Respiratory Evaluation and Training as an Adjunct to Manual Therapy

Study Title: Breathing Evaluation and Retraining as an Adjunct to Manual Therapy
Authors: L. McLaughlin, C.H. Goldsmith & K. Coleman
Journal: Manual Therapy
Date: 2011

Summary:

• Here's a short little study that evaluated the presence of poor respiratory chemistry in patients suffering from neck and low back pain, as well as the efficacy of biofeedback training on chemistry, pain and function. If you are a frequent reader of this blog then you'll know that trunk muscles have a dual postural stability and respiratory function. You'll also know that the presence of poor respiratory control may result in faulty thoracic, cervical, and scapular mechanics. Well the authors of this paper took a series of 29 cases with neck and/or back pain who failed conservative outpatient manual and rehabilitative therapy and studied whether or not they possessed poor respiratory chemistry.  Such (poor) chemistry was identified via a capnograph which measures CO2 levels at the end of a normal exhale.
• Respiratory retraining was the main intervention in this study, consisting of awareness training, capnograph feedback, and manual therapy to improve mobility. Not only did the results demonstrate that all 29 patients possessed below normal ETCO2 levels, but outcome measures recorded improved in all patients following the intervention.
• While most, if not all, of you probably do not own a capnograph, this study does provide good evidence that 1) many of your patients suffering from neck and/or back pain probably also have some level of poor respiratory control, and 2) pain levels can improve following a clinical intervention that includes both respiratory training and manual mobilization.
• Unfortunately however, most physical therapy, chiropractic, athletic training, and massage therapy programs don't include respiratory training techniques in their educational curriculum. 

McLaughlin, L. et al. (2011). Breathing evaluation and retraining as an adjunct to manual therapy. Manual Therapy, 16; 51-52.