The Manual Diaphragm Release Technique improves diaphragmatic mobility, inspiratory capacity and exercise capacity in people with chronic obstructive pulmonary disease: a randomised trial

Rocha, Taciano; Souza, Helga Cecília Muniz de; Brandão, D.; Rattes, Catarina; Ribeiro, Luana Carneiro; Campos, Shirley Lima; Aliverti, Andréa; Andrade, Armèle Dornelas de

doi:10.1016/j.jphys.2015.08.009

Cited by 77 publications

(118 citation statements)

References 21 publications

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“…Furthermore, there have only been a limited number of studies investigating the effect of diaphragmatic manipulation in the presence of respiratory diseases such as COPD. 23,24 In a recent review paper, Heneghan and colleagues 24 concluded there is currently no evidence to support or reject the use of manipulative therapy for improving lung function in patients with COPD. This view is contradicted by Wearing et al with respect to spinal manipulative therapy and COPD.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Evaluation of Diaphragmatic Mobility and Contractility After Osteopathic Manipulative Techniques in Healthy Volunteers: A Prospective, Randomized, Double-Blinded Clinical Trial

Mancini¹,

Cesari

Lunghi³

et al. 2019

Journal of Manipulative and Physiological Therapeutics

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Objective: The purpose of this study was to investigate the effect of a session of osteopathic manipulative techniques on diaphragmatic motion and thickness in healthy participants. Methods: This was a prospective, randomized, double-blinded, case vs sham vs control clinical trial performed in an outpatient osteopathic clinic in Rome, Italy. Sixty-seven healthy participants, mean age 40.4 ± 14.5 years, received an ultrasound evaluation of diaphragmatic motion and thickness, followed by a systematic osteopathic evaluation. After randomization, the experimental group (n = 22) received osteopathic manipulation, whereas the sham (n = 22) and the control (n = 22) groups had a light touch approach and simple observation, respectively. After a 1-session intervention, new osteopathic and ultrasound assessments were repeated in all participants. Results: A statistically significant increase in diaphragmatic mobility was observed in the experimental group after the osteopathic manipulation (Δ = 14.5 mm, P b .001; analysis of variance P b .001 vs both sham: Δ = -0.22 mm, and control: Δ = -2.09 mm groups). A strong linear relationship was observed between the diaphragmatic motion gradient, measured with ultrasonography, and the score assigned by the operator evaluating the change of diaphragm mobility after intervention. Conclusion: Osteopathic techniques used in this study improved the diaphragmatic motion (but not the muscle thickness) in healthy participants. Further studies are needed to confirm our findings and eventually identify the clinical conditions that may benefit from osteopathic manipulative treatment of the diaphragm. (J Manipulative Physiol Ther 2019;42:47-54)

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Section: Discussionmentioning

confidence: 99%

Ultrasound Evaluation of Diaphragmatic Mobility and Contractility After Osteopathic Manipulative Techniques in Healthy Volunteers: A Prospective, Randomized, Double-Blinded Clinical Trial

Mancini¹,

Cesari

Lunghi³

et al. 2019

Journal of Manipulative and Physiological Therapeutics

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“…We understand the strategic importance of the function of the diaphragm muscle on circulatory function and we know that if approached using manual techniques it can improve its function and excursions, with benefits to all bodily systems [30,31]. We know that the pelvic floor if treated using osteopathic methods, it's functional ability is improved [32].…”

Section: Discussionmentioning

confidence: 99%

The Five Diaphragms in Patients Following Cardiac Surgery in Sternotomy: An Observational Study

Bordoni¹

2017

IJCAM

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The recovery and rehabilitation process of patients following heart surgery in sternotomy is lengthy and requires significant time. This observational study on five diaphragms in patients undergoing a sternotomy is the first of its kind.Objectives: Evaluate the position of the 5 bodily diaphragms, creating a platform of useful information for the practice of manual therapy. Understand if the diaphragm position coincides with the clinical status of the patient.Setting: Department for Cardiac Rehabilitation, Foundation Don Carlo Gnocchi IRCCS. Materials and methods:From January 2012 to July 2016, 300 cardiac patients underwent evaluation following a cardiothoracic intervention. In a supine position, palpation was conducted on the pelvic floor, the respiratory diaphragm, the thoracic outlet, the buccal floor and the cerebellar tentorium. The evaluation was undertaken on the first day of recovery in the ward. Rating scales were conducted such as the VAS, the walking test and the air life, an instrument for measuring the volume of air inhaled.Results: Eleven different positional organisation structures of the 5 diaphragms have been highlighted which do not correspond to the patient's clinical status. Conclusions:The data collected from the study allows us to obtain important information to guide the work of the manual therapist, but does not have a direct relationship with the patient's functional status.

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“…A recent study on COPD patients showed that parameters such as mobility, exercise capacity, maximal respiratory pressure, and vital capacity were improved by working the anterior chondrocostal arch with the manual diaphragm release technique [29].…”

Section: Physiotherapy Manual Therapy and The Diaphragmmentioning

confidence: 99%

Proposal for a New Manual Evaluation Scale for the Diaphragm Muscle: Manual Evaluation of the Diaphragm Scale – MED Scale

Bordoni¹,

Marelli²,

Morabito³

et al. 2017

IJCAM

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The main functions of the diaphragm are altered in the presence of respiratory diseases, due to a reduction in muscle mass and electrical coordination, and a nonphysiological adaptation of the intrinsic protein structure. Patients with COPD or OSAS, and people weaned from ventilation machines follow a rehabilitation path and physiotherapy to recover the diaphragm strength, combining manual and osteopathic therapy with specificic techniques which can be directly used on the rib muscle. The operator manually evaluates the mobility of the diaphragm before and after physiotherapy; the initial evaluation is useful to address the training, and the final one to evaluate the outcome.In literature a manual assessment of the less mobile areas of the diaphragm is currently missing, these information would be vital for the operators, in order to decide which muscle areas need to be treated. The scale proposed in the present article can be useful to address the treatment on specific affected areas and can improve informational exchange on the patient's specific needs between different professional persons. The article is the first step to present the scale as a hypothesis. Subsequently, we will make a second article to validate the scale with objective clinical tools.

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The Manual Diaphragm Release Technique improves diaphragmatic mobility, inspiratory capacity and exercise capacity in people with chronic obstructive pulmonary disease: a randomised trial

Abstract: NCT02212184.

Cited by 77 publications

References 21 publications

Ultrasound Evaluation of Diaphragmatic Mobility and Contractility After Osteopathic Manipulative Techniques in Healthy Volunteers: A Prospective, Randomized, Double-Blinded Clinical Trial

Ultrasound Evaluation of Diaphragmatic Mobility and Contractility After Osteopathic Manipulative Techniques in Healthy Volunteers: A Prospective, Randomized, Double-Blinded Clinical Trial

The Five Diaphragms in Patients Following Cardiac Surgery in Sternotomy: An Observational Study

Proposal for a New Manual Evaluation Scale for the Diaphragm Muscle: Manual Evaluation of the Diaphragm Scale – MED Scale

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