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Effects of Osteopathic Manual Therapy on Hyperinflation in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Cross-Over Study

  • M. Maskey-Warzechowska
  • M. Mierzejewski
  • K. GorskaEmail author
  • R. Golowicz
  • L. Jesien
  • R. Krenke
Chapter
Part of the Advances in Experimental Medicine and Biology book series

Abstract

Osteopathic manual therapy (OMT) may reduce hyperinflation in patients with chronic obstructive pulmonary disease (COPD) by improving breathing mechanics. The aim of the study was to evaluate the immediate effects of OMT on hyperinflation in stable COPD patients with forced expired volume in 1 s (FEV1) <50% predicted. Nineteen COPD patients of the median age 68 (IQR 63–72) years and the median FEV1 39.8 (IQR 33.4–46.6) % predicted were enrolled into the study. For the first session, patients were randomly assigned to either OMT or sham therapy. During the second session, the two groups of patients were crossed over. Pulmonary function and dyspnea were compared before and after both procedures. Neither pulmonary function nor dyspnea differed significantly before and after OMT or sham procedures. However, 36.7% and 47.4% patients achieved the minimally important difference for residual volume (RV) reduction after both OMT and sham therapy, respectively. Responders to OMT had a greater median (IQR) baseline sense of dyspnea compared to non-responders, assessed on a visual analog scale, of 7.0 (4.5–7.0) vs. 3.0 (0.0–5.0), p = 0.040, respectively. Although OMT did not have an immediate effect on hyperinflation or dyspnea, a subgroup experienced a reduction in RV following OMT and sham therapy. Future studies are needed to identify the characteristics of responders.

Keywords

Airway obstruction COPD Dyspnea Hyperinflation Osteopathic therapy Pulmonary function Residual volume 

Notes

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The project was approved by the institutional Bioethics Committee of the Medical University of Warsaw in Poland and it was registered at ClinicalTrial.gov (NCT02755363).

Informed Consent

Written informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • M. Maskey-Warzechowska
    • 1
  • M. Mierzejewski
    • 1
  • K. Gorska
    • 1
    Email author
  • R. Golowicz
    • 2
  • L. Jesien
    • 2
  • R. Krenke
    • 1
  1. 1.Department of Internal Medicine, Pulmonary Diseases and AllergyMedical University of WarsawWarsawPoland
  2. 2.Flanders International College of OsteopathyWarsawPoland

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