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J Can Chiropr Assoc. 2013 Sep;57(3):243-50.

Association between heart rate variability and manual pulse rate.

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Assistant Director of Research, Sherman College of Chiropractic, P.O. Box 1452, Spartanburg, SC 29304, , Ext. 232, Email:


in English, French


One model for neurological assessment in chiropractic pertains to autonomic variability, tested commonly with heart rate variability (HRV). Since HRV may not be convenient to use on all patient visits, more user-friendly methods may help fill-in the gaps. Accordingly, this study tests the association between manual pulse rate and heart rate variability. The manual rates were also compared to the heart rate derived from HRV.


Forty-eight chiropractic students were examined with heart rate variability (SDNN and mean heart rate) and two manual radial pulse rate measurements. Inclusion criteria consisted of participants being chiropractic students. Exclusion criteria for 46 of the participants consisted of a body mass index being greater than 30, age greater than 35, and history of: a) dizziness upon standing, b) treatment of psychiatric disorders, and c) diabetes. No exclusion criteria were applied to the remaining two participants who were also convenience sample volunteers. Linear associations between the manual pulse rate methods and the two heart rate variability measures (SDNN and mean heart) were tested with Pearson's correlation and simple linear regression.


Moderate strength inverse (expected) correlations were observed between both manual pulse rate methods and SDNN (r = -0.640, 95% CI -0.781, -0.435; r = -0.632, 95% CI -0.776, -0.425). Strong direct (expected) relationships were observed between the manual pulse rate methods and heart rate derived from HRV technology (r = 0.934, 95% CI 0.885, 0.962; r = 0.941, 95% CI 0.897, 0.966).


Manual pulse rates may be a useful option for assessing autonomic variability. Furthermore, this study showed a strong relationship between manual pulse rates and heart rate derived from HRV technology.


adjustment; chiropractic; heart rate; manipulation; pulse rate

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