Manual therapy in diaphragm muscle: effect on respiratory muscle strength and chest mobility

Abstract

Introduction: Manual therapy employs hands as a way of healing, being a manipulation for therapeutic purposes. However, there is little evidence about their effects on the respiratory system. Objective: To describe the effect of manual therapy in the diaphragm, the breathing muscle strength and mobility of the rib cage. Method: Descriptive, longitudinal, interventionist and quantitative survey, conducted in Cardiopneumofuncional Therapy Laboratory of the Federal University of Ceará (UFC). The sample consisted of 40 female students, sedentary, aged between 18 and 35 years of UFC physiotherapy course. The following techniques were performed: "lift diaphragm" and double pillars psoas diaphragm. Data collection was carried out in three stages on the same day by the same researcher using homogeneous verbal commands. It was considered statistically significant value of p = 0.05. Results: After application of the techniques carried out a comparative analysis which demonstrated a statistically significant difference in maximal expiratory pressure, with p <0.0001, and all coefficients cirtometry, being p <0.0025 (axillary), p < 0.0085 (xiphoid) and p <0.0005 (basal). Conclusion: The manual therapy techniques performed on the diaphragm influence the muscular strength, due to increased maximal expiratory pressure; and mobility of the rib cage, reflected in increased cirtometry coefficients.

Immediate effects of diaphragmatic myofascial release on the physical and functional outcomes in sedentary women: A randomized placebo-controlled trial

“…The authors adopted a sitting position that does not favor the elongation of the muscular fibers of the diaphragm, and they excluded sedentary individuals what might also contribute to a difference in results with our study. The results of another study (Braga et al, 2016) are in agreement with our results related to chest wall mobility immediately after two diaphragmatic release techniques in sedentary young women. This may be because the techniques performed in both studies used the same protocol in a similar population and the outcomes were measured by the same evaluation tool (cirtometry).…”

Manual therapies in cystic fibrosis care: a scoping review

“…As one or more of these properties can be changed by pulmonary disease processes, muscle strength can become negatively affected. MT has been shown to have positive effects on respiratory muscle strength [ 20 , 21 ]. However, none of the studies included in this review reported on the effects of MT on respiratory muscle strength in CF.…”

“…One group of interventions, used in the treatment of musculoskeletal pain and dysfunction, are manual therapies (MTs). MTs as part of conventional care have mainly been explored by chiropractors, osteopaths and physiotherapist for various health care contexts and have been shown to have positive effects in several conditions, e.g., musculoskeletal pain, impaired mobility and respiratory muscle strength, anxiety, and gastrointestinal function [16][17][18][19][20][21]. In accordance with a broadened multimodal practice in CF, as described above, there is room to explore interventions that are currently not included in the international guidelines, e.g., MT.…”

Manual Therapy Interventions in Patients With Chronic Obstructive Pulmonary Disease: A Comprehensive Narrative Review

“…The diaphragm, being the primary respiratory muscle, undergoes modifications in its contractile force and influences lung volumes and capacities, when subjected to shortening. This phenomenon arises from considering lung volume as a matrix representing the length index of the respiratory muscle [ 6 , 7 ]. Stretching muscle fibers encourages the growth of sarcomeres, which in turn lengthens shortened muscles.…”