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Review
. 2024 Jun 17;16(6):e62511.
doi: 10.7759/cureus.62511. eCollection 2024 Jun.

Manual Therapy Interventions in Patients With Chronic Obstructive Pulmonary Disease: A Comprehensive Narrative Review

Priyanka K Chilhate  1 , Lajwanti Lalwani  1
Affiliations
Review

Manual Therapy Interventions in Patients With Chronic Obstructive Pulmonary Disease: A Comprehensive Narrative Review

Priyanka K Chilhate et al. Cureus. .

Abstract

Chronic obstructive pulmonary disease (COPD) is a breathing problem with ongoing airflow issues and changes in how the chest moves. Different manual therapy methods, like releasing the diaphragm, manipulating the spine and joints, and treating soft tissues, have been used for people with COPD. This review looks into how these manual therapy approaches affect COPD patients. Articles were searched in Google Scholar, PubMed, and Elsevier using keywords such as COPD, manual therapy, thoracic excursion, and pulmonary function. Only studies conducted between 2015 and 2023, employing randomized controlled trials (RCTs), crossover RCTs, or comparative studies with COPD subjects, thoracic excursion, chest expansion, or pulmonary function tests (PFTs) as outcome measures, and involving physiotherapy interventions were included. Out of 82 articles searched, 10 met the inclusion criteria, comprising six RCTs, three crossover RCTs, and one comparative study. Data extraction was performed by one reviewer, encompassing intervention descriptions, inclusion/exclusion criteria, baseline data, and outcome values. The findings suggest that conventional physiotherapy combined with manual therapy techniques such as stretching, osteopathic manual therapy, manual diaphragmatic release, soft tissue therapy, and spinal manipulation have improved thoracic excursion and pulmonary function in COPD patients. Therefore, these manual therapy techniques are recommended for enhancing thoracic excursion and pulmonary function in COPD patients.

Keywords: copd; manual therapy; pulmonary function; respiratory muscle; thoracic excursion.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Diaphragmatic stretching
Image credit: [25]
Figure 2
Figure 2. Manual diaphragm release technique
Image credit: [26]
Figure 3
Figure 3. Spinal and rib manipulation
Image credit: [16] 1) Posrerior-anterior force; 2) Anterior-posterior force
Figure 4
Figure 4. Rib-raising technique variations
Image credit: [27] A) Supine position; B) Lateral recumbent positioning; C) Seated positioning
Figure 5
Figure 5. Lymphatic pump drainage
Image credit: [27] A) Thoracic lymphatic drainage; B) Peripheral lymphatic drainage
See this image and copyright information in PMC

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