A Preliminary Clinical Trial

Roger M. Engel, DO, DC, PhD

Journal of Manipulative and Physiological Therapeutics: Volume 36, Issue 8 , Pages 490-496, October 2013

Abstract
Objective
The purpose of this preliminary study was to demonstrate the feasibility of a study that measures the short-term effects of a course of manual therapy (MT) and exercise (Ex) in people with moderate chronic obstructive pulmonary disease (COPD).

Methods
Fifteen participants (9 males; mean age, 56.1 years), with moderate COPD (mean % predicted forced expiratory volume in the first second [FEV1% predicted], 61.8%), were randomly allocated to 1 of 3 groups: soft tissue therapy only (ST); ST and spinal manipulation (SM); or ST, SM, and Ex. The intervention continued for 4 weeks. Outcome measures included FEV1, forced vital capacity (FVC), chronic respiratory questionnaire (CRQ-SAS) scores, distance walked in a 6-minute walking test, and monitoring for adverse events.

Results
There was an increase in FVC for the SM + ST + Ex group compared with ST only and ST + SM (1.01 and 1.00 L, respectively). Distance walked increased in the ST + SM and ST + SM + Ex groups compared with ST only (120.0 and 168.0 m, respectively). Dyspnea levels decreased in the ST + SM and ST + SM + Ex groups compared with ST only (0.64 and 0.44, respectively). There were no major or moderate adverse events reported following ST or SM interventions.

Conclusions
For this small group of patients, combining MT with Ex produced short improvements in FVC, distance walked, and dyspnea levels, with no major or moderate adverse events. This preliminary study showed that a larger study evaluating the clinical outcomes of MT for people with moderate COPD appears feasible.

Journal Abstract Online:  http://www.jmptonline.org/article/S0161-4754(13)00198-X/abstract