Combining chiropractic with exercise therapy could improve symptoms for people with chronic obstructive pulmonary disease (COPD), according to new research.
Chronic obstructive pulmonary disease (COPD) is a type of lung disease that develops with the breakdown of lung tissue and the blockage of airways within the lungs. The disease is characterized by a chronic bronchitis and emphysema, and often includes symptoms like cough, shortness in breath, a tightness in the chest, and the production of mucus. Unlike asthma, COPD worsens over time. While COPD can be caused by genetics or air pollution, the most common cause is smoking. Early treatment for COPD, combined with smoking cessation, may ease symptoms and slow the progression of the disease.
Exercise therapy is known to improve quality of life and survival in patients with COPD, but increasing exercise capacity can be challenging, since physical activity can induce difficulties in breathing (dyspnea).
Now preliminary research suggests that manual therapies may improve exercise capacity and symptoms in COPD patients. In a new study published in the Journal of Manipulative and Physiological Therapeutics, researchers studied a group of 15 patients with moderate COPD who were assigned to receive one of three interventions: 1) soft tissue therapy 2) spinal manipulation and soft tissue therapy (SM+ST); or 3) spinal manipulation, soft tissue therapy, and exercise (SM+ST+Ex).
Adding spinal manipulation or a combination of exercise and spinal manipulation improved dyspnea levels, compared to patients in the ST group. Patients receiving all three interventions had the best improvements in terms of lung function, as measured by the forced vitality capacity (FVC). These patients also had enhanced exercise capacity, which was measured by calculating changes in walking speed and distance before and after treatment.
Although exercise therapy has already been shown to boost exercise capacity in patients with COPD, this study suggests that the addition of manual therapies can lead to better lung functioning.
Patients with chronic pulmonary disease may have decreased chest wall mobility. This forces the respiratory muscles to work at sub-optimal lengths, leading to fatigue and remodeling of the muscles. Dysfunction in the thoracic spine may exacerbate chest wall rigidity. The authors of this study hypothesized that manual therapy could delay the onset of respiratory muscle fatigue by allowing the muscles to “operate closer to their optimal length.”
Chiropractors often use a combination of all three interventions (exercise, soft tissue therapy, and spinal adjustments) to relieve chronic pain associated with musculoskeletal conditions. While more research is needed to confirm the results, this study suggests a combined treatment approach may have the potential to benefit patients with chronic pulmonary disease.
Engel RM, et al. Short-term effects of a course of manual therapy and exercise in people with moderate obstructive pulmonary disease: a preliminary clinical trial. Journal of Manipulative and Physiological Therapeutics 2013; 36(8):490-496. doi: 10.1016/j.jmpt.2013.05.028.