{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:58:52Z","timestamp":1785214732820,"version":"3.55.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n This review aims to examine the influence of physiotherapy interventions on the ANS in patients with spinal pain conditions.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n 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: \u22120.10, 0.32;\n I2<\/jats:italic>\n = 55%) or neck pain (SMD = 0.09; 95% CI: \u2013 0.29, 0.46;\n I2 =<\/jats:italic>\n 74%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n This systematic review and meta-analysis found no evidence that physiotherapy interventions induce ANS modulation compared to other interventions.<\/jats:p>\n <\/jats:sec>\n \n Funding:<\/jats:title>\n None<\/jats:p>\n <\/jats:sec>\n \n Registration:<\/jats:title>\n PROSPERO (registration no.: CRD42023460760)<\/jats:p>\n 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