Efficacy of Costal Mobilization Techniques and Manual Diaphragm Release Technique in Patients COPD

• ClinicalTrials.gov Identifier: NCT03022942
• Recruitment Status: Unknown
• First Posted: January 18, 2017
• Last Update Posted: April 11, 2018
• Sponsor: Universidade Federal de Pernambuco
• Information provided by (Responsible Party): HELENA MEDEIROS ROCHA, Universidade Federal de Pernambuco

Study Description

Brief Summary:

To evaluate the acute and chronic effects of costal mobilization techniques and diaphragmatic release in chest cavity kinematics, diaphragmatic mobility and functional capacity in patients with chronic obstructive pulmonary disease

Condition or disease	Intervention/treatment	Phase
Copd; Chest Disorders; Diaphragmatic Disorder	Other: GROUP Costal mobilization & Diaphragm Release; Other: GROUP Manual Diaphragm Release	Not Applicable

Detailed Description:

Study will be a controlled clinical trial in which participants will be randomized into 2 groups: GROUP A (costal mobilization techniques and Manual Diaphragm Release Technique), GROUP B (Manual Diaphragm Release Technique). After the initial evaluation, participants will undergo six sessions of care according to randomization and will be reevaluated in 3 following situations: immediately after the first session, at the end of treatment and one week after the last session. The evaluation will be performed through Optoelectronic plethysmography , Pollar, Ultrasound and 6-minutes walk test.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 14 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double (Participant, Investigator)
• Primary Purpose: Health Services Research
• Official Title: Efficacy of Costal Mobilization Techniques and Diaphragm Release in Thoracoabdominal Kinematics, Diaphragm Mobility and Submaximal Functional Capacity in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial
• Study Start Date: January 2017
• Estimated Primary Completion Date: June 2018
• Estimated Study Completion Date: December 2018

Arms and Interventions

Arm	Intervention/treatment
Experimental: Costal mobilization & Diaphragm Release; Costal mobilization. Lying: two sets of ten deep respiratory cycles with one minute interval between sets. Sitting: two series with interval of one minute between them. Manual Diaphragm Release Technique: will be applied during two series of ten deep respiratory cycles, with one minute interval between sets.	Other: GROUP Costal mobilization & Diaphragm Release; Costal mobilization technique (Rib raising): The patient will be lying. The Therapist supports the last four pulps of both hands at the rib angles, gently traverses the rib angles in the posterior-anterior direction, using the stretcher as a lever to facilitate the elevation of the costal angles. Siting: The Therapist hugs the patient by supporting the ribs of the fingers at the rib angles, gently traverses the rib angles bilaterally in the anterior-lateral direction. Manual Diaphragm Release Technique: The therapist makes manual contact with the underside of the costal border of the common cartilage of the last rib. In the inspiratory phase, the therapist draws the points of contact with both hands in a cephalad direction and slightly Accompanying the movement of the rib cage.; Other Names: GROUP Rib Raising & Diaphragm Release; GROUP A
Active Comparator: Manual Diaphragm Release; Manual Diaphragm Release Technique: will be applied during two series of ten deep respiratory cycles, with one minute interval between sets.	Other: GROUP Manual Diaphragm Release; The therapist makes manual contact with the underside of the costal border of the common cartilage of the last rib. In the inspiratory phase, the therapist draws the points of contact with both hands in a cephalad direction and slightly Accompanying the movement of the rib cage.; Other Name: GROUP B

Outcome Measures

Primary Outcome Measures :

1. Mobility of the thoracic cage [ Time Frame: Three weeks total: Thirty minutes after the first intervention, after two weeks of intervention and after one week without treatment (follow up) ]
   Will be measured by optoelectronic plestimography

Secondary Outcome Measures :

1. Diaphragma mobility [ Time Frame: Three weeks total: Thirty minutes after the first intervention, after two weeks of intervention and after one week without treatment (follow up) ]
   Will be measured with ultrasonography
2. functional capacity [ Time Frame: Three weeks total: after two weeks of intervention and after one week without treatment (follow up) ]
   Will be measured six minute walk test
3. heart rate variability [ Time Frame: 1 day: before and after the intervention ]
   Will be measured Pollar

Eligibility Criteria

• Ages Eligible for Study: 21 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Diagnosis of COPD (spirometry with FEV1 <80% and FEV1 / FVC <0.7) of both sexes, who are not undergoing another physiotherapeutic treatment, from to 21 years of age, clinically stable without exacerbation in the last 6 weeks.

Exclusion Criteria:

• Patients with rheumatic or orthopedic diseases;
• Deformities / abnormalities in the spine that compromise the mechanics of the respiratory system;
• Rib fracture for less than 1 year;
• Respiratory co-morbidities;
• History of thoracic or abdominal surgery for less than 1 year;
• Osteoporosis and IMC > 30kg / m²

Contacts and Locations

Contacts

Contact: HELENA M ROCHA; hmr.fisio@gmail.com

Locations

Brazil

Universidade Federal de Pernambuco; Recruiting

Recife, Pernambuco, Brazil, 50670-901

Contact: HELENA M ROCHA hmr.fisio@gmail.com

Sponsors and Collaborators

Universidade Federal de Pernambuco

Investigators

• Principal Investigator: HELENA M ROCHA; Universidade Federal de Pernambuco

More Information

• Responsible Party: HELENA MEDEIROS ROCHA, Graduate, Universidade Federal de Pernambuco
• ClinicalTrials.gov Identifier: NCT03022942
• Other Study ID Numbers: Lacap UFPE
• First Posted: January 18, 2017
• Last Update Posted: April 11, 2018
• Last Verified: April 2018

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Undecided

Additional relevant MeSH terms:

Disease; Pathologic Processes