The effect of manual therapy and low intensity exercise on lung function and quality of life in healthy adults between 50 and 65 years: a randomised controlled trial

Objective: To investigate the effect of multiple sessions of manual therapy and exercise on the lung function of healthy adults between the ages of 50 and 65 years. 
Methods: 144 healthy participants were randomised into three groups: exercise only (Ex), mobilisation and exercise (MB) and manipulation and exercise (MT). All participants received 6 intervention sessions over a 3-week period with follow-up measurements at 3-, 6- and 9-weeks post-intervention. Exercise consisted of treadmill walking for 10 minutes; MB involved a standardised mobilisation protocol designed to increase mobility in the thoracic spine and rib cage; while MT was administered as high velocity low amplitude thoracic manipulation. Outcome measures included lung function (spirometry), chest wall expansion (tape measure) and quality of life (SF-36). Adverse events related to all three interventions were also recorded.
Results: There were no significant differences between groups over time for lung function or chest expansion (p >/= 0.13). Results from the SF-36 showed no significant difference between any pair of groups in the change from baseline to 12-months post-intervention (p >/= 0.20). There were no reports of severe adverse events following any of the interventions.
Discussion: The main finding was that a short course of manual therapy combined with low intensity exercise did not deliver changes in lung function or chest expansion in healthy older people. The relative inexperience of the practitioners delivering the manual therapy may have been a confounding factor and contributed to the nature of the results.