NCT07381842

The Effects of Manual Therapy on the Spatiotemporal Gait Characteristics in Patients With Chronic Obstructive Pulmonary Disease

An Investigation of the Effects of Manual Therapy on the Spatiotemporal Gait Characteristics in Patients With Chronic Obstructive Pulmonary Disease

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 40 (estimated)
• Sponsor: Hacettepe University · Academic / Other
• Sex: All
• Age: 40 Years
• Healthy volunteers: Not accepted

Summary

The primary aim of this study is to investigate the effects of manual therapy on spatiotemporal characteristics of gait and gait variability, functional exercise capacity, and pulmonary function in patients with chronic obstructive pulmonary disease (COPD). The secondary aims of the study are to determine the effects of manual therapy on balance, respiratory muscle strength, quality of life, physical activity, symptom severity, accessory respiratory muscle activation, peripheral muscle strength, chest wall mobility, dysfunctional breathing, pain, and posture.

Detailed description

Musculoskeletal changes secondary to systemic inflammation in chronic obstructive pulmonary disease (COPD) negatively affect both ventilatory efficiency and ventilation-perfusion matching during walking, leading to a reduction in functional capacity. Current and conventional pulmonary rehabilitation approaches generally aim to improve aerobic capacity, muscle strength, and respiratory muscle endurance. However, aspects such as thoracic spine mobility, costotransverse and costovertebral joint biomechanics, the craniocaudal positioning of the diaphragm, and accessory respiratory muscle activation are still not adequately addressed in existing rehabilitation programs. The effects of manual therapy applied to the thoracic region, trunk, and accessory respiratory muscles on both exercise capacity and the spatiotemporal characteristics of gait have not yet been clearly established. Given the multisystem involvement in COPD, the application of manual therapy-an intervention with a high level of evidence in the management of other musculoskeletal conditions-offers an innovative approach to treatment. It is plausible that muscle energy techniques, one of the manual therapy methods, may reduce hypertonicity in excessively activated accessory respiratory muscles during breathing and thereby enhance chest wall expansion. In the existing literature, the limited number of studies investigating manual therapy interventions in COPD have primarily focused on pulmonary function and exercise capacity; however, there is still no consensus regarding the outcomes. Considering the biomechanical connection between the thoracic cage and the trunk and extremities, it can be hypothesized that manual therapies in COPD may influence gait by affecting lower extremity movements. In this context, manual therapy may impact not only respiratory parameters but also gait performance through the interaction between biomechanics, respiration, and posture in patients with COPD.

Conditions

• COPD (Chronic Obstructive Pulmonary Disease)
• Manuel Therapy
• Gait Biomechanics
• Muscle Energy Technique
• Functional Capacity

Interventions

Type	Name	Description
OTHER	Manual therapy Group	For muscle energy techniques, the post-isometric relaxation (PIR) technique will be applied. Participants will be instructed to perform an isometric contraction against mild resistance (20-30% of maximal effort), which will be maintained for 7-10 seconds, followed by a 3-second relaxation period. PIR applications will be performed bilaterally for each muscle group, in 2 sets with a total of 10 repetitions. The muscle groups to which MET will be applied include the pectoralis major and minor, upper trapezius, scalene muscles, sternocleidomastoid, and latissimus dorsi. For the diaphragmatic relaxation technique, the therapist will follow the elevation of the ribs and gently draw the contact points cranially and slightly laterally. During expiration, the therapist will maintain resistance by deepening the contact toward the internal costal margin. The maneuver will be applied in two sets of 10 deep breaths, with a 1-minute rest interval between sets.
OTHER	Control group	Self-stretching and breathing exercise

Timeline

• Start date: 2026-02-08
• Primary completion: 2026-11-08
• Completion: 2028-01-08
• First posted: 2026-02-02
• Last updated: 2026-02-02

Locations

1 site across 1 country: Turkey (Türkiye)