COMBINED EFFECT OF MUSCLE ENERGY TECHNIQUE AND JOINT MANIPULATION IN MALE AND FEMALE PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A QUASI EXPERIMENTAL STUDY
Background: Chronic Obstructive Pulmonary Disease (COPD) influence function of diaphragm muscle thus affecting maximal inspiratory pressure. So, the present study is planned to analyze combined effect of Muscle Energy Technique (MET) and Joint Manipulation (JM) on lung function and diaphragm muscle strength. Purpose: The purpose of the study was aimed to evaluate the effectiveness of both MET and JM to improve the pulmonary function by improving chest expansion, thoracic spine mobility and diaphragm muscle function. Method: Study design was one group pretest-posttest of 16 patients with COPD aged between 35-65 years. Patients were diagnosed with COPD receive MET of accessory muscle, C4-C6 spine and JM of the thoracic spine, six times for 3 week of period. Primary outcome measure is Lung function (Spirometry) and secondary outcomes Portable capsule sensing pressure gauge, Measuring tape, Pulse oximeter, Modified borg rating perceived exertion scale, COPD Assessment Tool (CAT), mMRC (modified Medical Research Council) scale of dyspnea, BODE index, diaphragm excursion(chest X-ray) and COPD GOLD ABCD Assessment Tool classification. Outcome measurements were taken on two occasions both pre and post application of independent variable. Result: Data analysis was done by paired t-test and Wilcoxon signed- rank test. The significance level value was set at 0.05. Primary outcome measure FEV1/FVC ratio showed highly significant result and in secondary outcomes measures, statistical significant improvement was seen except for Diaphragm excursion. Conclusion: There were significant improvement was seen on pulmonary function, chest expansion, maximum inspiratory pressure, dyspnea in patients with COPD after application of MET and JM.