As one of chest physiotherapy (CPT) techniques, manual stretching of intercostal and other respiration related muscles to mobilize thoracic cage had been frequently performed in patients with airflow limitation, especially in Japan. Purpose of those techniques is supposed to improve chest flexibility and alleviate dyspnea. To examine hypothesis that CPT techniques in patients with chronic obstructive pulmonary disease (COPD) may change the mechanical properties of the chest.
Eight patients with COPD (mean age: 67.0 ± 4.4 years, M:F=8:0) were studied. We performed physiological measurements including spirometry, oxygen consumption during quiet breathing at sitting position (VO2), maximal voluntary ventilation (MVV), and maximal inspiratory and expiratory pressures (MIP, MEP). Thoracic gas volume and specific airway conductance (sGaw) were also measured using body plethysmography. After those baseline measurements, the CPT described above including manual breathing support techniques were performed for about total 40 minutes. Immediately after the CPT, pulmonary function tests were repeated.
Inspiratory capacity (IC) and vital capacity (VC) significantly increased (p<0.05, p<0.01). Forced expiratory volume in 1 second (FEV1) was unchanged. Functional residual capacity (FRC) and residual volume (RV) significantly decreased (p<0.01) after CPT. Both sGaw and VO2 were tended to decrease, but it could not reach to the statistic significance. MEP, MIP, and MVV were not significantly change.
After CPT, lung volume decreased, and IC increased in patients with COPD.
Decreased lung volume and increased IC by CPT possibly contribute to improve breathlessness in patients with COPD. Further research is needed to elucidate how long this effects last.
Kayomi Matsumoto, None.