Effectiveness of Chest Wall Mobilization Program in Improving Respiratory Function for Patients With COPD

NCT04122365 | Unknown DMC

• 1 other identifier: COPD Study
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Patients with severe COPD will be recruited from the Respiratory Outpatient Clinic of Kowloon Hospital. Baseline (pre-intervention) assessment for all recruited subjects will be conducted by one physiotherapist assessor who is blinded to the group allocation of the subject for respiratory function, musculoskeletal performance, physical performance and quality of life. Then, the subjects will be randomly allocated into either the intervention group with therapist-assisted chest wall mobilization exercises, low intensity walking exercise, home exercises and education sessions or the control group with low intensity walking exercise, home exercises and education sessions. The intervention program will last for 6 weeks with 2 sessions / week (i.e. a total of 12 sessions) in accordance to the recommendation for exercise training programs for patients with COPD by the American College of Sports Medicine. Post-program evaluation will be conducted upon program completion at 6 week. A follow-up session on 3 month after the completion of the program will be carried out to evaluate the cumulative effect of the chest wall mobilization program on respiratory function, musculoskeletal performance, exercise performance and quality of life of the patients.

Conditions

COPD

Keywords

Chest Wall Mobilization Program; Respiratory Function

Outcome Measures

Primary Outcomes (2)

• Lung Function

  FEV1, FVC and Ratio

  4.5 months

• Respiratory Muscles Function

  Maximum Inspiratory Pressure, Maximum Expiratory Pressure

  4.5 months

Secondary Outcomes (8)

• Cervical and Thoracic Range of Movement

  4.5 months

• Cervical and Respiratory Muscles Activity

  4.5 months

• Respiratory Muscle Oxygenation

  4.5 months

• Thoracic Excursion

  4.5 months

• Six-Minute Walk Test

  4.5 months

Study Arms (2)

Interventional group

EXPERIMENTAL

Chest Wall Mobilization Program

Other: Chest Wall Mobilization Program

Control Group

OTHER

Routine limbs exercises and education

Other: Control

Interventions

Chest Wall Mobilization Program OTHER

Soft tissue therapy and joints mobilization

Interventional group

Control OTHER

Routine limbs exercises and education

Control Group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• \. COPD patients in out-patient setting: Patients with FEV1/FVC \< 0.70 and
• GOLD stage III ( Severe) :
• % \< or = FEV1 \< 50% predicted
• \*GOLD - Global Initiative for Chronic Obstructive Lung Disease
• \. Ambulatory
• \. Able to communicate
• \. Competent to give written consent

You may not qualify if:

• Contraindications to chest wall mobilization:
• Severe and unstable rib fracture
• Metastasis bone cancer
• Tuberculosis spondylitis
• Severe osteoporosis
• Hospitalization due to acute exacerbation of COPD in recent 1 month
• Current Smoker

Sponsors & Collaborators

• The Hong Kong Polytechnic University: lead

Study Sites (1)

Kowloon Hospital

Kowloon, 000, Hong Kong

RECRUITING

Related Publications (15)

• Balady, G.J., Berra, K.A., Golding, L.A., Gordan, N.F., Mahler, D,A., Myers, J.N., & Sheldahl, L.M. (2017). ACSM's Guidelines for Exercise Testing and Prescription. Philadelphia: Lippincott Williams & Wilkins.

  BACKGROUND

• de Sa RB, Pessoa MF, Cavalcanti AGL, Campos SL, Amorim C, Dornelas de Andrade A. Immediate effects of respiratory muscle stretching on chest wall kinematics and electromyography in COPD patients. Respir Physiol Neurobiol. 2017 Aug;242:1-7. doi: 10.1016/j.resp.2017.03.002. Epub 2017 Mar 10.

  PMID: 28286249 BACKGROUND

• Duiverman ML, de Boer EW, van Eykern LA, de Greef MH, Jansen DF, Wempe JB, Kerstjens HA, Wijkstra PJ. Respiratory muscle activity and dyspnea during exercise in chronic obstructive pulmonary disease. Respir Physiol Neurobiol. 2009 Jun 30;167(2):195-200. doi: 10.1016/j.resp.2009.04.018. Epub 2009 May 3.

  PMID: 19406254 BACKGROUND

• Ekstrum, J.A., Lisa L. Black & Karen A. Paschal (2009). Effects of a Thoracic Mobility and Respiratory Exercise Program on Pulmonary Function and Functional Capacity in Older Adults. Physical & Occupational Therapy in Geriatrics, 27(4), 310-327.

  BACKGROUND

• Engel RM, Vemulpad SR, Beath K. Short-term effects of a course of manual therapy and exercise in people with moderate chronic obstructive pulmonary disease: a preliminary clinical trial. J Manipulative Physiol Ther. 2013 Oct;36(8):490-6. doi: 10.1016/j.jmpt.2013.05.028. Epub 2013 Sep 17.

  PMID: 24053900 BACKGROUND

• Engel RM, Vemulpad S. The effect of combining manual therapy with exercise on the respiratory function of normal individuals: a randomized control trial. J Manipulative Physiol Ther. 2007 Sep;30(7):509-13. doi: 10.1016/j.jmpt.2007.07.006.

  PMID: 17870419 BACKGROUND

• Engel R, Vemulpad S. The role of spinal manipulation, soft-tissue therapy, and exercise in chronic obstructive pulmonary disease: a review of the literature and proposal of an anatomical explanation. J Altern Complement Med. 2011 Sep;17(9):797-801. doi: 10.1089/acm.2010.0517. Epub 2011 Aug 12.

  PMID: 21838523 BACKGROUND

• Gosling, C., & Williams, K.A. (2004). Comparison of the effects of thoracic manipulation and rib raising on lung function of asymptomatic individuals. Journal of Osteopathic Medicine, 7, 103.

  BACKGROUND

• Heneghan NR, Adab P, Balanos GM, Jordan RE. Manual therapy for chronic obstructive airways disease: a systematic review of current evidence. Man Ther. 2012 Dec;17(6):507-18. doi: 10.1016/j.math.2012.05.004. Epub 2012 Jun 15.

  PMID: 22703901 BACKGROUND

• Heneghan, N., Adab, P., Jackman, S., & Balanos, G. (2015). Musculoskeletal dysfunction in chronic obstructive pulmonary disease (COPD): An observational study. International Journal of Therapy and Rehabilitation, 22(3), 119-128.

  BACKGROUND

• Kaneko H, Shiranita S, Horie J, Hayashi S. Reduced Chest and Abdominal Wall Mobility and Their Relationship to Lung Function, Respiratory Muscle Strength, and Exercise Tolerance in Subjects With COPD. Respir Care. 2016 Nov;61(11):1472-1480. doi: 10.4187/respcare.04742. Epub 2016 Oct 18.

  PMID: 27794081 BACKGROUND

• Kelzuyuki, Tabira, Sekikawa, Noriko, Iwashiro, Motoki, Kawato, Seiji, Sekikawa, Kiyokazu, Kawamata, Mikio, Oike, Takayuki. (2007). The immediate effect of chest mobilization tech. in patients of COPD. The Journal of Japanese Physical Therapy Association, 34(2), 59-64.

  BACKGROUND

• Leelarungrayub D, Pothongsunun P, Yankai A, Pratanaphon S. Acute clinical benefits of chest wall-stretching exercise on expired tidal volume, dyspnea and chest expansion in a patient with chronic obstructive pulmonary disease: a single case study. J Bodyw Mov Ther. 2009 Oct;13(4):338-43. doi: 10.1016/j.jbmt.2008.11.004. Epub 2009 Jan 29.

  PMID: 19761957 BACKGROUND

• Parmar, D., & Bhise, A. (2015). The immediate effect of Chest mobilization technique on chest expansion in patients of COPD with restrictive impairment. International Journal of Science and Research, 4(6), 2413-2416.

  BACKGROUND

• Putt MT, Watson M, Seale H, Paratz JD. Muscle stretching technique increases vital capacity and range of motion in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2008 Jun;89(6):1103-7. doi: 10.1016/j.apmr.2007.11.033.

  PMID: 18503806 BACKGROUND

MeSH Terms

Conditions

Pulmonary Disease, Chronic Obstructive; Respiratory Aspiration

Condition Hierarchy (Ancestors)

Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Respiration Disorders

Study Officials

• TSUI

  The Hong Kong Polytechnic University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

TSUI

CONTACT

852-60329857; yytsui_amy@yahoo.com.hk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 23, 2019
• First Posted: October 10, 2019
• Study Start: October 1, 2019
• Primary Completion: October 1, 2020
• Study Completion: June 1, 2021
• Last Updated: October 10, 2019

Record last verified: 2019-05

Data Sharing

• IPD Sharing: Will not share

Locations

HK (1)