Abstract
Aim: Chronic Obstructive Pulmonary Disease (COPD) influences the function of the diaphragm muscle, thus affecting the maximum inspiratory pressure. It is a constantly progressive disease characterized by chronic obstruction of pulmonary flow, which is irreversible in nature. We reviewed the literature for evidence of improvement in pulmonary function through Muscle Energy Technique and Joint Manipulation by decreasing the work of accessory muscles of breathing, improvement in chest expansion, improving thoracic spine mobility, and increasing diaphragm muscle strength.
Material and Methods: Articles used in the review were only in English, and non-English language articles were excluded. The database used to extract the literature was restricted to PubMed, Science Direct, Cochrane. Participants with COPD of both genders between 40 to70 years of age were included. Only articles with randomized controlled trials and non-randomized controlled trials and studies, which used manual therapy involving muscle energy techniques and manipulation were included. Studies that did not use main treatment such as physical hand contact were excluded. Outcome measurements included spirometry, Health-Related Quality of Life, Modified Borg Exertion Scale, pulse oximeter and Maximum Inspiratory Pressure, exercise capacity was measured with 6-minute walk test.
Result: The current evidence regarding the effect of joint manipulation, Muscle Energy Technique, and manual therapy on the musculoskeletal system in patients with COPD is inconclusive. The analysis included six randomized controlled trials and non-randomized controlled trials having dissimilar study design, study population, as well as outcome measures. All studies showed a higher risk of bias.
Discussion: The current study provides less evidence about muscle energy technique and joint manipulations effect on COPD patients but found a significant effect of both techniques in combination with manual therapy on pulmonary functions.