Medical Rehabilitation of Patients with Chronic Obstructive Pulmonary Disease Using Manipulative Action Techniques

Nina Stepenovna Ayrapetova

doi:10.11648/j.rs.20180302.12

Abstract

This study was conducted to evaluate the efficiency of manipulative action techniques in complex treatment of patients with chronic obstructive pulmonary disease and represents the results of clinical and functional tests. Differentiated indications for use of different techniques of chest massage and manual therapy were proposed. Parallel group randomized prospective comparative study was conducted on 137 patients with COPD. In accordance with the classification (GOLD, 2013), all patients were diagnosed with COPD of medium severity. 75 (54.7%) patients had persistent disease, 80 (58.4%) and 57 (41.6%) patients suffered from respiratory insufficiency of I and II degree, respectively. Respiration function was assessed by pneumotachometry study performed during forced expiratory maneuvers and by spirometry methods; pulmonary hemodynamics and myocardial contractile function of the right ventricle were assessed by reopulmonography methods; central hemodynamics was assessed by tetrapolar thoracic rheography. The research led to the following overall findings. The massage technique focused on asymmetric areas of the chest develops the most active anti-inflammatory action as compared to other physical impact techniques we investigated. This technique should be used with caution in the presence of hypokinetic type of blood circulation and pulmonary hypertension. The classical massage technique of the chest has the advantage as we can consider the possibility to prescribe this technique to patients with more severe course of COPD, including but not limited to presence of pulmonary and systemic cardiac hemodynamic disorders, alveolar hypoxia.

Highlights

Significant increase in chronic obstructive pulmonary disease (COPD) prevalence, run up to 10.1% among individuals that are on the wrong side of forty, raise a reasonable concern
The intensive massage technique focused on asymmetric areas of the chest possesses the most active antiinflammatory action, as compared to other techniques of physical impact we have investigated
This technique should be used with caution in the presence of hypokinetic type of blood circulation and pulmonary hypertension

Summary

Introduction

Significant increase in chronic obstructive pulmonary disease (COPD) prevalence, run up to 10.1% among individuals that are on the wrong side of forty, raise a reasonable concern. COPD takes up the second place amongst noncommunicable disease and leads by such values like number of day of disability and invalidity. COPD is one and only disease associated with continued increasing mortality. All mentioned above set up an acute health and social significance in regard of new treatment and rehabilitative options development for this patient population [1,2,3,4]. Pursuant to pathogenesis of COPD, the key role pertains to inflammatory process which remains latent even at remission and triggering the bronchial obstruction development. With the aggravation of pathological process we observe the growth of pulmonary ventilation and respiratory metabolism disorders, development of pulmonary hypertension, chronic cor pulmonale.

Methods

Results

Conclusion