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Short-term effects of a course of manual therapy and exercise in people with moderate chronic obstructive pulmonary disease: a preliminary clinical trial [with consumer summary] |
Engel RM, Vemulpad SR, Beath K |
Journal of Manipulative and Physiological Therapeutics 2013 Oct;36(8):490-496 |
clinical trial |
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; 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 purpose of this preliminary study was to demonstrate the feasibility of a study that measures the short-term effects of a course of manual therapy (MT) and exercise (Ex) in people with moderate chronic obstructive pulmonary disease (COPD). METHODS: Fifteen participants (9 males; mean age 56.1 years), with moderate COPD (mean % predicted forced expiratory volume in the first second (FEV1% predicted), 61.8%), were randomly allocated to 1 of 3 groups: soft tissue therapy only (ST); ST and spinal manipulation (SM); or ST, SM, and Ex. The intervention continued for 4 weeks. Outcome measures included FEV1, forced vital capacity (FVC), chronic respiratory questionnaire (CRQ-SAS) scores, distance walked in a 6-minute walking test, and monitoring for adverse events. RESULTS: There was an increase in FVC for the SM+ST+Ex group compared with ST only and ST+SM (1.01 and 1.00 L, respectively). Distance walked increased in the ST+SM and ST+SM+Ex groups compared with ST only (120.0 and 168.0 m, respectively). Dyspnea levels decreased in the ST+SM and ST+SM+Ex groups compared with ST only (0.64 and 0.44, respectively). There were no major or moderate adverse events reported following ST or SM interventions. CONCLUSIONS: For this small group of patients, combining MT with Ex produced short improvements in FVC, distance walked, and dyspnea levels, with no major or moderate adverse events. This preliminary study showed that a larger study evaluating the clinical outcomes of MT for people with moderate COPD appears feasible.
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