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Medium term effects of including manual therapy in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD): a randomized controlled pilot trial.
J Man Manip Ther. 2016 May; 24(2):80-9.JM

Abstract

STUDY DESIGN

Randomized clinical trial.

OBJECTIVE

To investigate the effect of including manual therapy (MT) in a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD).

BACKGROUND

The primary source of exercise limitation in people with COPD is dyspnea. The dyspnea is partly caused by changes in chest wall mechanics, with an increase in chest wall rigidity (CWR) contributing to a decrease in lung function. As MT is known to increase joint mobility, administering MT to people with COPD carries with it the potential to influence CWR and lung function.

METHODS

Thirty-three participants with COPD, aged between 55 and 70 years (mean = 65·5±4 years), were randomly assigned to three groups: pulmonary rehabilitation (PR) only, soft tissue therapy (ST) and PR, and ST, spinal manipulative therapy (SM), and PR. Outcome measures including forced expiratory volume in the 1st second (FEV1), forced vital capacity (FVC), 6-minute walking test (6MWT), St. George's respiratory questionnaire (SGRQ), and the hospital anxiety and depression (HAD) scale were recorded at 0, 8, 16, and 24 weeks.

RESULTS

There was a significant difference in FVC between the three groups at 24 weeks (P = 0·04). For the ST+SM+PR group versus PR only the increase was 0·40 l (CI: 0·02, 0·79; P = 0·03). No major or moderate adverse events (AE) were reported following the administration of 131 ST and 272 SM interventions.

DISCUSSION

The increase in FVC is a unique finding. Although the underlying mechanisms responsible for this outcome are not yet understood, the most likely explanation is the synergistic effect resulting from the combination of interventions. These results support the call for a larger clinical trial in the use of MT for COPD.

Authors+Show Affiliations

Department of Chiropractic, Macquarie University, North Ryde, Sydney, NSW, Australia.Southcare, Sutherland Hospital, Sydney, NSW, Australia.Department of Statistics, Macquarie University, Sydney, NSW, Australia.Faculty of Science, Macquarie University, North Ryde, Sydney, NSW, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27559277

Citation

Engel, Roger Mark, et al. "Medium Term Effects of Including Manual Therapy in a Pulmonary Rehabilitation Program for Chronic Obstructive Pulmonary Disease (COPD): a Randomized Controlled Pilot Trial." The Journal of Manual & Manipulative Therapy, vol. 24, no. 2, 2016, pp. 80-9.
Engel RM, Gonski P, Beath K, et al. Medium term effects of including manual therapy in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD): a randomized controlled pilot trial. J Man Manip Ther. 2016;24(2):80-9.
Engel, R. M., Gonski, P., Beath, K., & Vemulpad, S. (2016). Medium term effects of including manual therapy in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD): a randomized controlled pilot trial. The Journal of Manual & Manipulative Therapy, 24(2), 80-9. https://doi.org/10.1179/2042618614Y.0000000074
Engel RM, et al. Medium Term Effects of Including Manual Therapy in a Pulmonary Rehabilitation Program for Chronic Obstructive Pulmonary Disease (COPD): a Randomized Controlled Pilot Trial. J Man Manip Ther. 2016;24(2):80-9. PubMed PMID: 27559277.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medium term effects of including manual therapy in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD): a randomized controlled pilot trial. AU - Engel,Roger Mark, AU - Gonski,Peter, AU - Beath,Ken, AU - Vemulpad,Subramanyam, PY - 2016/8/26/entrez PY - 2016/8/26/pubmed PY - 2016/8/26/medline KW - COPD KW - Chronic obstructive pulmonary disease KW - Manual therapy KW - Pulmonary rehabilitation KW - Spinal manipulation SP - 80 EP - 9 JF - The Journal of manual & manipulative therapy JO - J Man Manip Ther VL - 24 IS - 2 N2 - STUDY DESIGN: Randomized clinical trial. OBJECTIVE: To investigate the effect of including manual therapy (MT) in a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD). BACKGROUND: The primary source of exercise limitation in people with COPD is dyspnea. The dyspnea is partly caused by changes in chest wall mechanics, with an increase in chest wall rigidity (CWR) contributing to a decrease in lung function. As MT is known to increase joint mobility, administering MT to people with COPD carries with it the potential to influence CWR and lung function. METHODS: Thirty-three participants with COPD, aged between 55 and 70 years (mean = 65·5±4 years), were randomly assigned to three groups: pulmonary rehabilitation (PR) only, soft tissue therapy (ST) and PR, and ST, spinal manipulative therapy (SM), and PR. Outcome measures including forced expiratory volume in the 1st second (FEV1), forced vital capacity (FVC), 6-minute walking test (6MWT), St. George's respiratory questionnaire (SGRQ), and the hospital anxiety and depression (HAD) scale were recorded at 0, 8, 16, and 24 weeks. RESULTS: There was a significant difference in FVC between the three groups at 24 weeks (P = 0·04). For the ST+SM+PR group versus PR only the increase was 0·40 l (CI: 0·02, 0·79; P = 0·03). No major or moderate adverse events (AE) were reported following the administration of 131 ST and 272 SM interventions. DISCUSSION: The increase in FVC is a unique finding. Although the underlying mechanisms responsible for this outcome are not yet understood, the most likely explanation is the synergistic effect resulting from the combination of interventions. These results support the call for a larger clinical trial in the use of MT for COPD. SN - 1066-9817 UR - https://www.unboundmedicine.com/medline/citation/27559277/Medium_term_effects_of_including_manual_therapy_in_a_pulmonary_rehabilitation_program_for_chronic_obstructive_pulmonary_disease__COPD_:_a_randomized_controlled_pilot_trial_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27559277/ DB - PRIME DP - Unbound Medicine ER -
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