title: Immediate effect of manual therapy on respiratory functions and inspiratory muscle strength in patients with COPD.
abstract: OBJECTIVE
  The objective of this study was to investigate the immediate effect of manual therapy (MT) on respiratory functions and inspiratory muscle strength in patients with COPD.
  
  
  METHODS
  Thirty patients with severe COPD (eight females and 22 males; mean age 62.4±6.8 years) referred to pulmonary physiotherapy were included in this study. The patients participated in a single session of MT to measure the short-term effects. The lung function was measured using a portable spirometer. An electronic pressure transducer was used to measure respiratory muscle strength. Heart rate, breathing frequency, and oxygen saturation were measured with a pulse oximeter. For fatigue and dyspnea perception, the modified Borg rating of perceived exertion scale was used. All measurements were taken before and immediately after the first MT session. The ease-of-breathing visual analog scale was used for rating patients' symptoms subjectively during the MT session.
  
  
  RESULTS
  There was a significant improvement in the forced expiratory volume in the first second, forced vital capacity, and vital capacity values (P<0.05). The maximal inspiratory pressure and maximal expiratory pressure values increased significantly after MT, compared to the pre-MT session (P<0.05). There was a significant decrease in heart rate, respiratory rate (P<0.05), and dyspnea and fatigue perception (P<0.05).
  
  
  CONCLUSIONS
  A single MT session immediately improved pulmonary function, inspiratory muscle strength, and oxygen saturation and reduced dyspnea, fatigue, and heart and respiratory rates in patients with severe COPD. MT should be added to pulmonary rehabilitation treatment as a new alternative that is fast acting and motivating in patients with COPD.
authors.affiliation: Department of Musculoskeletal Physiotherapy.
authors.forename: Gul Deniz
authors.initials: GD
authors.lastname: Yilmaz Yelvar
authors.affiliation: Department of Cardiopulmonary Physiotherapy.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Çirak
authors.affiliation: Department of Neurological Rehabilitation, School of Physiotherapy and Rehabilitation.
authors.forename: Yasemin Parlak
authors.initials: YP
authors.lastname: Demir
authors.affiliation: Department of Musculoskeletal Physiotherapy.
authors.forename: Murat
authors.initials: M
authors.lastname: Dalkilinç
authors.affiliation: Department of Respiratory Medicine, Faculty of Medicine, Turgut Özal University, Ankara, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Bozkurt
mesh_terms: D000368:Aged; D004417:Dyspnea / Q000503:physiopathology / Q000534:rehabilitation; D005260:Female; D005541:Forced Expiratory Volume; D006339:Heart Rate; D006801:Humans; D001239:Inhalation; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D026201:Musculoskeletal Manipulations / Q000379:methods*; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D012132:Respiratory Muscles / Q000503:physiopathology*; D012720:Severity of Illness Index; D013147:Spirometry; D016896:Treatment Outcome; D014797:Vital Capacity
keywords: COPD; fatigue; inspiratory muscle strength; manual therapy; pulmonary function dyspnea