title: The immediate effect of soft tissue manual therapy intervention on lung function in severe chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  In chronic obstructive pulmonary disease (COPD), accessory respiratory muscles are recruited as a compensatory adaptation to changes in respiratory mechanics. This results in shortening and overactivation of these and other muscles. Manual therapy is increasingly being investigated as a way to alleviate these changes. The aim of this study was to measure the immediate effect on lung function of a soft tissue manual therapy protocol (STMTP) designed to address changes in the accessory respiratory muscles and their associated structures in patients with severe COPD.
  
  
  METHODS
  Twelve medically stable patients (n=12) with an existing diagnosis of severe COPD (ten: GOLD Stage III and two: GOLD Stage IV) were included. Residual volume, inspiratory capacity and oxygen saturation (SpO2) were recorded immediately before and after administration of the STMTP. A Student'st-test was used to determine the effect of the manual therapy intervention (P<0.05).
  
  
  RESULTS
  The mean age of the patients was 62.4 years (range 46-77). Nine were male. Residual volume decreased from 4.5 to 3.9 L (P=0.002), inspiratory capacity increased from 2.0 to 2.1 L (P=0.039) and SpO2increased from 93% to 96% (P=0.001).
  
  
  CONCLUSIONS
  A single application of an STMTP appears to have the potential to produce immediate clinically meaningful improvements in lung function in patients with severe and very severe COPD.
authors.affiliation: Laboratory of Biomechanics and Kinesiology, San José Hospital, Santiago, Chile; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Unit of Kinesiology and Physical Therapy, San José Hospital, Santiago, Chile.
authors.forename: Carlos
authors.initials: C
authors.lastname: Cruz-Montecinos
authors.affiliation: Departamento de Kinesiología, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.
authors.forename: Diego
authors.initials: D
authors.lastname: Godoy-Olave
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Contreras-Briceño
authors.affiliation: Departamento de Kinesiología, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.
authors.forename: Paulina
authors.initials: P
authors.lastname: Gutiérrez
authors.affiliation: Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Torres-Castro
authors.affiliation: Unit of Kinesiology and Physical Therapy, San José Hospital, Santiago, Chile.
authors.forename: Leandro
authors.initials: L
authors.lastname: Miret-Venegas
authors.affiliation: Department of Chiropractic, Macquarie University, Sydney, Australia.
authors.forename: Roger M
authors.initials: RM
authors.lastname: Engel
mesh_terms: D000368:Aged; D002677:Chile; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012132:Respiratory Muscles / Q000503:physiopathology*; D012720:Severity of Illness Index; D064746:Therapy, Soft Tissue; D013997:Time Factors; D016896:Treatment Outcome
keywords: expiratory reserve volume; inspiratory capacity; plethysmography; residual volume