Effects of Manual Therapy and Respiratory Muscle Training on the Maximal Inspiratory Pressure in Patients With Asthma

Universidad Autonoma de Madrid

Status: Completed

Conditions: Asthma; Inspiratory Capacity; Exercise Therapy; Respiratory Muscle Training; Manual Therapies

Treatments: Device: Powerbreathe; Other: IMT + Manual Therapy and Motor Control Exercise; Other: Inspiratory Muscle training (IMT)

Study type: Interventional

Funder types: Other

Identifiers

NCT02690831

Universidad Autonoma de Madrid

Details and patient eligibility

About

The aim of this study is to assess if an intervention of manual therapy and motor control exercises combined with an inspiratory muscle training program is more effective than an inspiratory muscle training program alone in increasing the maximum inspiratory pressure in patients with asthma. In addition, the study pretends to evaluate the changes caused by the intervention regarding possible postural changes and thoracic diameter.

Enrollment: 40 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Asthmatics subjects aged between 18 and 65 years

Exclusion criteria

• Were excluded participants who presented neurologic, psychiatric or cognitive pathologies which difficult the cooperation, inflammatory disease of the cervical spine and/or severe orthopedic problems that difficult the daily activities, history of thoracic surgery, vertebral fracture, abnormal thorax radiography, spinal and thoracic structured musculoskeletal disorders and to present any contraindication of treatment techniques (e.g. ostheophorosis). In case of exacerbation of asthma, missing more than one treatment session and/or to appear any contraindication to continue the treatment routine during the six weeks of the study the patient also were excluded.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups

Inspiratory Muscle training (IMT)

Active Comparator group

Description:

The IMT program consisted of supervised and domiciliary exercises: 1. - The supervised exercises was performed in the presence of physiotherapist. This consisted of 30 min 2 days for 6 weeks using the threshold device (Powerbreathe classic level 1, Gaiam Ltd; Southam, Warwickshire, UK). This program involve 5 sets of 5 repetitions with 30 seconds rest between each one. The load of the training was distributed as follow: * First week: 30% Maximum Inspiratory Pressure (MIP) * Second week: 40% MIP * Third week: 50% MIP * Fourth week: 50% MIP * Fifth week: 60% MIP * Sixth week: 60% MIP 2. - The domiciliary exercises consisted of Yoga Breathing Exercises (Pranayama) that combines the inspiration and expiration through one or both nostrils, and requires the activation of chest and abdomen.

Treatment:

Other: Inspiratory Muscle training (IMT)

Device: Powerbreathe

IMT + Manual Therapy and Motor Control Exercise

Experimental group

Description:

The protocol for this group is identical to the previous group with the sole difference that is added a manual therapy (MT) and a motor control exercises (MCE). The MT protocol was performed for 15min, whereas the MCE was 10min. Below it described both protocols: 1. - MT: * Upper cervical region mobilization in flexion * Lower cervical postero-anterior mobilization + maintained traction * Costovertebral joint postero-anterior mobilization * Thrust dorsal * Cervical postero-anterior mobilization 2. - MCE: * Isometric contraction of the deep neck flexors. * Isometric contraction of the neck extensors. * Neural self-mobilization. * Cervical retraction with theraband. * Sphinx. * Scapular adduction exercises in prone. * Scapular adduction exercises in sitting position with theraband.

Treatment:

Device: Powerbreathe

Other: IMT + Manual Therapy and Motor Control Exercise