Fondazione Salvatore Maugeri, IRCCS, Istituto Scientifico di Montescano, UO di Pneumologia Riabilitativa, 27040 Montescano (PV), Italy.
Complement Ther Med. 2012 Feb-Apr;20(1-2):16-22. doi: 10.1016/j.ctim.2011.10.008. Epub 2011 Nov 27.
Few and contrastingly data are available about use of osteopathic manipulative treatment (OMT) in patients with chronic obstructive pulmonary disease (COPD).
Comparing the effects of the combination of pulmonary rehabilitation and OMT compared with pulmonary rehabilitation (PR) in patients with severely impaired COPD.
Rehabilitative pulmonary department.
Patients underwent exercise training, OMT, educational support and nutritional and psychological counselling.
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.
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.
This study suggests that OMT+PR may improve exercise capacity and reduce RV in severely impaired COPD patients with respect to PR alone.
关于慢性阻塞性肺疾病（COPD）患者使用整骨疗法治疗（OMT）的数据很少且相互矛盾。
比较严重 COPD 患者接受肺康复（PR）联合 OMT 与单纯 PR 的效果。
康复肺科病房。
患者接受运动训练、OMT、教育支持以及营养和心理辅导。
6 分钟步行试验（6MWT-主要结局）和肺功能测试（次要结局）评估在训练开始和结束时的运动能力。患者随机分为接受 PR+软组织手法治疗（G1）或 OMT+PR（G2），每周 5 天，持续 4 周。
评估了 20 例稳定的 COPD 患者（5 名女性，平均年龄 63.8±5.1 岁；FEV1 预测值的 26.9±6.3%），这些患者因住院肺康复而就诊。与基线相比，两组的 6MWT 均有统计学上的改善。特别是，G2 组增加了 72.5±7.5m（p=0.01），G1 组增加了 23.7±9.7m。组间比较显示差异为 48.8m（95%可信区间：17 至 80.6m，p=0.04）。此外，在 G2 组中，我们发现残气量（RV）减少（从 4.4±1.5l 降至 3.9±1.5l，p=0.05）。组间比较显示差异显著（-0.44l；95%可信区间：-0.26 至-0.62l，p=0.001）。此外，仅在 G2 组中我们发现 FEV1 增加。
本研究表明，与单纯 PR 相比，OMT+PR 可能会改善严重 COPD 患者的运动能力并降低 RV。
