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Acute Effect of Combined Manual Therapy and Therapeutic Exercise versus Short-Acting Bronchodilator on Ventilatory Function in Patients with COPD

[ Vol. 14 , Issue. 2 ]


Ahmad Mahdi Ahmad*, Ehab Ahmed Abdel Halim and Mohammed Shaker Sadek   Pages 95 - 99 ( 5 )


Background: Manual Therapy has recently gained popularity and interests from health care providers in the field of Pulmonary Rehabilitation programs for COPD patients as it has proved to have great health and clinical benefits. Additional benefits in clinical outcomes may be obtained by adding therapeutic exercise to manual therapy.

Objective: The aim of this research was to study the acute effect of combined myofascial release based-manual therapy for pectoralis minor muscle and therapeutic strengthening exercises for shoulder depressors and scapular adductors, compared to the effect of a single administration of shortacting bronchodilator in COPD patients.

Method: Fifty four male patients with COPD were equally divided into two groups; group A (n=27) received one physiotherapy treatment session combining pectoralis minor muscle myofacial release and therapeutic strengthening exercises for shoulder depressors & scapular adductors, while group B (n=27) received an inhaled short-acting bronchodilator for one time. Measurement included ventilatory function as the main outcome, and chest expansion & Verbal Descriptor Scale (VDS) of muscle pain as secondary outcomes.

Results: FEV1, FVC, MVV, chest expansion, and VDS of pectoralis minor muscle tightness pain significantly improved only in group A (P ˂ 0.05). Nevertheless, there was no statistically significant difference between the two groups except for VDS.

Conclusion: a single physiotherapy intervention of myofascial release-based manual therapy combined with therapeutic exercise has succeeded to induce some clinical benefits in patients with COPD. This protocol may represent an alternatively novel physiotherapy intervention that can be included in pulmonary rehabilitation programs for COPD patients.


COPD, manual therapy, myofascial release, pulmonary rehabilitation, therapeutic exercise, ventilatory function.


Department of Physical Therapy for Cardiovascular and Respiratory Disorders, Faculty of Physical Therapy, Cairo University, Giza, Physiotherapy Department, Dermatology and Leprosy Hospital, Banha, Qalybia, Department of Chest Diseases, Faculty of Medicine, Banha University, Qalybia

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