Manual Therapy in Patients With Asthma

Physical therapists have traditionally included various forms of manual therapy among the therapeutic approaches to respiratory conditions. The aim of this study was to evaluate the effect of diaphragmatic stretching technique on pulmonary ventilation, rig bage excursion and spirometric values in patients diagnosed with asthma.

Asthma is a chronic lung disease involving an inflammation and a narrowing of the airways. Asthma causes wheezing, chest tightness, shortness of breath, and coughing. A variety of manual therapies are commonly used to treat patients with asthma. There is a need to conduct studies in order to examine the effects of manual therapies on clinically relevant outcomes. Techniques aim to increase movement in the rib cage and the spine to try and improve the working of the lungs and circulation.

30 Patients with asthma are included in this group. They will receive a diaphragm stretching technique

The therapist stands behind the patient and passes his hands around the thoracic cage, carefully introducing fingers under the costal margins. The patient slightly rounds the trunk in order to relax rectus abdominis. During the exhalation of the patient the therapist grasps the lower ribs and costal margin and eases the hands caudally. This traction was maintained during 5-7 minutes.

The same therapist, patient position and duration of the technique, but using disconnected ultrasound

The amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. It is going to be measured using a spirometer as recommended by the American Thoracic Society.

Abdominal kinematic measurements can be used as an evaluative method to quantify possible alterations in abdominal movements.

The airway diffusion capacity will be measure using the deep breeze device. This is a non-invasive and radiation-free gadget that provides a dynamic image of the lungs, delivering both structural and functional information.

This is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation. It is going to be measured using a spirometer as recommended by the American Thoracic Society.

Rib cage excursion can be used as an evaluative method for diaphragmatic breathing excursion to quantify possible alterations in thoracic capacity and chest wall compliance as achieved by all expiratory and inspiratory muscles

Inclusion Criteria: Age ranging between 18 and 45 years. Diagnosis of asthma. No exacerbations during last month. Exclusion Criteria: History of spine surgery. Diabetes, neurological or a cardiovascular disease. Spine deformities and use of orthopedic devices.