title: Physical Therapy Treatment of Impaired Chest Mobility in Patients with Airway Sensory Hyperreactivity.
abstract: OBJECTIVE
  In sensory hyperreactivity (SHR), patients have symptoms from the airways and the chest induced by environmental irritants like scenting products and cigarette smoke. They are characterized by increased cough reaction to inhaled capsaicin compared with healthy controls. Lung function tests are normal, and asthma medications have no or little effect. In a recent published article, patients with SHR were found to have impaired chest mobility and increased pain sensitivity. The purpose of this study was to evaluate if a physiotherapeutic intervention can increase chest mobility in SHR, influence these patients' symptoms and reduce capsaicin cough sensitivity.
  
  
  METHODS
  Forty-one SHR patients were initially randomized in to groups, one for training and one for symptom registration in this controlled training study. It consisted of a daily training programme containing simple movements to increase the flexibility of the chest, a breathing exercise and a relaxation session as well as symptom registration. Chest expansion was measured with a measuring tape and thoracic and abdominal movement with light sensors. Pain sensitivity was assessed using pressure algometry and a standardized capsaicin inhalation threshold provocation-evaluated cough sensitivity.
  
  
  RESULTS
  Twenty seven patients were left for analyses after 12 weeks and 26 patients after 24 weeks. Chest mobility and upper thoracic respiratory movements improved (p < 0.01), feeling of chest pressure and the capsaicin cough sensitivity decreased (p < 0.01). The patients also showed of significantly lowered pain pressure thresholds measured with algometry, compared with healthy controls (p < 0.001).
  
  
  CONCLUSIONS
  Improvement of chest mobility after physiotherapeutic intervention indicates that these patients may have acquired a dysfunctional breathing pattern. The regular use of a training programme and structural breathing instructions can be used to improve chest mobility, chest symptoms and capsaicin cough sensitivity in patients with SHR and signs of dysfunctional breathing. Copyright © 2016 John Wiley & Sons, Ltd.
authors: Departments of Physiotherapy and Occupational Therapy, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden.
authors: Ewa-Lena
authors: EL
authors: Johansson
authors: Department of Internal Medicine/Respiratory Medicine and Allergology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Ewa
authors: E
authors: Ternestén-Hasseus
authors: Departments of Physiotherapy and Occupational Therapy, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden.
authors: Monika Fagevik
authors: MF
authors: Olsén
authors: Department of Internal Medicine/Respiratory Medicine and Allergology, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors: Eva
authors: E
authors: Millqvist
mesh_terms: D000328:Adult; D000368:Aged; D001985:Bronchial Provocation Tests; D002211:Capsaicin / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011788:Quality of Life; D012016:Reference Values; D012129:Respiratory Function Tests; D012130:Respiratory Hypersensitivity / Q000175:diagnosis* / Q000534:rehabilitation*; D012138:Respiratory Therapy / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013147:Spirometry / Q000379:methods; D013548:Sweden; D013909:Thorax / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D002211:Capsaicin
keywords: Physiotherapy; breathing exercises; home exercise