2007 Volume 34 Issue 2 Pages 59-64
This study investigated the immediate effect of chest mobilization techniques in patients with chronic obstructive pulmonary disease (COPD). We measured pulmonary function, chest expansion, oxygen saturation (SpO2),pulse rate and breathlessness in 16 COPD patients (13 male and 3 female, mean ± SD age 72.2 ± 6.2 yrs) before and after treatment. Chest expansion, defined as the difference in chest girth between the maximal inspiration and maximal expiration, was measured at three levels: the axilla, xiphoid and 10th rib. Breathlessness was measured with a visual analogue scale (VAS). Patients were treated with chest mobilization comprising rib rotation, chest wall rotation. lateral flexion of the chest wall, chest wall extension, and pectoralis major muscle stretch by expert physical therapists. Chest expansion at the level of 10th rib showed a significant improvement and pulse rate was significantly decreased after treatment. However, chest expansion at the other levels, pulmonary function, SpO2 and breathlessness were unchanged. In the patients who also demonstrated a restrictive ventilatory impairment (vital capacity<80% predicted: n=11), chest expansion at the level of axilla, xiphoid and 10th rib all significantly improved and pulse rate was significantly lower after treatment. These results suggest that flexibility of the respiratory muscles and mobility of the costovertebral joints, facet joints and sternocostal joints may improve flowing chest mobilization. We recommend the use of chest mobilization technique in COPD patients, in particular those with a restrictive ventilatory impairment.
