Comparison of Diaphragmatic Stretch Technique and Manual Diaphragm Release Technique on Diaphragmatic Excursion in Chronic Obstructive Pulmonary Disease: A Randomized Crossover Trial

Alaparthi, Gopala Krishna and *, Shyam Krishnan and Rai, Santosh and *, Anand R and Acharya, Vishak K. and Acharya, Preetam Rajgopal and Nair, Aishwarya Surya (2019) Comparison of Diaphragmatic Stretch Technique and Manual Diaphragm Release Technique on Diaphragmatic Excursion in Chronic Obstructive Pulmonary Disease: A Randomized Crossover Trial. Pulmonary Medicine, 2019 (63643). pp. 1-7. ISSN 20901836

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Abstract

Background. Chronic Obstructive Pulmonary Disease (COPD) impairs the function of the diaphragm by placing it at a mechanical disadvantage, shortening its operating length and changing the mechanical linkage between its various parts. Tis makes the diaphragm’s contraction less efective in raising and expanding the lower rib cage, thereby increasing the work of breathing and reducing the functional capacity. Aim of the Study. To compare the efects of diaphragmatic stretch and manual diaphragm release technique on diaphragmatic excursion in patients with COPD. Materials and Methods. Tis randomised crossover trial included 20 clinically stable patients with mild and moderate COPD classifed according to the GOLD criteria. Te patients were allocated to group A or group B by block randomization done by primary investigator. Te information about the technique was concealed in a sealed opaque envelope and revealed to the patients only afer allocation of groups. Afer taking the demographic data and baseline values of the outcome measures (diaphragm mobility by ultrasonography performed by an experienced radiologist and chest expansion by inch tape performed by the therapist), group A subjects underwent the diaphragmatic stretch technique and the group B subjects underwent the manual diaphragm release technique. Both the interventions were performed in 2 sets of 10 deep breaths with 1-minute interval between the sets. Te two outcome variables were recorded immediately afer the intervention. A wash-out period of 3 hours was maintained to neutralize the efect of given intervention. Later the patients of group A and group B were crossed over to the other group. Results. In the diaphragmatic stretch technique, there was a statistically signifcant improvement in the diaphragmatic excursion before and afer the treatment. On the right side, p=0.00 and p=0.003 in the midclavicular line and midaxillary line. On the lef side, p=0.004 and p=0.312 in the midclavicular and midaxillary line. In manual diaphragm release technique, there was a statistically signifcant improvement before and afer the treatment. On the right side, p=0.000 and p=0.000 in the midclavicular line and midaxillary line. On the lef side, p=0.002 and p=0.000 in the midclavicular line and midaxillary line. Tere was no statistically signifcant diference in diaphragmatic excursion in the comparison of the postintervention values of both techniques. Conclusion. Te diaphragmatic stretch technique and manual diaphragm release technique can be safely recommended for patients with clinically stable COPD to improve diaphragmatic excursion.

Item Type: Article
Uncontrolled Keywords: copd, diaphragm mobility,diaphragmatic stretch ,manual diaphragm release technique
Subjects: Allied Health > Mangalore Campus > Physiotherapy
Medicine > KMC Mangalore > Pulmonary Medicine
Medicine > KMC Mangalore > Radio Diagnosis and Imaging
Depositing User: KMCMLR User
Date Deposited: 08 Jan 2019 11:19
Last Modified: 08 Jan 2019 11:19
URI: http://eprints.manipal.edu/id/eprint/152793

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