Prospective Effects of Manual Diaphragmatic Release and Thoracic Lymphatic Pumping in Childhood Asthma.

Abstract

Manual noninvasive respiratory techniques have traditionally been used to treat respiratory pathologies. The aim of this study was to analyze the effects of the diaphragmatic release technique and the thoracic lymphatic pump technique versus conventional respiratory retraining in children with asthma. Using a quasi-experimental design, 60 children with asthma were allocated to undergo the diaphragmatic release technique (n = 20), thoracic lymphatic pump technique (n = 20), or conventional respiratory retraining (n = 20) in this study. Serum immunoglobulin E levels, diaphragmatic mobility, pulmonary function, and P(A-a)O2 were assessed before and after 12 treatment sessions that were conducted over nonconsecutive days in a 4-week program. After 12 treatments, the changes in the serum immunoglobulin E level for each group was not significantly different from the other groups. Compared with conventional respiratory retraining, the diaphragmatic release technique was associated with a significant improvement in FVC (P = .001) and FEV1 (P = .002); the thoracic lymphatic pump technique showed no differences. With regard to diaphragmatic mobility, both the diaphragmatic release technique and the thoracic lymphatic pump technique yielded significantly favorable effects when compared with conventional respiratory retraining (P < .001 and P = .01, respectively). Further, no significant between-group differences were detected in terms of the P(A-a)O2 (P = .07). The thoracic lymphatic pump technique and conventional respiratory retraining approaches were helpful interventions that could be used to alleviate the symptoms of childhood asthma. Nevertheless, the diaphragmatic release technique was a potentially more effective intervention.