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Rehabil Res Pract. 2014;2014:898763. doi: 10.1155/2014/898763. Epub 2014 May 29.

Effects of posteroanterior thoracic mobilization on heart rate variability and pain in women with fibromyalgia.

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Department of Physical Therapy, School of Medicine, Federal University of Rio de Janeiro, 8° Floor 3 (8E-03), Prof Rodolpho Paulo Rocco Street, 21941-913 Rio de Janeiro, RJ, Brazil.
Physical Therapy Division, University of Brasília, QNN 14 Área Especial, Ceilândia Sul, 72220-140 Brasília, DF, Brazil.
Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois, 1919 W. Taylor Street (MC 898), Chicago, IL 60612, USA.
Healthy-School Unit, Federal University of Sao Carlos, 235 Km. Washington Luis Rodovia, 13565-905 Sao Carlos, SP, Brazil.
Laboratory of Cardiopulmonary Physiotherapy, Federal University of Sao Carlos, 235 Km. Washington Luis Rodovia, 13565-905 Sao Carlos, SP, Brazil.


Fibromyalgia (FM) has been associated with cardiac autonomic abnormalities and pain. Heart rate variability (HRV) is reduced in FM with autonomic tone dominated by sympathetic activity. The purpose of this study was to evaluate the effects of one session of a posteroanterior glide technique on both autonomic modulation and pain in woman with FM. This was a controlled trial with immediate followup; twenty premenopausal women were allocated into 2 groups: (i) women diagnosed with FM (n = 10) and (ii) healthy women (n = 10). Both groups received one session of Maitland mobilization grade III posteroanterior central pressure glide, at 2 Hz for 60 s at each vertebral segment. Autonomic modulation was assessed by HRV and pain by a numeric pain scale before and after the intervention. For HRV analyses, heart rate and RR intervals were recorded for 10 minutes. FM subjects demonstrated reduced HRV compared to controls. Although the mobilization technique did not significantly reduce pain, it was able to improve HRV quantified by an increase in rMSSD and SD1 indices, reflecting an improved autonomic profile through increased vagal activity. In conclusion, women with FM presented with impaired cardiac autonomic modulation. One session of Maitland spine mobilization was able to acutely improve HRV.

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