Efficacia del trattamento manipolativo osteopatico nella broncopneumopatia cronica ostruttiva grave: uno studio pilota.

Abstract

Objectives:
Few and contrastingly data are available about use of osteopathic manipulative treatment (OMT) in patients with chronic obstructive pulmonary disease (COPD).
Design: Comparing the effects of the combination of pulmonary rehabilitation and OMT compared with pulmonary rehabilitation (PR) in patients with severely impaired COPD.
Setting: Rehabilitative pulmonary department.

Interventions:
Patients underwent exercise training, OMT, educational support and nutritional and psychological counselling. Main outcomes measures: Exercise capacity through 6 min walk test (6MWT — primary outcome) and pulmonary function test (secondary outcomes) were evaluated at the beginning and at the end of the training. Patients were randomly assigned to receive PR + soft manipulation (G1) or OMT + PR (G2) for 5 days/week for 4 weeks.

Results:
20 stable COPD patients (5 female — mean age, 63.8 ± 5.1 years; FEV1 26.9 ± 6.3% of predicted) referred for in-patient pulmonary rehabilitation were evaluated. Respect to the
baseline, 6 MWT statistically improved in both group. In particular, G2 group gained 72.5 ± 7.5 m (p = 0.01) and G1 group 23.7 ± 9.7 m. Between group comparison showed a difference of 48.8 m
(95% CI: 17 to 80.6 m, p = 0.04). Moreover, in G2 group we showed a decrease in residual volume (RV — from 4.4 ± 1.5 l to 3.9 ± 1.5 l, p = 0.05). Between group comparison showed an important
difference (−0.44 l; 95% CI: −0.26 to −0.62 l, p = 0.001). Furthermore, only in G2 group we showed an increase in FEV1. Conclusions: This study suggests that OMT + PR may improve exercise capacity and reduce RV in severely impaired COPD patients with respect to PR alone.