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In addition to reducing the sensitivity of muscle spindles or the segmental sites of a reflex pathway,1 spinal manipulation is thought to affect the neural outputs to both muscle and visceral organs by affecting both paraspinal muscle reflexes and motor neuron excitability.2 A new trial3 sought to determine the effect of spinal manipulative therapy upon both heart rate variability and baroflex sensitivity to add to the body of literature demonstrating the physiological effects of spinal manipulation.