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Effect of selective manual therapy techniques in chronic obstructive pulmonary disease: a randomized control trial
Mohamed AS, El Sabbahi SA, Elkorashy RI, Grace MO
Journal of Taibah University Medical Sciences 2024 Nov;19(6):1087-1097
clinical trial
9/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: Yes; 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: 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). METHODS: 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. RESULTS: 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 5.21degree, kyphosis angle MD 3.1degree, anteroposterior (AP) chest expansion MD 1.08 cm, and lateral chest expansion MD 1.54 cm. CONCLUSION: 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.

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