Effects of additional manual therapy over inspiratory muscle training in patients with chronic obstructive pulmonary disease: A randomized controlled trial

Abstract

The benefits of inspiratory muscle training(IMT) in patients with chronic obstructive pulmonary disease(COPD) were reported.But in severe COPD patients, benefit from IMT may be limited.There is need for further research in new and complementary modalities to improve IMT efficiency in severe COPD patients.Manual therapy(MT) additional over IMT may be such a new approach that has not yet been investigated in COPD. Aims: To investigate effects of MT additional over IMT on functional capacity,respiratory muscle strength,pulmonary function,dyspnea, fatigue and quality of life in severe COPD patients. Methods: A prospective single-blind randomized trial.40 patients(62,4±6,8 years, FEV1 29,6±6,3%) with COPD in GOLD stage III-IV were included. Patients were randomly assigned to receive either MT additional over IMT at 40% of maximal inspiratory pressure(MIP)(n= 20) or only IMT(n= 20) for 12 weeks. MT group received MT during 12 weeks for 30 minutes additional to IMT. Pulmonary function using spirometry, respiratory muscle strength using mouth pressure device, functional capasity using six minute walk test, dyspnea using Modifiye Medical Resarh Council(MMRC) dyspnea scale, fatique using fatique severity scale and quality of life using St. George9s Respiratory Questionnaire(SGRQ) were evaluated. Results: 6MWT distance increased 71m in MT group and 39m in IMT group. MT group had significantly greater improvement in FEV1%,FVC%,PEF%, respiratory muscle strength,dyspnea,fatique and quality of life compared with IMT group(p Conclusions: MT additional over IMT may be an alternative method to improve IMT efficiency in severe COPD patients.