Abstract
Background
This randomized controlled pilot study evaluated the efficacy of osteopathic treatment in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) assessed using spirometry, COPD Assessment Test (CAT) and six minutes walking test (6MWT). The main goals were to improve the quality of life of patients with stable moderate-to-severe COPD, and to revise the parameters of the assessment tests, such as spirometry and 6MWT.
Methods
The study comprised several phases and patients were divided into two groups: group A (controls) received conventional pharmacological treatment with Indacaterol–Glycopyrronium and, while group B (OMT group) received both traditional therapy and osteopathic manipulative treatment (OMT) at different stages of the study. The osteopathic approach focused on maxillary sinus, vertebral-pleural ligaments, phrenic nerves, ribs, pleura, lungs, bronchi, subclavian muscles, and trapezoid and conoid ligaments.
Results
Overall, 32 patients were randomized and treated. Patients of the OMT group got better improvements in all tests compared to the control group: spirometry: FVC (p<0.5411), total FEV1 (p<0.5061); CAT: OMT (p<0.0005) - controls (p<0.188) 6MWT OMT (p<0.0038) - controls (p<0.5326). The clinical results collected in phase (T3) confirm those obtained in the first sessions; the results of CAT questionnaire (p<0.0005) and 6MWT (p<O, OO38) highlighted score improvements of patients treated with osteopathy compared to patients in the other group.
Conclusions
The results showed that the patients with COPD who received the conventional pharmacological treatment in association with the OMT therapy demonstrated a good response to the osteopathic treatment, thus leading to significant improvements in their health and wellbeing, and a better daily functioning.
Acknowledgments
The study was supported and conducted by a multi-disciplinary team with the collaboration of Centro di Riabilitazione Calaciura, Biancavilla and CSDOI (Centro Studi Osteopatia Italiano) of Catania.
We thank Paolo Desirò DO for his valuable advice, Santi Scirè for having made the model, Jessica Petriliggieri DO for the photography.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Delaration of interest: All authors state there is no conflicts of interest.
References
[1] Viegi G, Pistelli F, Sherril DF. Definition, epidemiology and natural history of COPD. EurRespir J 2007;30:993–1013.10.1183/09031936.00082507Search in Google Scholar PubMed
[2] Monninkhof E, van der Valk P, van der Palen J, van Herwaarden C, Partridge MR, Zielhuis G. Self-management education for patients with chronic obstructive pulmonary disease: a systematic review. Thorax 2003;58:394–8.10.1136/thorax.58.5.394Search in Google Scholar PubMed PubMed Central
[3] Silva RO. Clinical phenotypes in chronic obstructive pulmonary disease. RevMed Chile 2012;140:926–33.Search in Google Scholar
[4] Effing T, Monninkhof EM, van der Valk PD, van der Palen J, van Herwaarden CL, Partidge MR, et al. Self-management education for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2007;4:CD002990.10.1002/14651858.CD002990.pub2Search in Google Scholar PubMed
[5] Maltais F, Bourbeau J, Shapiro S, Lacasse Y, Perrault H, Baltzan M, et al. Chronic obstructive pulmonary disease axis of respiratory health network, fonds de recherche en santé du Québec. Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med 2008;149:869–78.10.7326/0003-4819-149-12-200812160-00006Search in Google Scholar PubMed
[6] Steel A, Sundberg T, Reid R, Ward L, Bishop FL, Leach M, et al. Osteopathic manipulative treatment: a systematic review and critical appraisal of comparative effectiveness and health economics reserch. Musculoskelet Sci Pract 2017;27:165–75.10.1016/j.math.2016.10.067Search in Google Scholar PubMed
[7] Anthony GC. Fondamenti di medicina osteopatica, 2 edizione italiana ed. Osteopathic rationale: Casa Editrice Ambrosiana, 2015.Search in Google Scholar
[8] Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of ATS/ERS position paper. Eur Respir J 2004;23:932–46.10.1183/09031936.04.00014304Search in Google Scholar PubMed
[9] Lacasse Y, Goldstein R, Lasserson TJ, Martin S. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2006;18:CD003793.10.1002/14651858.CD003793.pub2Search in Google Scholar PubMed
[10] Clini EM, Crisafulli E, Costi S, Rossi G, Lorenzi C, Fabbri LM, et al. Effects of early inpatient rehabilitation after acute exacerbation of COPD. Respir Med 2009;103:1526–31.10.1016/j.rmed.2009.04.011Search in Google Scholar PubMed
[11] Carone M, Patessio A, Ambrosino N, Baiardi P, Balbi B, Balzano G, et al. Effect of pulmonary rehabilitation in chronic respiratory failure (CRF) due to chronic obstructive pulmonary disease (COPD): the Maugeri study. Respir Med 2007;101:2447–53.10.1016/j.rmed.2007.07.016Search in Google Scholar PubMed
[12] Puhan M, Scharplatz M, Troosters T, Walters EH, Steurer J. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2009;21:CD005305.10.1002/14651858.CD005305.pub2Search in Google Scholar PubMed
[13] Garcia-Aymerich J, Lange P, Benet M, Schnohr P, Antó JM. Regular physical activity modifies smoking-related lung function decline and reduces risk of chronic obstructive pulmonary disease. A population-based cohort study. Am J RespirCrit Care Med 2007;175:458–63.10.1164/rccm.200607-896OCSearch in Google Scholar PubMed
[14] ATS Statement. Guidelines for the six minute walk test. Am J RespirCrit Care Med 2002;116:111–7.Search in Google Scholar
[15] Heneghan NR, Adab P, Balanos GM, Jordan RE. Manual therapy for chronic obstructive airways disease: a systematic review of current evidence. Man Ther 2012;17:507–18.10.1016/j.math.2012.05.004Search in Google Scholar PubMed
Supplementary Material
The online version of this article offers supplementary material (DOI:https://doi.org/10.1515/jcim-2018-0128).
© 2019 Walter de Gruyter GmbH, Berlin/Boston
