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The effect of combining manual therapy with exercise on the respiratory function of normal individuals: a randomized control trial [with consumer summary]
Engel RM, Vemulpad S
Journal of Manipulative and Physiological Therapeutics 2007 Sep;30(7):509-513
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The objective of this study was to explore the effect of combining manual therapy with exercise on respiratory function in normal individuals. METHODS: The study design was a randomized control trial. Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were measured in 20 healthy, nonsmoking individuals before and after 3 interventions: exercise only, chiropractic manual therapy only, and manual therapy followed by exercise. The participants, 18 to 28 years of age, were randomly allocated to a control and 3 intervention groups. Each participant underwent 6 sessions of interventions over a 4-week period. RESULTS: The exercise only group showed a significant decrease in FVC (p = 0.002, generalized linear model (GLM)) and FEV1 readings (p = 0.0002, GLM). The manual therapy only group showed a significant increase in FVC (p = 0.000, GLM) and FEV1 (p = 0.001, GLM). The group that received both manual therapy and exercise showed increases in FVC and FEV1 immediately after manual therapy followed by an additional increase after exercise. The overall increase in this group was not statistically significant. Participants in the control group showed no change in FVC or FEV1. CONCLUSIONS: Manual therapy appears to increase the respiratory function of normal individuals. The potential for this intervention administered before exercise to permit additional tolerance within the respiratory system that could allow an extended exercise program than was previously possible is discussed.
Reprinted from the Journal of Manipulative and Physiological Therapeutics with copyright permission from the National University of Health Sciences.

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