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The Effect of OMT on Patients With COPD: Correlating Pulmonary Function Tests With Biochemical Alterations

Not Applicable
Completed
Conditions
Chronic Obstructive Pulmonary Disease
Interventions
Other: sham omt
Procedure: Osteopathic Manipulative Treatment (OMT)
Registration Number
NCT01582958
Lead Sponsor
Michigan State University
Brief Summary

This project proposes to test the hypothesis that osteopathic manipulative treatment (OMT) given to patients with moderate to severe chronic obstructive pulmonary disease (COPD) enrolled in a 12-week pulmonary rehabilitation program (PRP) will result in improved respiratory pump function over and above that seen in sham and control groups. Specifically, we will study the effects of three OMT techniques: (a) thoracic inlet indirect myofascial release; (b) rib raising with continued stretch of the paraspinal muscle to the L2 level; and (c) cervical paraspinal muscle stretch with suboccipital muscle release. The key clinical readouts will include: spirometry, P100 (and index of diaphragm and inspiratory muscle efficiency), maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), as well as laser evaluation of chest wall excursion. Supplementing these objective parameters will be several more subjective clinical outcome measures: exercise tolerance (6-minute walk test), dyspnea (shortness of breath questionnaire), and quality of life questionnaire. Finally, an attempt will be made to correlate biochemical alterations that may shed light on the biological mechanism underlying the OMT procedures.

Detailed Description

According to the above directions (provide a more extensice description, if desired), I am choosing to just submit the brief summary.

Thank you, Sherman Gorbis, DO

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
45
Inclusion Criteria
  • postbronchodilator FEV1/FVC <0.7 and FEV1 <80% predicted [FEV1 =volume that has been exhaled at the end of the first second of forced expiration] and FVC volume of air that can be forcibly blown out after full inspiration]
  • history of smoking >20 pack-years
  • stable condition at inclusion with no infection or exacerbation for at least two months
  • optimal medical therapy for at least eight weeks with no change
Exclusion Criteria
  • history of active pulmonary disease such as asthma
  • positive bronchodilator test
  • treatment with N-acetylcysteine
  • previous diagnosis of hypertension or current anti-hypertensive treatment
  • known unstable or moderate to severe heart disease (arrhythmia, ischemic heart disease, or cardiomyopathy)
  • previous diagnosis of chronic illness such as diabetes, renal failure, hypercholesterolemia, hepatic cirrhosis, cancer, rheumatoid arthritis or any other systemic inflammatory disease
  • neuromuscular or disabling cognitive problems
  • engagement in any exercise-training program during the past three months
  • substance abuse in the preceding six months

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
placebosham omtReceives normal pulmonary rehabilitation care plus positioned to receive OMT but OMT is not provided.
TreatmentOsteopathic Manipulative Treatment (OMT)This arm will receive the usual Pulmonary Rehabilitation Program plus OMT, the intervention.
Primary Outcome Measures
NameTimeMethod
Change from baseline in spirometry at 6 weeks and 12 weeksbaseline, 6 weeks, 12 weeks

amount (volume) and/or speed (flow) of air that can be inhaled and exhaled

Change from baseline in P100 at 6 weeks and 12 weeksbaseline, 6 weeks, 12 weeks

an index of diaphragm and inspiratory muscle efficiency (endurance)

Change from baseline in MIP (maximum inspiratory pressure) and MEP (maximum expiratory pressure)at 6 weeks and 12 weeks.baseline, 6 weeks, 12 weeks

assessments of inspiratory and expiratory muscle function, respectively

Change from baseline in inspiratory capacity at 6 weeks and 12 weeks.baseline, 6 weeks, 12 weeks

representing an indirect evaluation of chest wall excursion

Secondary Outcome Measures
NameTimeMethod
Change from baseline in exercise tolerance at 6 weeks and 12 weeks.baseline, 6 weeks, 12 weeks

6-minute walk test

Change from baseline in dyspnea (shortness of breath) at 6 weeks and 12 weeks.baseline, 6 weeks, 12 weeks

shortness of breath questionnaire

Change from baseline in profiling of the plasma metabolome at 6 weeks and 12 weeks.baseline, 6 weeks, 12 weeks

mass spectrometry (both non-targeted profiling of entire suite of metabolites and targeted profiling of oxylipins and endocannabinoid metabolites

Change from baseline in quality of life at 6 weeks and 12 weeks.baseline, 6 weeks, 12 weeks

Short Form 36 questionnaire

Change from baseline in profiling of plasma proteins at 6weeks and 12 weeks.baseline, 6 weeks, 12 weeks

antibody microarray analysis (particularly targeting the inflammatory/anti-inflammatory cytokines)

Trial Locations

Locations (1)

McClaren Greater Lansing

🇺🇸

Lansing, Michigan, United States

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