Manual Therapy, Thera-band Exercise and Walking
Condition: Aging
Study type: Interventional

Summary: 
      Worldwide, the number of older adults is expected to more than double by 2050 and more than
      triple by 2100, with most of the increase in developing countries. This situation has become
      a challenge to health professions such as physical therapy, since aging involves a gradual
      reduction in the capacity to adapt and an increase in vulnerability to health issues such as
      chronic non-communicable diseases and musculoskeletal disorders. The respiratory system, as
      the rest of the body, is exposed to both physiological aging and disease. According to the
      World Health Organization , respiratory diseases such as trachea, bronchi, or lung cancer,
      lower respiratory tract infections, or chronic obstructive pulmonary disease are found in the
      third, fifth, and sixth cause of death, respectively, among the top ten.

      Therefore, bronchopulmonary and thoracic pathology constitutes an important problem for
      Public Health, both due to the high number of affected subjects and to their potential
      severity For this reason, the recommendations of the European, North American and national
      societies, highlight, among other aspects, the importance of the prevention of these
      diseases. They also insist on the need to maintain the integrity of the thoraco-abdominal
      anatomical elements and preventive treatment in those at risk, before symptoms appear. These
      recommendations together with the change of perspective that is being taken into account when
      treating aging have led to the fact that in the last decade more research has been started on
      the respiratory system in older people without respiratory problems.

      The aim of this trial is to investigate whether manual therapy, elastic band exercise or
      walking can mitigate the effects of age-related changes in lung function in adults over 60
      years old. Also whether there is a difference in effect between the different forms of
      therapy.
    

Detailed description: 
      Study design A 4-week program will be implemented with sessions 2 days a week, 45-60 minutes
      per session. It would be convenient for each group to have 30 participants each. Group1:
      walking group. 40 minutes walking with supervision of the physiotherapist. 2 times per week.;
      Group 2: walking (40 minutes) plus self-administered thorax manual therapy (20 minutes). It
      will be applied in group and supervised by a physiotherapist. 2 times per week.; Group 3:
      walking (40 minutes) plus thorax exercises with elastic-band (20 minutes). It will be applied
      in group and supervised by a physiotherapist. 2 times per week.;Group 4: control group will
      do usual life and assessments as the rest of the groups.

      Oucome measures Pulmonary function: pulmonary function evaluation via forced spirometry
      dynamic lung volumes (forced vital capacity, FVC; forced expired volume at 1 second, FEV1).
      Chest wall expansion: A measuring tape is used to measure chest expansion in centimetres (cm)
      at two levels of the rib cage: upper chest expansion and lower chest. Exercise tolerance: 6
      Six Minute Walk Test. Smoking Index. The smoking index is a unit for measuring cigarettes
      consumption over a long period. Musculoskeletal Pain: visual analog scale. The pain VAS is a
      unidimensional measure of pain intensity, which has been widely used in diverse adult
      populations. Perception of change after treatment: Patient Global Impression of Improvement.
      Quality of life. Trigger points pain: by algometer. Change in thorax position: Distance
      between acromion-bed. Functional capacity: Sit-to-stand. Frailty: FRAIL Questionnaire.
      Motivation and self-efficacy: Participation motives are measured with the Exercise Motivation
      Index.
    

Intervention name(s): Group1, walking group; Group 2, Walking plus manual therapy; Group 3; Walking plus exercises with Theraband
Intervention type(s): Other; Other; Other
Intervention description(s): The walking group includes a weekly walking goal of 75 minutes.; Walking plus self-administered thorax manual therapy; Walking plus thorax exercises with Theraband
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment