Cervicothoracic Spinal Manipulation, Autonomic and Psychological Response, and Pain-Mediated Quality of Life in Chronic Neck Pain with Forward Shoulder Posture: A Biopsychosocial Mechanism Analysis from a Randomized Controlled Trial
Background: Forward shoulder posture in chronic neck pain is associated with autonomic dysregulation, perceived stress, and reduced quality of life, yet randomized evidence on biopsychosocial mechanism is limited.Purpose: To characterize the autonomic, psychological, and quality-of-life response to adding cervicothorac...