027)); SDNNms (Control: Post-45 (p = 0.037); CM: Post-45 (p = 0.014) and Post-60 (p = 0.019)); PNN50% (CM: Post-0 (p = 0.044), Post-15 (p = 0.044) and Post-45 (p = 0.019)); LF Power (ms2) (CM: Post-60 (p = 0.001)), and LF\/HF ratio (MM: Post-60 (p = 0.022). Conclusions: Although no statistically significant between-condition differences were detected, within-condition changes with moderate-to-large effect sizes suggest potential clinical relevance of CM and MM. These preliminary findings emphasize the importance of effect sizes and may indicate greater translational significance in populations with non-elevated cardiovascular risk.<\/jats:p>","DOI":"10.3390\/healthcare13202554","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:50:16Z","timestamp":1760107816000},"page":"2554","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Upper Cervical Manipulation and Manual Massage Do Not Modulate Sympatho-Vagal Balance or Blood Pressure in Women: A Randomized, Placebo-Controlled Clinical Trial"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1866-553X","authenticated-orcid":false,"given":"Est\u00eav\u00e3o Rios","family":"Monteiro","sequence":"first","affiliation":[{"name":"Graduate Program in Rehabilitation Science, Centro Universit\u00e1rio Augusto Motta (PPGCR\/UNISUAM), Rio de Janeiro 21032-060, Brazil"},{"name":"Graduate Program in Biopsychosocial Health, Centro Universit\u00e1rio Augusto Motta (PPGBPS\/UNISUAM), Rio de Janeiro 21032-060, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5841-798X","authenticated-orcid":false,"given":"Linda S.","family":"Pescatello","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA"}]},{"given":"Gustavo Henrique","family":"Garcia","sequence":"additional","affiliation":[{"name":"Undergraduate Program in Physical Therapy, Centro Universit\u00e1rio Augusto Motta (UNISUAM), Rio de Janeiro 21041-020, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5344-1123","authenticated-orcid":false,"given":"Alexandre Gon\u00e7alves","family":"de Meirelles","sequence":"additional","affiliation":[{"name":"Graduate Program in Rehabilitation Science, Centro Universit\u00e1rio Augusto Motta (PPGCR\/UNISUAM), Rio de Janeiro 21032-060, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4277-6996","authenticated-orcid":false,"given":"Francine","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Physical Education, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-599, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4838-638X","authenticated-orcid":false,"given":"Rafael Cotta","family":"de Souza","sequence":"additional","affiliation":[{"name":"Graduate Program in Rehabilitation Science, Centro Universit\u00e1rio Augusto Motta (PPGCR\/UNISUAM), Rio de Janeiro 21032-060, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0177-9816","authenticated-orcid":false,"given":"Leandro Alberto Calazans","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Graduate Program in Rehabilitation Science, Centro Universit\u00e1rio Augusto Motta (PPGCR\/UNISUAM), Rio de Janeiro 21032-060, Brazil"},{"name":"Physiotherapy Department, Federal Institute of Rio de Janeiro (IFRJ), Rio de Janeiro 21710-240, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8598-4878","authenticated-orcid":false,"given":"Agnaldo Jos\u00e9","family":"Lopes","sequence":"additional","affiliation":[{"name":"Graduate Program in Rehabilitation Science, Centro Universit\u00e1rio Augusto Motta (PPGCR\/UNISUAM), Rio de Janeiro 21032-060, Brazil"},{"name":"Graduate Program in Biopsychosocial Health, Centro Universit\u00e1rio Augusto Motta (PPGBPS\/UNISUAM), Rio de Janeiro 21032-060, Brazil"},{"name":"Medical Sciences Postgraduation Program, School of Medical Sciences, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7404-7405","authenticated-orcid":false,"given":"Daniel","family":"Moreira-Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health, 4200-450 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s41581-019-0244-2","article-title":"The global epidemiology of hypertension","volume":"16","author":"Mills","year":"2020","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_2","unstructured":"NCD Risk Factor Collaboration (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet, 398, 957\u2013980."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1042\/CS20130407","article-title":"Immune mechanisms in hypertension and vascular injury","volume":"126","author":"Schiffrin","year":"2014","journal-title":"Clin. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ringwald-de Meyer, S., de La Harpe, R., Vollenweider, P., Marques-Vidal, P., and Vaucher, J. (2025). Factor associated with and risk of cardiovascular disease in people with uncontrolled hypertension. Sci. Rep., 15.","DOI":"10.1038\/s41598-024-84824-z"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1249\/MSS.0000000000001943","article-title":"Physical activity to prevent and treat hypertension: A systematic review","volume":"51","author":"Pescatello","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Monteiro, E.R., Pescatello, L.S., Leit\u00e3o, L., de Miranda, M.J.C., Marchetti, P.H., Novaes, M.R., da Silva Ara\u00fajo, G., Corr\u00eaa Neto, V.G., and da Silva Novaes, J. (2025). Muscular performance and blood pressure after different pre-strength training strategies in recreationally strength-trained women: Cross-over trial. J. Cardiovasc. Dev. Dis., 12.","DOI":"10.20944\/preprints202406.1915.v1"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"J\u00e4nig, W. (2006). The Integrative Action of the Autonomic Nervous System: Neurobiology of Homeostasis, Cambridge University Press.","DOI":"10.1017\/CBO9780511541667"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1590\/S0102-76382009000200018","article-title":"Basic notions of heart rate variability and its clinical applicability","volume":"24","author":"Vanderlei","year":"2009","journal-title":"Rev. Bras. Cir. Cardiovasc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2825","DOI":"10.1519\/JSC.0000000000002562","article-title":"Cardiac autonomic and blood pressure responses to an acute foam rolling session","volume":"32","author":"Lastova","year":"2018","journal-title":"J. Strength Cond. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12998-019-0293-4","article-title":"The effect of a single spinal manipulation on cardiovascular autonomic activity and the relationship to pressure pain threshold: A randomized, cross-over, sham-controlled trial","volume":"28","author":"Picchiottino","year":"2020","journal-title":"Chiropr. Man. Therap."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Jupin, C., Aibar, V.B., and Sarhan, F.R. (2025). Short-Term Effects of Spinal Manual Therapy on the Nervous System in Managing Musculoskeletal Pain: A Systematic Review. J. Clin. Med., 14.","DOI":"10.3390\/jcm14113830"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jmpt.2016.10.014","article-title":"Procedure selection and patient positioning influence spine kinematics during high-velocity, low-amplitude spinal manipulation applied to the low back","volume":"40","author":"Bell","year":"2017","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3233\/BMR-169615","article-title":"The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review","volume":"30","author":"Hidalgo","year":"2017","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_14","first-page":"CD004249","article-title":"Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment","volume":"2015","author":"Gross","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.spinee.2018.01.013","article-title":"Manipulation and mobilization for treating chronic low back pain: A systematic review and meta-analysis","volume":"18","author":"Coulter","year":"2018","journal-title":"Spine J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"l689","DOI":"10.1136\/bmj.l689","article-title":"Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: Systematic review and meta-analysis of randomised controlled trials","volume":"364","author":"Rubinstein","year":"2019","journal-title":"BMJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.jbmt.2015.08.007","article-title":"Effects of self-myofascial release: A systematic review","volume":"19","author":"Beardsley","year":"2015","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1067\/mmt.2001.112564","article-title":"Significant changes in systolic blood pressure post vectored upper cervical adjustment vs resting control groups: A possible effect of the cervico sympathetic and\/or pressor reflex","volume":"24","author":"Knutson","year":"2001","journal-title":"J. Manipulative Physiol. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.clch.2012.10.036","article-title":"Immediate effects of atlas manipulation on cardiovascular physiology","volume":"15","author":"Ward","year":"2012","journal-title":"Clin. Chiropr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"622","DOI":"10.2519\/jospt.2014.4820","article-title":"Blood pressure and heart rate response to posteriorly directed pressure applied to the cervical spine in young, pain-free individuals: A randomized, repeated-measures, double-blind, placebo-controlled study","volume":"44","author":"Yung","year":"2014","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcm.2014.12.005","article-title":"Effects of Upper and Lower Cervical Spinal Manipulative Therapy on Blood Pressure and Heart Rate Variability in Volunteers and Patients With Neck Pain: A Randomized Controlled, Cross-Over, Preliminary Study","volume":"14","author":"Win","year":"2015","journal-title":"J. Chiropr. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jmpt.2016.04.002","article-title":"Effect of Spinal Manipulation of Upper Cervical Vertebrae on Blood Pressure: Results of a Pilot Sham-Controlled Trial","volume":"39","author":"Goertz","year":"2016","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1519\/JSC.0000000000004137","article-title":"Effects of Manual Therapies and Resistance Exercise on Postexercise Hypotension in Women With Normal Blood Pressure","volume":"36","author":"Monteiro","year":"2022","journal-title":"J. Strength Cond. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jbmt.2023.11.038","article-title":"Enhance range-of-motion and hypotensive effect in elderly submitted to three manual therapy techniques: Cross-over study","volume":"37","author":"Monteiro","year":"2024","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3822\/ijtmb.v15i4.739","article-title":"Acute Effects of a Single-Session of Full-Body Foam Rolling on Heart Rate Variability","volume":"15","author":"Kopec","year":"2022","journal-title":"Int. J. Ther. Massage Bodyw."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jbmt.2017.09.025","article-title":"Effects of spinal manipulation and myofascial techniques on heart rate variability: A systematic review","volume":"22","author":"Borges","year":"2018","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1007\/s00421-023-05382-2","article-title":"Acute self-myofascial release modulates cardiac autonomic function and hemodynamic parameters at rest and reduces cardiovascular stress reaction","volume":"124","author":"Ketelhut","year":"2024","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"105149","DOI":"10.1016\/j.jbspin.2021.105149","article-title":"Vagus nerve stimulation in musculoskeletal diseases","volume":"88","author":"Courties","year":"2021","journal-title":"Jt. Bone Spine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.wneu.2021.09.090","article-title":"The Wandering Nerve: Positional Variations of the Cervical Vagus Nerve and Neurosurgical Implications","volume":"156","author":"Cunningham","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1519\/JSC.0b013e31829480f5","article-title":"Acute effects of self-myofascial release using a foam roller on arterial function","volume":"28","author":"Okamoto","year":"2014","journal-title":"J. Strength Cond. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1519\/JSC.0000000000001641","article-title":"Acute effects of lateral thigh foam rolling on arterial tissue perfusion determined by spectral doppler and power doppler ultrasound","volume":"31","author":"Hotfiel","year":"2017","journal-title":"J. Strength Cond. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jbmt.2023.04.017","article-title":"Effects of foam rolling and strength training on post exercise hypotension in normotensive women: A cross-over study","volume":"34","author":"Monteiro","year":"2023","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Monteiro, E.R., Aguilera, L.M., Ru\u00e1-Alonso, M., Ara\u00fajo, G.d.S., Corr\u00eaa Neto, V.G., Bentes, C.M., Vila\u00e7a-Alves, J., Reis, V.M., Ferreira, A.d.S., and Marchetti, P.H. (2025). Effect of Manual Massage, Foam Rolling, and Strength Training on Hemodynamic and Autonomic Responses in Adults: A Scoping Review. Healthcare, 13.","DOI":"10.20944\/preprints202502.1932.v1"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e081123","DOI":"10.1136\/bmj-2024-081123","article-title":"CONSORT 2025 statement: Updated guideline for reporting randomised trials","volume":"389","author":"Hopewell","year":"2025","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e1004589","DOI":"10.1371\/journal.pmed.1004589","article-title":"SPIRIT 2025 statement: Updated guideline for protocols of randomised trials","volume":"22","author":"Chan","year":"2025","journal-title":"PLoS Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3912","DOI":"10.1093\/eurheartj\/ehae178","article-title":"2024 ESC Guidelines for the management of elevated blood pressure and hypertension","volume":"45","author":"McEvoy","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1080\/10669817.2022.2148048","article-title":"Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers","volume":"31","author":"Gorrell","year":"2022","journal-title":"J. Man. Manip. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1123\/jsr.2016-0051","article-title":"The Diagnostic Accuracy of Clinical Diagnostic Tests for Thoracic Outlet Syndrome","volume":"26","author":"Hixson","year":"2017","journal-title":"J. Sport Rehabil."},{"key":"ref_39","unstructured":"Strazewski, J. (2014). The Essentials of Toggle Recoil (HIO), J.W. Strazewski Publisher."},{"key":"ref_40","unstructured":"2025 AHA\/ACC\/AANP\/AAPA\/ABC\/ACCP\/ACPM\/AGS\/AMA\/ASPC\/NMA\/PCNA (2025). Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. Hypertension, 82, e212\u2013e316."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"809","DOI":"10.33314\/jnhrc.v19i04.3949","article-title":"Validity of elite-hrv smartphone application for measuring heart rate variability compared to polar v800 heart rate monitor","volume":"19","author":"Chhetri","year":"2021","journal-title":"J. Nepal Health Res. Counc."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Himariotis, A.T., Coffey, K.F., Noel, S.E., and Cornell, D.J. (2022). Validity of a smartphone application in calculating measures of heart rate variability. Sensors, 22.","DOI":"10.3390\/s22249883"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"2009 American College of Sports Medicine Position Stand (2002). American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med. Sci. Sports Exerc., 34, 364\u2013380.","DOI":"10.1097\/00005768-200202000-00027"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1519\/JSC.0b013e318278eea0","article-title":"The importance of a priori sample size estimation in strength and conditioning research","volume":"27","author":"Beck","year":"2013","journal-title":"J. Strength Cond. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_46","unstructured":"Pallant, J. (2016). SPSS Survival Manual: A Step By Step Guide to Data Analysis Using SPSS Program, McGraw-Hill Education. [6th ed.]."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1016\/S0140-6736(81)92799-9","article-title":"Does placebo lower blood-pressure?","volume":"2","author":"Gould","year":"1981","journal-title":"Lancet"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1038\/npp.2010.81","article-title":"How placebos change the patient\u2019s brain","volume":"36","author":"Benedetti","year":"2011","journal-title":"Neuropsychopharmacology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/j.jash.2016.10.009","article-title":"Effect of placebo groups on blood pressure in hypertension: A meta-analysis of beta-blocker trials","volume":"10","author":"Wilhelm","year":"2016","journal-title":"J. Am. Soc. Hypertens"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/JCN.0000000000000217","article-title":"Effects of massage on blood pressure in patients with hypertension and prehy-pertension: A meta-analysis of randomized controlled trials","volume":"31","author":"Liao","year":"2016","journal-title":"J. Cardiovasc. Nurs."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1038\/nm0895-766","article-title":"Are there separate central nervous system pathways for touch and pain?","volume":"1","author":"Berkley","year":"1995","journal-title":"Nat. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1037\/cjep2007019","article-title":"Discriminative touch and emotional touch","volume":"61","author":"McGlone","year":"2007","journal-title":"Can. J. Exp. Psychol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1093\/brain\/awu370","article-title":"The perception of touch and the ventral somatosensory pathway","volume":"138","author":"Preusser","year":"2015","journal-title":"Brain"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1055\/s-0033-1337948","article-title":"Gender influence on post-resistance exercise hypotension and hemodynamics","volume":"34","author":"Queiroz","year":"2013","journal-title":"Int. J. Sports Med."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/13\/20\/2554\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:27:04Z","timestamp":1760110024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/13\/20\/2554"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,10]]},"references-count":54,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["healthcare13202554"],"URL":"https:\/\/doi.org\/10.3390\/healthcare13202554","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,10]]}}}