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    Immediate effects of cervical spine and sacroiliac joint manipulations on the autonomic nervous system and pedobarographic analysis: Randomized controlled trial
    (Elsevier, 2026) Turgut, Hayriye; Buyukkirli, Lker Lker Can; Hatik, Sefa Haktan; Aydin, Emine Busra
    Background: This study aimed to investigate the immediate effects of cervical and sacroiliac joint manipulations on autonomic nervous system activity and baropodometric parameters. Methods: Participants were randomly assigned to three groups with equal gender distribution. The cervical manipulation group received chiropractic manipulation at the C3-C5 level, while the sacroiliac group received manipulation at the sacroiliac joint. The control group received no intervention. Pre- and post-treatment evaluations were conducted after a 30-minute interval. Plantar pressure was measured via a pedobarographic device. Autonomic nervous system activity was assessed using the Polar H10. Blood pressure and heart rate were manually recorded using a sphygmomanometer and pulse oximeter. Statistical significance was set at p < 0.05. Results: No significant differences were found among groups in terms of age, gender, height, or BMI (Kruskal-Wallis, p > 0.05). The cervical manipulation group showed significant decreases in systolic and diastolic blood pressure and heart rate post-intervention (Wilcoxon, p < 0.05). The sacroiliac group showed a significant increase in heart rate only (Wilcoxon, p < 0.05). No significant changes were observed in baropodometric parameters or autonomic activity within or between groups (Wilcoxon and Kruskal-Wallis, p > 0.05). However, post-intervention comparisons showed cervical manipulation led to a greater reduction in systolic blood pressure, while sacroiliac manipulation led to a greater increase in heart rate compared to controls (Mann-Whitney U with Bonferroni correction, p < 0.05). Conclusion: While no significant changes were observed in baropodometric or autonomic parameters, chiropractic manipulation demonstrated short-term effects on blood pressure and heart rate. The accuracy of heart rate variability assessments should be reviewed, and further studies are needed to evaluate long-term cardiovascular and autonomic outcomes.