Effect of selective manual therapy techniques in chronic obstructive pulmonary disease: A randomized control trial

To investigate the effect of selective manual therapy (MT) techniques on chest expansion, pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC ratio), craniovertebral angle (CVA), kyphosis angle, functional capacity, and dyspnea in patients with chronic obstructive pulmonary disease (COPD).

A parallel double-blinded randomized controlled trial involved 52 male subjects with a mean age of 56.23 ± 3.54. Patients were randomly assigned to two groups, each consisting of 26 subjects: the control group (A) received only conventional physical therapy, and the experimental group (B) received both MT and conventional physical therapy. Treatment was administered three times per week for 8 weeks. Chest expansion by chest caliper; FVC, FEV1, and FEV1/FVC ratio by spirometry; CVA and kyphosis angle by Kinovea software; functional capacity by the 6-min walk test (6MWT); and dyspnea by the modified Medical Research Council dyspnea index all were measured at baseline and after 8 weeks.

Prior to treatment, there was no statistically significant differences between the two groups in the between-group analyses (p > 0.05). After treatment,a statistically significant difference was found between both groups, with a predilection for the experimental group in FEV1 middle difference (MD) of 0.55 L, FVC MD = 0.39 L, FEV1/FVC% MD = 18.97, dyspnea MD = -2.58, 6MWT MD = 92.81 m, CVA MD = 5.21°, kyphosis angle MD = 3.1°, anteroposterior (AP) chest expansion MD = 1.08 cm, and lateral chest expansion MD = 1.54 cm.

The combination of MT approaches with conventional physical therapy leads to a clinically significant difference in AP chest expansion, FVC, FEV1, CVA, functional capacity, and dyspnea, and a statistically significant difference in kyphosis angle, FEV1/FVC%, and lateral chest expansion compared to using conventional physical therapy only in patients with COPD.