Abstract
Manual therapy is suggested as a potentially therapeutic intervention that may improve pulmonary function. However, this form of therapy is largely based on clinical observations and hypothetical models rather than mechanistic knowledge. This study examined the influence of a single session of manual therapy applied to the thoracic spine and thorax on dynamic pulmonary function over an extended time frame in healthy adults. 21 healthy individuals (14 males) aged 19–35 (mean [SD] age = 23 [3.9], BMI [SD] = 22.97 [2.41]) completed one experimental testing session consisting of five pulmonary function tests and the delivery of a manual therapy intervention. Pulmonary function was measured at baseline and 1 minute, 10 minutes, 20 minutes and 30 minutes following the intervention. Baseline mean (SD) forced vital capacity (FVC), forced expired volume in 1 second (FEV1) and maximal voluntary ventilation (MVV) were 5.55(1.23 L), 4.64(0.92 L) and 165.7(40.0L min−1) respectively. The mean (SD) FEV1/FVC ratio was 0.84(0.07). There were no statistically significant changes in any of the pulmonary function measures following the manual therapy intervention. Our findings do not support the use of manual therapy to provide a short-term benefit in respiratory function to healthy adults.
Highlights
Thoracic manual therapy is a widely used manipulative technique in clinical practice
This study examined the effect of a single session of manual therapy applied to the thoracic spine and thorax on pulmonary function in healthy individuals
It has been previously proposed that manipulative therapy may enhance joint mobility and subsequently, enhance static and or dynamic lung function[7]. This was not the case in the present study with our findings indicating that a single thoracic manual therapy treatment applied to the thoracic spine and thorax does not result in immediate or transient (30 minutes) changes in pulmonary function. These findings are in contrast to Engel and Vemulpad[7] who reported increases in forced vital capacity (FVC)/forced expired volume in 1 second (FEV1) lung function measures following nonspecific high-velocity low-amplitude manipulation of the lower cervical and thoracic spine, and the posterior articulations of the associated ribs in healthy individuals
Summary
Thoracic manual therapy is a widely used manipulative technique in clinical practice. Thoracic manual therapy has been suggested as a therapeutic intervention with the potential to improve respiratory function among healthy individuals[7], research supporting this claim is limited. With the majority of the literature using patients with existing respiratory system limitations[3,5], very few studies have looked at the impact thoracic manual therapy may have on respiratory function in healthy adults[7]. One such study has reported improved respiratory function following thoracic manual therapy, is constrained by several factors. The duration of the treatment effect of thoracic manual therapy on respiratory function can have practical implications regarding potential enhancement of respiratory muscle function in healthy individuals. No previous studies have looked at the time course of any potential physiological benefits elicited by spinal manipulative therapy
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