title: The effect of combining manual therapy with exercise on the respiratory function of normal individuals: a randomized control trial.
abstract: OBJECTIVE
  The objective of this study was to explore the effect of combining manual therapy with exercise on respiratory function in normal individuals.
  
  
  METHODS
  The study design was a randomized control trial. Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were measured in 20 healthy, nonsmoking individuals before and after 3 interventions: exercise only, chiropractic manual therapy only, and manual therapy followed by exercise. The participants, 18 to 28 years of age, were randomly allocated to a control and 3 intervention groups. Each participant underwent 6 sessions of interventions over a 4-week period.
  
  
  RESULTS
  The exercise only group showed a significant decrease in FVC (P = .002, generalized linear model [GLM]) and FEV1 readings (P = .0002, GLM). The manual therapy only group showed a significant increase in FVC (P = .000, GLM) and FEV1 (P = .001, GLM). The group that received both manual therapy and exercise showed increases in FVC and FEV1 immediately after manual therapy followed by an additional increase after exercise. The overall increase in this group was not statistically significant. Participants in the control group showed no change in FVC or FEV(1).
  
  
  CONCLUSIONS
  Manual therapy appears to increase the respiratory function of normal individuals. The potential for this intervention administered before exercise to permit additional tolerance within the respiratory system that could allow an extended exercise program than was previously possible is discussed.
authors.affiliation: Department of Health and Chiropractic, Macquarie University, Sydney, New South Wales 2109, Australia. rengel@els.mq.edu.au
authors.forename: Roger M
authors.initials: RM
authors.lastname: Engel
authors.forename: Subramanyam
authors.initials: S
authors.lastname: Vemulpad
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D012119:Respiration; D012129:Respiratory Function Tests