Chest Wall Muscle Stretching and Acute Effects in Chronic Obstructive Pulmonary Disease

Study Overview
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Brief Summary
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The study hypothesis is chest wall muscle stretching increase distribution of volume variation of thoracoabdominal wall and reduce electromyographic activity of respiratory muscles in patients with Chronic Obstructive Pulmonary Disease.

Detailed Description
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Randomized controlled trial involving patients with Chronic Obstructive Pulmonary Disease evaluated before and immediately after a program of stretching muscles of the rib cage or after resting with time similar to the intervention, as volume variation of thoracoabdominal wall by optoelectronic plethysmography and on the electromyographic activity of accessory muscles of respiration.

Official Title
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Chest Wall Muscle Stretching and Acute Effects on Volume Variation of Thoracoabdominal Wall and Electromyographic Activity in Chronic Obstructive Pulmonary Disease

Conditions
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Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Procedure: Stretching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: clinical and functional diagnosis of Chronic obstructive pulmonary disease according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2009), forced expiratory volume in one second (FEV1) less than 80% predicted post-bronchodilator; clinical stability during the study, both sexes, age above 40 years, body mass index (BMI) between 18.5 and 29.9 kg / m²; smoking history, symptoms of cough, dyspnea or hypersecretion, ex-smokers for at least three months. Exclusion Criteria: Disease exacerbation for at least eight weeks, patients with other respiratory diseases, cardiovascular or osteoarticular and participants in pulmonary rehabilitation programs.

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Stretching<br>The respiratory muscle stretching were developed bilaterally as follows: Upper trapezius: head lateral flexion with a hand therapist supports the the occipital region and his shoulder, promotes the stretching; Sternocleidomastoid: was stretched with flexion lateral and rotation of the head to the side which hands on the occipital region and in the sternal region; Scalene: with one hand on the occipital region and the other in the sternum, the two points was stretched; Pectoralis major: the arm was abducted, flexed the forearm and hand was in the occipital region the therapist hands in the arm and in the side of the upper chest, which was stretched craniocaudal direction; Intercostal: therapist performs with both hands to mobilize and stretch the ribs in cranial-caudal directions. | Procedure: Stretching<br>* Patients submitted to respiratory muscle stretching related to the increase thoracic mobility. Stretching were performed in the upper trapezius, scalenes, sternocleidomastoids, major pectoral and intercostals. The muscle stretching were performed passively by a single therapist trained and experienced. The subjects were positioned supine or lateral, knees flexed in order to correct the lumbar curve. Stretching occurred during the expiratory phase, leading to muscle maximum length, with two series of ten consecutive incursions for each muscle, with an interval of one minute between series. The patients were properly informed to perform slow exhalations and pursed-lip during stretching.<br>|
| No Intervention: Rest<br>COPD patients were not submitted to any intervention, remaining at rest in the same place, position and time period to the treatment group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Distribution of volume variation of thoracoabdominal wall and electromyographic activity of respiratory muscles |  | 1 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Respiratory rate, minute volume, expiratory time, inspiratory time, relation inspiratory time/ total time |  | 1 hour |