Background Manual therapy, as a non-invasive treatment applied to the body surface, can release local fascia, relieve tension, promote blood circulation, and regulate physiological and pathological states. It has been widely used in the rehabilitation of various conditions, such as chronic pain and movement disorders. However, comprehensive evidence on the effectiveness of manual therapy for adults' psychological and physiological health is still lacking. This study aimed to evaluate the effects of manual therapy interventions on adults' physical and mental health through a systematic review and meta-analysis. Methods Up to November 1, 2025, we searched four databases—PubMed, Web of Science, the Cochrane Library, and Embase. Only randomized controlled trials were included to assess the effects of manual therapy on adults' physical activity, psychological status, and related outcomes. Outcomes included changes in clinical symptoms, systolic blood pressure, diastolic blood pressure, anxiety and depressive symptoms, and others. Quantitative analyses were conducted using Review Manager, and results were presented with forest plots. Publication bias was assessed using funnel plots and Egger's test. Risk of bias was evaluated with the Cochrane RoB 2.0 tool, and overall certainty of evidence was assessed using the GRADE approach. Results A total of 88 studies involving 5,524 participants were included. Manual therapy interventions were mainly categorized into three types: massage therapy, reflexology, and joint mobilization. Compared with controls, participants receiving manual therapy showed a reduction in clinical symptoms such as pain (VAS decreased by 16.01; 95% CI: −19.35 to −12.68; p 0.00001), systolic blood pressure (decreased by 3.91 mmHg; 95% CI: −4.63 to −3.18; p 0.00001), heart rate (decreased by 4.20 beats/min; 95% CI: −6.09 to −2.30; p 0.0001), respiratory rate (decreased by 0.85 breaths/min; 95% CI: −1.34 to −0.35; p = 0.0009), Pittsburgh Sleep Quality Index score (decreased by 4.06; 95% CI: −5.43 to −2.78; p 0.00001), and State–Trait Anxiety Inventory score (decreased by 9.68; 95% CI: −14.17 to −5.19; p 0.0001). Other outcomes, including depressive symptoms, quality of life, and physiological indicators such as cortisol, also improved. Conclusion This study provides preliminary evidence that manual therapy may help improve clinical symptoms, health-related indicators, and psychological status in adult patients, thereby enhancing overall quality of life. However, in light of the limitations of the current evidence, we cautiously suggest that, when aligned with patient preferences, manual therapy may be considered as an adjunctive option within comprehensive diagnostic and therapeutic strategies. Systematic review registration PROSPERO CRD420251244910.
Mo et al. (Tue,) studied this question.
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