Efficacy of Osteopathic Manipulative Techniques in Patients With Chronic Obstructive Pulmonary Disease

NCT06865703 | Completed DMC

• 1 other identifier: Osteopathic Techniques in COPD
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

This study will test the efficiency of rib rising technique and thoracic lymphatic pump technique combining with manual diaphragmatic release technique in patients with chronic obstructive pulmonary disease

Conditions

Copd

Keywords

diaphragmatic release; rib raising; thoracic lymphatic pump

Outcome Measures

Primary Outcomes (2)

• Diaphragmatic Excursion

  ultrasonography device applied on chest and used to measure the vertical movement of diaphragm unite of measure is centimeter (cm)

  all assessment will be performed two times one pretreatment and will be repeated post treatment almost 2 months

• Diaphragmatic thickness

  ultrasonography device applied on chest and used to measure diaphragmatic thickness and change of flexibility of the diaphragm unite of measure is millimeter (mm)

  all assessment will be performed two times one pretreatment and will be repeated post treatment almost 2 months

Secondary Outcomes (6)

• Level of Dyspnea

  all assessment will be performed two times one pretreatment and then will be repeated post treatment almost 2 months

• Oxygen saturation (%)

  assessment will be performed two times one pretreatment and will be repeated post treatment almost 2 months

• Resting Heart rate

  assessment will be performed two times one pretreatment and will be repeated post treatment almost 2 months

• Pulmonary function test (spirometry)

  all assessment will be performed two times one pretreatment and will be repeated post treatment almost 2 months

• maximum heart rate

  assessment will be performed two times one pretreatment and will be repeated post treatment almost 2 months

Study Arms (3)

group A

OTHER

Combination between rib raising and diaphragmatic release technique

Other: diaphragmatic release technique; Other: rib raising technique in group A

group B

OTHER

combination between thoracic lymphatic pump and diaphragmatic release technique

Other: diaphragmatic release technique; Other: THORACIC LYMPHATIC PUMP TECHNIGUE

group C (control group)

OTHER

Diaphragmatic release technique (control group)

Other: diaphragmatic release technique

Interventions

diaphragmatic release technique OTHER

The participant lay in the supine position and the therapist stood at the participant's head, the therapist passed his hands (the hypothenar and the lateral 3 fingers) under the costal cartilage of the seventh to the tenth ribs bilaterally, with the therapist's forearm aligned up toward the subject's shoulder. Then, the therapist quietly drew the diaphragm in and upward during the inspiratory phase. The therapist then went deeply with both hands toward the inner costal margin during the expiratory phase to resist the rebounding movement of the thoracic cage. The depth of this manual contact was progressively increased in subsequent respiratory cycles. The maneuver was repeated in 4 sets, each of which consisted of 5 deep breaths with 2-min intervals in between if needed

group A; group B; group C (control group)

rib raising technique in group A OTHER

• The patient is in supine position and therapist hand under the thorax The fingertips take up contact with the angular costae and move it up and in lateral traction and maintained and this will repeated until all ribs on the side are mobilized. This movement will be repeated several times until perceives an improvement in the rib flexibility

group A

THORACIC LYMPHATIC PUMP TECHNIGUE OTHER

* Patient in the supine position and therapist will stand the participant's head, facing The therapist places the thenar eminence of each hand to the pectoral region and infra clavicular and the other fingers were spread around the thoracic cage and angled toward the body's side to create consistent, compressive force across the thoracic cage The participant was then allowed to breathe in deeply and breath out. The therapist slowly reduced the compressive force and withdrew the participant. * During breath out rhythmic oscillatory compression in the posterior and caudal direction was applied to the chest wall. * By the end of the expiratory phase, the compressive force was maintained, and ask to take another deep breath. In this way, the participant encountered some resistance equivalent to the chest-wall movement during inspiration. The maneuver was repeated for 5 respiratory cycles, then hands to allow for full inspiration.

group B

Eligibility Criteria

• Age: 60 Years - 75 Years
• Gender Eligibility Details: male gender with age 60 to75 years old stable copd
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

* include Stable COPD patients * include Constant medication between the treatments. * include Aged from 60 TO 75 YEARS OLD * include moderate to severe COPD * include Smoker index \<400 * exclude Rib or vertebral fracture * exclude Skin disorder or scar in chest region or recent abdominal surgery. * exclude Unwilling to complete in study * exclude Cancer * exclude Cognitive impairment to understand orders * exclude severe osteoporosis * exclude Smoker index \>400

Contact the study team to discuss eligibility requirements. They can help determine if this study is right for you.

Sponsors & Collaborators

• Beni-Suef University: lead

Study Sites (1)

Faculty of Physical Therapy Beni Suef University

Cairo, Egypt

Location

Related Publications (12)

• Spencer LM, Alison JA, McKeough ZJ. Do supervised weekly exercise programs maintain functional exercise capacity and quality of life, twelve months after pulmonary rehabilitation in COPD? BMC Pulm Med. 2007 May 16;7:7. doi: 10.1186/1471-2466-7-7.

  PMID: 17506903 RESULT

• Sleszynski SL, Kelso AF. Comparison of thoracic manipulation with incentive spirometry in preventing postoperative atelectasis. J Am Osteopath Assoc. 1993 Aug;93(8):834-8, 843-5.

  PMID: 8407387 RESULT

• Fei F, J Siegert R, Zhang X, Gao W, Koffman J. Symptom clusters, associated factors and health-related quality of life in patients with chronic obstructive pulmonary disease: A structural equation modelling analysis. J Clin Nurs. 2023 Jan;32(1-2):298-310. doi: 10.1111/jocn.16234. Epub 2022 Jan 30.

  PMID: 35098602 RESULT

• O'Donnell DE, Milne KM, James MD, de Torres JP, Neder JA. Dyspnea in COPD: New Mechanistic Insights and Management Implications. Adv Ther. 2020 Jan;37(1):41-60. doi: 10.1007/s12325-019-01128-9. Epub 2019 Oct 30.

  PMID: 31673990 RESULT

• Koch J, Tsui C, Talsma J, Pierce-Talsma S. Osteopathic Manipulative Treatment for Inhaled Rib Somatic Dysfunction. J Am Osteopath Assoc. 2020 Jul 28. doi: 10.7556/jaoa.2020.109. Online ahead of print. No abstract available.

  PMID: 32722750 RESULT

• 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 RESULT

• Marizeiro DF, Florencio ACL, Nunes ACL, Campos NG, Lima POP. Immediate effects of diaphragmatic myofascial release on the physical and functional outcomes in sedentary women: A randomized placebo-controlled trial. J Bodyw Mov Ther. 2018 Oct;22(4):924-929. doi: 10.1016/j.jbmt.2017.10.008. Epub 2017 Oct 25.

  PMID: 30368336 RESULT

• Halpin DM, Miravitlles M, Metzdorf N, Celli B. Impact and prevention of severe exacerbations of COPD: a review of the evidence. Int J Chron Obstruct Pulmon Dis. 2017 Oct 5;12:2891-2908. doi: 10.2147/COPD.S139470. eCollection 2017.

  PMID: 29062228 RESULT

• Global Initiative for chronic obstructive lung disease (GOLD).

  RESULT

• Ragab K. Elnaggar PhD & Mohammed A. Shendy Bulletin of Faculty of Physical Therapy

  RESULT

• Feizi H, Alizadeh M, Nejadghaderi SA, Noori M, Sullman MJM, Ahmadian Heris J, Kolahi AA, Collins GS, Safiri S. The burden of chronic obstructive pulmonary disease and its attributable risk factors in the Middle East and North Africa region, 1990-2019. Respir Res. 2022 Nov 19;23(1):319. doi: 10.1186/s12931-022-02242-z.

  PMID: 36403049 RESULT

• Bordoni B. Lymphatic Pump Manipulation in Patients with Chronic Obstructive Pulmonary Disease. Cureus. 2019 Mar 11;11(3):e4232. doi: 10.7759/cureus.4232.

  PMID: 31123654 RESULT

MeSH Terms

Conditions

Pulmonary Disease, Chronic Obstructive

Condition Hierarchy (Ancestors)

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

Study Officials

• SHERIN Hassan, PROF.DR.

  FACULTY OF PHYSICAL THERAPY Beni suef university

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist

Study Record Dates

• First Submitted: February 24, 2025
• First Posted: March 10, 2025
• Study Start: March 20, 2025
• Primary Completion: September 20, 2025
• Study Completion: October 20, 2025
• Last Updated: April 30, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)