Physiotherapy (PhD) / Φυσικοθεραπεία (PhD)

Introduction: Neurodynamic techniques (NDTs), such as sliders and tensioners, are used in manual therapy to relieve pain and enhance function, however their effects on the sympathetic nervous system (SNS) remain unexplored. Objective: This study aimed to evaluate the effects of slider and tensioner NDTs on SNS activity in asymptomatic individuals and assess their effect in modulating autonomic responses. Methods: A double-blind randomized controlled trial with 90 healthy participants randomised into slider, tensioner, or control groups. Skin conductance (SC) was continuously monitored during a 20-minute intervention. Blood pressure, SC, body temperature (BT) and heart rate (HR) were assessed pre- and postintervention. Data were analysed using 2-way ANOVA. Results: Both slider and tensioner NDTs significantly increased SC compared to the control group for the left leg (slider: mean ± standard deviation: 2.34 ± 0.15 μS, tensioner: 2.56 ± 0.12 μS, control: 1.12 ± 0.10 μS; p < 0.001) and the right leg (slider: 2.27 ± 0.18 μS, tensioner: 2.38 ± 0.13 μS, control: 1.08 ± 0.11 μS; p < 0.001). No significant difference in SC was observed between the left and right legs within any group (p > 0.05). HR showed no significant difference between groups during the intervention phase (p = 0.54). BT and systolic blood pressure (SBP) showed no significant difference between groups (p > 0.68). Diastolic blood pressure (DBP) was significantly higher in the control group compared to the intervention groups (slider: 72.3 ± 4.5 mmHg; tensioner: 71.9 ± 5.1 mmHg; control: 78.1 ± 3.9 mmHg; p < 0.05). Conclusions: Both slider and tensioner NDTs elicited significant sympathoexcitatory responses, confirming their efficacy in modulating the SNS, with the tensioner NDT showing a greater effect size. BT, HR and SBP showed no change. These findings suggest both techniques may enhance autonomic regulation. Further research is needed to explore biochemical and long-term effects, providing evidence to support clinical decision-making and their application in symptomatic populations.