The Journal of the American Osteopathic Association, 2006/08, 106(8):485. doi: 10.7556/jaoa.2006.106.8.471, type of study: ,rct,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

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Keywords:

chronic obstructive pulmonary disease [31]
COPD [40]
dyspnea [9]
OMT [3925]
osteopathic manipulative treatment [3946]
pilot study [216]
randomized controlled trial [947]

Abstract:

Purpose: Contribute to our knowledge of the effects of OMT on breathing and exercise tolerance in patients with COPD. Hypothesis 1: One OMT intervention will have an immediate effect of improving dyspnea in a stable COPD subject, as measured by response to the Borg scale. Hypothesis 2: One OMT intervention will improve exercise tolerance in a stable COPD subject, as measured by distance in the six-minute walk test. Methods: After obtaining informed consent, initial plethysmography and spirometry test were performed by a respiratory technician to verify that subjects met the pulmonary function test inclusion criteria. After acceptance into the study protocol, subjects were randomly assigned to either the Osteopathic Manipulative Treatment group or the no treatment (ie, rest) group. Demographics were then recorded and questionnaires were completed. Subjects filled out the St. George Respiratory Questionnaire, The American Thoracic Society Dyspnea Index and Borg Scale. The entire study took place in the Internal Medicine Department at UNTHSC-TCOM. Results: Exploratory data analyses revealed equal variances in all descriptive measures. Between group differences were not statistically significant for any demographics or for the Quality of Life measures. No immediate effects of OMT were statistically significant following exercise for any of the outcomes of interest. Examination of individual cases within the sample provides clinically important information to contribute to our knowledge of how OMT versus rest may affect the six-minute walk and the Borg Scale for COPD patients. Conclusions: Current OMT literature does not provide standards for dosage and frequency; therefore, this pilot study took the first step of looking at immediate effects. It is not possible to conclude appropriate dosage and frequency based on the findings of this study. Future studies with larger number of subjects and varying dosage and frequency will aid in determining these factors. Clinically important differences in the experimental groups provides information needed to design a larger study with improvements in design.