Immediate effects of osteopathic manipulative treatment in elderly patients with chronic obstructive pulmonary disease.
BACKGROUND
Osteopathic manipulative treatment (OMT) has long been advocated for patients with respiratory disorders, but little definitive evidence exists to support its use in this population.


OBJECTIVE
To investigate the immediate effect of OMT on pulmonary function parameters in elderly subjects with chronic obstructive pulmonary disease.


METHODS
Subjects aged 65 years or older with a forced expiratory volume in 1 second to forced vital capacity ratio of less than 70% were recruited and randomly assigned to receive either OMT or sham therapy. The OMT protocol consisted of seven standardized osteopathic manipulative techniques, while the sham therapy protocol comprised light touch applied to the same anatomic regions and for the same duration (20 min). All subjects received baseline and posttreatment pulmonary function testing. A telephone survey was conducted 1 day after the intervention to collect subjective feedback and assess the success of blinding protocols.


RESULTS
Of the 35 study participants, 18 were randomly assigned to the OMT group and 17 to the sham group. Compared with the sham group, the OMT group showed a statistically significant decrease in the forced expiratory flow at 25% and 50% of vital capacity and at the midexpiratory phase; the expiratory reserve volume; and airway resistance. The OMT group also had a statistically significant increase in the residual volume, total lung capacity, and the ratio of those values compared with the sham group. Most subjects (82%, OMT group; 65%, sham group) reported breathing better after receiving their treatment. Only 53% of subjects in the OMT group and 41% in the sham group correctly guessed their group assignment.


CONCLUSIONS
Results suggest an overall worsening of air trapping during the 30 minutes immediately following one multitechnique OMT session relative to the sham group.
Noll
Donald R
DR
Department of Internal Medicine, Kirksville (Mo) College of Osteopathic Medicine-A.T. Still University, USA. dnoll@vcom.vt.edu
Degenhardt
Brian F
BF
Johnson
Jane C
JC
Burt
Selina A
SA
D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D026301:Manipulation, Osteopathic; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*; D012129:Respiratory Function Tests