The effectiveness and safety of Chuna manual therapy adjuvant to Western medicine in patients with chronic obstructive pulmonary disease: Study protocol for a randomized, single-blind, investigator-initiated, pilot trial

Effect of selective manual therapy techniques in chronic obstructive pulmonary disease: A randomized control trial

Objective

To investigate the effect of selective manual therapy (MT) techniques on chest expansion, pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC ratio), craniovertebral angle (CVA), kyphosis angle, functional capacity, and dyspnea in patients with chronic obstructive pulmonary disease (COPD).

Methods

A parallel double-blinded randomized controlled trial involved 52 male subjects with a mean age of 56.23 ± 3.54. Patients were randomly assigned to two groups, each consisting of 26 subjects: the control group (A) received only conventional physical therapy, and the experimental group (B) received both MT and conventional physical therapy. Treatment was administered three times per week for 8 weeks. Chest expansion by chest caliper; FVC, FEV1, and FEV1/FVC ratio by spirometry; CVA and kyphosis angle by Kinovea software; functional capacity by the 6-min walk test (6MWT); and dyspnea by the modified Medical Research Council dyspnea index all were measured at baseline and after 8 weeks.

Results

Prior to treatment, there was no statistically significant differences between the two groups in the between-group analyses (p > 0.05). After treatment,a statistically significant difference was found between both groups, with a predilection for the experimental group in FEV1 middle difference (MD) of 0.55 L, FVC MD = 0.39 L, FEV1/FVC% MD = 18.97, dyspnea MD = -2.58, 6MWT MD = 92.81 m, CVA MD = 5.21°, kyphosis angle MD = 3.1°, anteroposterior (AP) chest expansion MD = 1.08 cm, and lateral chest expansion MD = 1.54 cm.

Conclusion

The combination of MT approaches with conventional physical therapy leads to a clinically significant difference in AP chest expansion, FVC, FEV1, CVA, functional capacity, and dyspnea, and a statistically significant difference in kyphosis angle, FEV1/FVC%, and lateral chest expansion compared to using conventional physical therapy only in patients with COPD.

The Effectiveness and Safety of Chuna Manual Therapy Adjuvant to Western Medicine in Patients with Chronic Obstructive Pulmonary Disease: A Randomized, Single-Blind, Investigator-Initiated, Pilot Trial

Recently, non-pharmacological treatments are gaining increasing importance for improving the quality of life in patients with chronic obstructive pulmonary disease (COPD). This pilot study aimed to evaluate the feasibility of conducting extensive research on Chuna manual therapy (CMT). This study investigated the effectiveness and safety of CMT adjuvant to Western medicine (WM) in patients with COPD. Forty patients with COPD were randomized into two groups in a 1:1 ratio: experimental (CMT plus WM) and control (WM only) groups. The CMT intervention was administered once a week for eight weeks. The primary outcome measured was the 6-min walk distance (6MWD). Secondary outcomes measured were: forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), assessments using the modified Medical Research Council (mMRC) scale and Visual Analog Scale (VAS) for dyspnea, the COPD Assessment Test (CAT), St. George's Respiratory Questionnaire (SGRQ), and the EuroQoL five-dimensional questionnaire (EQ-5D). The mean differences in FEV1 (L) between Weeks 1 and 8 were statistically significant between the groups (p = 0.039). Additionally, the experimental group showed improved 6MWD, mMRC, VAS for dyspnea, CAT, SGRQ (total), and EQ-VAS scores than the control group. However, the differences between the two groups were not statistically significant. No adverse events were observed during this trial. CMT has the potential to alleviate symptoms, improve quality of life, and delay the decline in lung function in patients with COPD. The results of this pilot study could lead to large-scale clinical trials in the future.