The following is a summary of “Effect of chest wall mobilization on respiratory muscle function in patients with severe chronic obstructive pulmonary disease (COPD): A randomized controlled trial,” published in the DECEMBER 2023 issue of Pulmonology by Tsui, et al.

Research has consistently underscored the importance of pulmonary function in patients with Chronic Obstructive Pulmonary Disease (COPD). Specifically, studies have illuminated the direct relationship between pulmonary function and the expansion of the chest wall. In COPD patients, compromised chest wall expansion hampers rib cage mobility and reduces the functional capacity of respiratory muscles, thereby undermining respiratory efficiency.

The study enlisted thirty male adults, with an average age of 74.97 ± 6.29 years, diagnosed with severe COPD. These participants were randomized into either an experimental or control group. While both groups underwent standardized educational sessions and walking exercises bi-weekly for a span of six weeks, the experimental group was subjected to additional chest wall mobilizations encompassing stretching and joint mobilization techniques. Evaluations, including assessments of pulmonary function, respiratory muscle strength, thoracic excursion, and cervical and thoracic range of motion, were conducted at baseline, post-intervention, and during a 3-month follow-up.

Notably, the experimental group exhibited marked enhancements in respiratory muscle strength, thoracic excursion, and thoracic range of motion (P < 0.01), barring thoracic flexion. A significant correlation was observed between reduced lower thoracic excursion and increased maximum inspiratory (β = 13.64, P < 0.001) and expiratory pressures (β = 16.23, P < 0.001). Multiple regression analyses further revealed that the thoracic range of motion, particularly extension (P < 0.001) and bilateral rotation (P < 0.01), was strongly associated with an augmented lower thoracic excursion (adjusted R² = 0.876).

Integrating chest wall mobilizations into the rehabilitation regimen for severe COPD patients can lead to notable enhancements in thoracic extension and rotation. These improvements culminate in increased lower thoracic excursion, enabling respiratory muscles to operate optimally. Consequently, this fosters heightened respiratory muscle strength, underscoring the potential benefits of incorporating chest wall mobilization techniques in COPD management.

Source: resmedjournal.com/article/S0954-6111(23)00324-4/fulltext