The Effectiveness of Manual Therapy on Musculoskeletal and Respiratory Parameters in Patients with Chronic Low Back Pain: A Systematic Review

Tatsios, Petros; Koumantakis, George A.; Karakasidou, Palina; Philippou, Anastasios

doi:10.1615/critrevphysrehabilmed.2021038977

Cited by 4 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on the current evidence underlying the observed respiratory dysfunction in patients with NSCNP [ 9 ], a previous cohort study incorporating breathing management demonstrated improvement in musculoskeletal and respiratory outcomes, with full resolution of symptoms [ 8 ]. According to the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT), manual therapy (MT) is a specialized area of physical therapy for the management of neuromusculoskeletal conditions based on clinical reasoning and using precise treatment approaches, including manual techniques and specific therapeutic exercises, while, in parallel, considering the psychosocial state of each patient [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several biomechanical, neurophysiological, psychological, and other nonspecific mechanisms are stimulated via MT to improve musculoskeletal and respiratory outcomes [ 11 ] in patients with NSCNP. Many systematic reviews analyze the effectiveness of MT in musculoskeletal outcomes [ 10 ], but there is a deficit in the existing literature regarding the effectiveness of MT in respiratory outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effectiveness of Spinal, Diaphragmatic, and Specific Stabilization Exercise Manual Therapy and Respiratory-Related Interventions in Patients with Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis

et al. 2022

Self Cite

View full text Add to dashboard Cite

Patients with nonspecific chronic neck pain (NSCNP) exhibit respiratory dysfunction. This systematic review aimed to analyze randomized controlled trials (RCTs) investigating the effect of spinal and/or diaphragmatic and/or specific stabilization exercise manual therapy and/or respiratory exercises on musculoskeletal and respiratory diagnostic outcomes in patients with NSCNP. A systematic search and selection of RCTs was performed in three scientific databases (Pubmed, Scopus, and Physiotherapy Evidence Database (PEDro)) and one search engine (Google Scholar) from inception to April 2022. Relevant studies published in the English language were extracted, evaluated, and independently rated for methodological quality (PEDro scale). The quality of the evidence was assessed with the GRADE approach. Out of 1089 studies collected in total, 1073 were excluded (i.e., did not meet the inclusion criteria or were duplicates). Sixteen RCTs were finally included, rated on 5.62/10 (PEDro score) on average for methodological quality. Overall, there was sparse evidence that spinal and/or diaphragmatic manual therapy and/or trunk stabilization exercises and/or respiratory exercises significantly improved pain, disability, and respiratory outcomes in patients with NSCNP immediately post-treatment. However, the clinical heterogeneity between studies was significant, and the level of certainty of the evidence was low to very low. More, high-quality RCTs are required, contributing to the holistic diagnostic monitoring and management of patients with NSCNP.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Spinal, Diaphragmatic, and Specific Stabilization Exercise Manual Therapy and Respiratory-Related Interventions in Patients with Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Diaphragmatic breathing endogenously stimulates the vagus nerve. The latter response effectively suppresses peripheral inflammatory cytokine release, decreases sympathetic tone, activates the parasympathetic nervous system’s relaxation response, and contributes to pain control [ 13 ]. We contend that the addition of breathing reeducation exercises will decrease the respiratory rate, as well as restore dysfunctional breathing and the respiratory chemistry (end tidal CO 2 increase, pH normalization, and improved tissue oxygenation), contributing to a decrease in the excitability of the nervous and muscular system, resulting in analgesia [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…According to the International Federation of Orthopedic Manipulative Physical Therapists (IFOMPT), manual therapy (MT) is defined as: “a specialized area of physical therapy for the management of neuro-musculoskeletal conditions, based on clinical reasoning, using highly specific treatment approaches, including manual techniques and therapeutic exercises,” considering in parallel to the psychosocial state of each patient [ 13 ]. To improve musculoskeletal and respiratory outcomes, MT stimulates a number of biomechanical, neurophysiological, and psychologically mediated mechanisms [ 13 ]. The effectiveness of MT in musculoskeletal outcomes has been examined in numerous systematic reviews [ 11 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Manual Therapy in the Cervical Spine and Diaphragm, in Combination with Breathing Reeducation Exercises, in Patients with Non-Specific Chronic Neck Pain: Protocol for Development of Outcome Measures and a Randomized Controlled Trial

et al. 2022

Self Cite

View full text Add to dashboard Cite

Until now, non-specific chronic neck pain has mainly been considered as a musculoskeletal system dysfunction, with associated psychological involvement due to its prolonged or recurrent nature. However, patients with non-specific chronic neck pain frequently additionally exhibit respiratory dysfunction. Emerging evidence suggests that addressing the respiratory dysfunction in these patients will provide additional therapeutic benefits in musculoskeletal and respiratory-related outcomes for several reasons (biomechanical, biochemical, and psychological). Motor control dysfunction of the muscles surrounding the spine (diaphragm included) negatively affects the mechanics and biochemistry of breathing (pH-homeostasis). An impaired and ineffective breathing pattern has been recognized as the primary source of many unexplained symptoms (anxiety, depression, confusion, chest pain, hypocapnia, and breathlessness) in patients with non-specific chronic neck pain. The proposed protocol’s purpose is dual: to assess the relative effectiveness of manual therapy in the cervical spine and the diaphragm, in combination with breathing reeducation exercises, along with cervical spine manual therapy or usual physical therapy care on the underlying dysfunctions in patients with non-specific chronic neck pain via a randomized controlled clinical trial, and to validate part of the outcome measures. Several musculoskeletal and respiratory dysfunction outcomes will be employed to delimit the initial extent and level of dysfunction and its resolution with the treatments under study.

show abstract

Respiratory dysfunction in persistent somatic symptoms: A systematic review of observational studies

Niwa,

Fila-Pawłowska,

Van den Bergh

et al. 2024

Journal of Psychosomatic Research

View full text Add to dashboard Cite

The Effectiveness of Manual Therapy on Musculoskeletal and Respiratory Parameters in Patients with Chronic Low Back Pain: A Systematic Review

Cited by 4 publications

References 0 publications

The Effectiveness of Spinal, Diaphragmatic, and Specific Stabilization Exercise Manual Therapy and Respiratory-Related Interventions in Patients with Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis

The Effectiveness of Spinal, Diaphragmatic, and Specific Stabilization Exercise Manual Therapy and Respiratory-Related Interventions in Patients with Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis

The Effectiveness of Manual Therapy in the Cervical Spine and Diaphragm, in Combination with Breathing Reeducation Exercises, in Patients with Non-Specific Chronic Neck Pain: Protocol for Development of Outcome Measures and a Randomized Controlled Trial

Respiratory dysfunction in persistent somatic symptoms: A systematic review of observational studies

Contact Info

Product

Resources

About