Chronic obstructive pulmonary disease, or COPD, is significant contributor to the burden of disease in many countries. In Australia alone, 14.5% of Australians over age 40 suffer from a limitation of airflow in their lungs. This increases to 29.2% of Australians over the age of 75. It is the “second leading cause of avoidable hospital admissions and a leading cause of death and disease burden after heart disease, stroke and cancer [1].”
The causes of COPD can include anything from cigarette smoking, asthma, passive smoking and exposure to environmental pollutants and chemicals [1] to name a few, and to date there is no cure. However, a recent study published in the International Journal of Chronic Obstructive Pulmonary Disease, reveals an interesting therapeutic possibility.
It appears that a single application of a soft tissue manual therapy protocol may have the potential to produce “immediate and clinically meaningful improvements in lung function in patients with severe and very severe COPD [2].”
The study, undertaken in Chile, looked across 300 patient records but only found 12 who fit the exclusion criteria (demanding medical stability with no exacerbations in the previous 2 months, and severe or very severe COPD). The trial used a soft-tissue manual therapy protocol that consisted of seven pre-determined soft tissue techniques [2].
The authors wrote:
“Results from this study show that a single application of a soft tissue MT protocol designed to address the soft tissues of the chest wall has the potential to produce immediate improvements in lung function in patients with severe and very severe COPD. Furthermore, the reduction in RV [residual volume] may prove to be clinically relevant as it was above the threshold for minimal important difference.”
The results from the intervention included [2]:
- a decrease in heart rate from 83.8±14.1 beats per minute pre-intervention to 76.5±15.3 bpm post-intervention
- a decreased respiratory rate from 20.4±4.3 respirations per minute pre-intervention to 15.7±3.8 rpm post-intervention and;
- Oxygen saturation increased from 92.8%±2.8% pre-intervention to 95.8%±2.4% post-intervention.
While the study was only a small one and certainly not without it’s limitations, it does represent interesting development in the case for manual therapies to be considered for this particular disease.
Previous research has looked at immediate improvements in lung function after manual therapy and thoracic mobilisation [3]. Results from that study do indeed line up with this one, despite different modalities used.
As it stands, further research is required, but it’s worth noting that clinically significant results can be reaped from the use of manual therapies in COPD. For more information, including the specific protocol used, check out the full report.
References
[1] Staff Writer (2016), “COPD: The Statistics,” The Lung Foundation Australia, http://lungfoundation.com.au/health-professionals/clinical-resources/copd/copd-the-statistics/ retrieved 9 March 2017
[2] Cruz-Montecinos C, Godoy-Olave D, Contreras-Briceno F, Gutierrez P, Torress-Castro R, Miret-Venegas L, Engel R (2017), “The immediate effect of softi tissue manual therapy intervention on lung function in severe chronic obstructive pulmonary disease,” International Journal of Chronic Obstructive Pulmonary Disease, Feb 21;12:691-696. doi: 10.2147/COPD.S127742. eCollection 2017, https://www.dovepress.com/the-immediate-effect-of-soft-tissue-manual-therapy-intervention-on-lun-peer-reviewed-article-COPD retrieved 9 March 2017
[3] Yelvar GDY, Çirak Y, Demir YP, Dalkilinç M, Bozkurt B. Immediate effect of manual therapy on respiratory functions and inspiratory muscle strength in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:1353–1357.
