The effect of manual therapy on pulmonary function in healthy adults

Bradley A Wall, Jeremiah J Peiffer, Barrett Losco, Jeffrey J Hebert, Bradley A Wall, Jeremiah J Peiffer, Barrett Losco, Jeffrey J Hebert

Abstract

Manual therapy is suggested as a potentially therapeutic intervention that may improve pulmonary function. However, this form of therapy is largely based on clinical observations and hypothetical models rather than mechanistic knowledge. This study examined the influence of a single session of manual therapy applied to the thoracic spine and thorax on dynamic pulmonary function over an extended time frame in healthy adults. 21 healthy individuals (14 males) aged 19-35 (mean [SD] age = 23 [3.9], BMI [SD] = 22.97 [2.41]) completed one experimental testing session consisting of five pulmonary function tests and the delivery of a manual therapy intervention. Pulmonary function was measured at baseline and 1 minute, 10 minutes, 20 minutes and 30 minutes following the intervention. Baseline mean (SD) forced vital capacity (FVC), forced expired volume in 1 second (FEV1) and maximal voluntary ventilation (MVV) were 5.55(1.23 L), 4.64(0.92 L) and 165.7(40.0L min(-1)) respectively. The mean (SD) FEV1/FVC ratio was 0.84(0.07). There were no statistically significant changes in any of the pulmonary function measures following the manual therapy intervention. Our findings do not support the use of manual therapy to provide a short-term benefit in respiratory function to healthy adults.

References

    1. McGuiness J., Vicenzino B. & Wright A. Influence of a cervical mobilization technique on respiratory and cardiovascular function. Manual Therapy 2, 216–220, (1997).
    1. Engel R. & Vemulpad S. The Role of spinal manipulation, soft-tissue therapy, and exercise in chronic obstructive pulmonary disease : a review of the literature and proposal of an anatomical explanation. Journal of alternative and complementary medicine 17, 797–807 (2011).
    1. Dougherty P. E., Engel R. M., Vemulpad S. & Burke J. Spinal Manipulative Therapy for Elderly Patients With Chronic Obstructive Pulmonary Disease: A Case Series. J. Manipulative Physiol. Ther. 34, 413–417, (2011).
    1. Balon J. et al.. A Comparison of Active and Simulated Chiropractic Manipulation as Adjunctive Treatment for Childhood Asthma. New England Journal of Medicine 339, 1013–1020, 10.1056/NEJM199810083391501 (1998).
    1. Bockenhauer S. E., Julliard K. N., Lo K. S., Huang E. & Sheth A. M. Quantifiable effects of osteopathic manipulative techniques on patients with chronic asthma. Journal of the American Osteopathic Association 102, 371–375 (2002).
    1. Noll D. R., Degenhardt B. F., Johnson J. C. & Burt S. A. Immediate Effects of Osteopathic Manipulative Treatment in Elderly Patients With Chronic Obstructive Pulmonary Disease. JAOA: Journal of the American Osteopathic Association 108, 251–259 (2008).
    1. Engel R. M. & Vemulpad S. The Effect of Combining Manual Therapy with Exercise on the Respiratory Function of Normal Individuals: A Randomized Control Trial. J. Manipulative Physiol. Ther. 30, 509–513, (2007).
    1. Vicenzino B., Cartwright T., Collins D. & Wright A. Cardiovascular and respiratory changes produced by lateral glide mobilization of the cervical spine. Manual Therapy 3, 67–71, (98)80020-9 (1998).
    1. Harriss D. J. & Atkinson G. Ethical standards in sport and exercise science research: 2014 update. Int. J. Sports Med. 34, 1025–1028, 10.1055/s-0033-1358756 (2013).
    1. Cleland J. A., Childs J. D., McRae M., Palmer J. A. & Stowell T. Immediate effects of thoracic manipulation in patients with neck pain: a randomized clinical trial. Man. Ther. 10, 127–135, 10.1016/j.math.2004.08.005 (2005).
    1. Masaracchio M., Cleland J. A., Hellman M. & Hagins M. Short-term combined effects of thoracic spine thrust manipulation and cervical spine nonthrust manipulation in individuals with mechanical neck pain: a randomized clinical trial. J. Orthop. Sports Phys. Ther. 43, 118–127, 10.2519/jospt.2013.4221 (2013).
    1. Maitland G. D. Maitland’s vertebral manipulation/edited by Maitland Geoffrey D. et al.. 7th edn, (Elsevier Butterworth-Heinemann, 2005).
    1. Pellegrino R. et al.. Interpretative strategies for lung function tests. Eur. Respir. J. 26, 948–968, 10.1183/09031936.05.00035205 (2005).
    1. Humerfelt S., Eide G. E. & Gulsvik A. Association of years of occupational quartz exposure with spirometric airflow limitation in Norwegian men aged 30–46 years. Thorax 53, 649–655, 10.1136/thx.53.8.649 (1998).
    1. Koppenhaver S. L. et al.. Association Between Changes in Abdominal and Lumbar Multifidus Muscle Thickness and Clinical Improvement After Spinal Manipulation. J. Orthop. Sports Phys. Ther. 41, 389–399, 10.2519/jospt.2011.3632 (2011).
    1. Fritz J. M. et al.. Preliminary Investigation of the Mechanisms Underlying the Effects of Manipulation: Exploration of a Multivariate Model Including Spinal Stiffness, Multifidus Recruitment, and Clinical Findings. Spine 36, 1772–1781 10.1097/BRS.0b013e318216337d (2011).

Source: PubMed

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