Manual therapy for chronic obstructive airways disease: A systematic review of current evidence

Abstract Chronic obstructive pulmonary disease (COPD) is a growing global problem. Despite mounting evidence of significant co morbidity including musculoskeletal changes, evidenced based non pharmacological management approaches are limited to smoking cessation and pulmonary rehabilitation. Existin...

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Bibliographic Details
Published in:Manual therapy 2012-12, Vol.17 (6), p.507-518
Main Authors: Heneghan, Nicola R, Adab, Peymane, Balanos, George M, Jordan, Rachel E
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Chronic obstructive pulmonary disease
COPD
Disease Management
Dyspnea - therapy
Evidence-Based Medicine
Exercise Therapy
Female
Humans
Lung - physiopathology
Male
Manipulation, Osteopathic
Manual therapy
Massage
Middle Aged
Muscle Stretching Exercises
Musculoskeletal manipulation
Physical Medicine and Rehabilitation
Pulmonary Disease, Chronic Obstructive - diagnosis
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary Disease, Chronic Obstructive - therapy
Respiratory Function Tests
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Summary:Abstract Chronic obstructive pulmonary disease (COPD) is a growing global problem. Despite mounting evidence of significant co morbidity including musculoskeletal changes, evidenced based non pharmacological management approaches are limited to smoking cessation and pulmonary rehabilitation. Existing evidence suggests manual therapy may be beneficial in the management of COPD. A systematic review was conducted of key databases up until May 2010. Studies were included if they were RCTs or pre/post study designs testing an MT intervention and included a physiological measure of lung function. Descriptive results were collated. Pooling of data and meta-analysis was not possible due to heterogeneity in key characteristics. From 3086 articles 24 full text articles were evaluated, resulting in 7 included studies (5 RCTs, 2 pre-post studies) from 2 countries. Of all COPD subjects ( n  = 131) interventions included; osteopathic manipulative therapy (OMT) ( n  = 100), massage ( n  = 5), muscle stretching ( n  = 14), and passive movements ( n  = 12). Of the 7 included studies, 6 had high risk of bias with many design/reporting faults, with only one OMT study ( n  = 25) being evaluated as low risk of bias. In this study, performance based measures of pulmonary function (FEV1, FVC) changed minimally (
ISSN:1356-689X
1532-2769
DOI:10.1016/j.math.2012.05.004