Effects of Adding Respiratory Training to Osteopathic Manipulative Treatment on Exhaled Nitric Oxide Level and Cardiopulmonary Function in Patients With Pulmonary Arterial Hypertension.

Limited research exists regarding nonpharmacologic management of pulmonary arterial hypertension (PAH), except for exercise training. The objective of this study was to investigate the effects of osteopathic manipulative treatment (OMT) alone and combined with respiratory training on fractional exhaled nitric oxide (FeNO), and cardiopulmonary function in patients with PAH. This single-blind, prospective, randomized controlled study included 54 patients with PAH who were randomly allocated to OMT, combined intervention, and control groups. The OMT group (n = 16) and combined intervention group (n = 16) received OMT and yoga respiratory training plus OMT, respectively, twice a week for 8 weeks. The control group (n = 16) received no intervention. All patients undertook an educational lecture. FeNO level, pulmonary function, 6-minute walk distance (6MWD), maximal inspiratory and expiratory pressures, and handgrip strength were assessed at baseline and 8 weeks. Combined intervention and OMT groups significantly improved all outcome measures after 8 weeks of treatment (p <0.01), except mean forced expiratory flow between 25% and 75% of forced vital capacity, which did not change in the OMT group (p >0.05). The control group showed significant deteriorations in 6MWD, inspiratory and peripheral muscle strength, and pulmonary function except peak expiratory flow at 8 weeks (p <0.05). The combined intervention group revealed significantly greater improvements of FeNO, 6MWD, respiratory and peripheral muscle strength, and pulmonary function except mean forced expiratory flow between 25% and 75% of forced vital capacity compared with the OMT group (p <0.05). All outcomes significantly improved in both intervention groups versus the control group (p <0.05). Our study demonstrated that adding respiratory training to OMT provided further benefit to FeNO level and cardiopulmonary function compared with OMT alone and that the OMT might be a useful and safe intervention for patients who cannot attend cardiac rehabilitation programs.

Effects of Kinesio Taping and compression stockings on pain, edema, functional capacity and quality of life in patients with chronic venous disease: a randomized controlled trial.

OBJECTIVE: The aim of this study was to compare the effects of Kinesio Taping and compression stockings on pain, edema, functional capacity and quality of life in patients with chronic venous disease (CVD). DESIGN: This is a prospective, randomized, controlled, single-blind clinical trial. SETTING: The study was conducted in a physiotherapy and rehabilitation unit of a university hospital. SUBJECTS: A total of 62 patients with early-stage CVD were allocated to either an experimental group or a control group. INTERVENTIONS: Experimental group (n = 29) received Kinesio Taping intervention once a week for four weeks, while control group (n = 29) received compression stockings for four weeks. All patients additionally undertook an exercise training programme including calf muscle pump exercises, flexibility exercises and diaphragmatic breathing. MAIN MEASURES: Visual analogue scale, lower limb circumference measurements, 6-minute walk test and Short Form 36 questionnaire were applied before and after four weeks of treatment. RESULTS: Control group showed statistically significant improvements in pain (P < 0.001), ankle circumferences (right, P = 0.002; left, P = 0.037), calf circumferences (right, P = 0.020; left, P = 0.022), knee circumference (left, P = 0.039) and thigh circumferences (right, P = 0.029; left, P = 0.002) compared with experimental group. There were no significant differences between groups with respect to functional capacity and quality of life (P > 0.05). Both groups significantly improved 6-minute walk distance (P < 0.001) and Short Form 36 physical component summary (experimental group, P = 0.002; control group, P = 0.006). CONCLUSION: This study demonstrated that Kinesio Taping and compression stockings revealed similar improvements of functional capacity and quality of life in patients with CVD. The symptoms of pain and edema caused by CVD can be decreased more efficiently with compression stockings than Kinesio Taping intervention.