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Health Watch discusses COPD, a common and preventable disease.

When it comes to managing and treating patients with COPD, medications and nonpharmacological interventions both need to be part of the plan.

Osteopathic manipulation and various other manual techniques have been developed and performed by osteopathic physicians through the years, but none have been adequately studied in patients with COPD. A small group study reported a reduction in symptoms and better arterial oxygenation over a limited period of time.26 Other studies added thoracic lymphatic pump interventions along with rib raising and myofascial release during 1 treatment period, and again symptoms improved, but there was no increase in measured expiratory airflow or favorable changes in lung volumes that could have suggested that a decrease in thoracic trapped gas volume occurred, which could have explained why these interventions improved symptoms.27,28 Because multiple techniques were used, it was impossible to determine the contribution of each treatment intervention to the final outcome. Despite these findings, patients may have some symptomatic improvement with manipulative interventions, suggesting that more research is needed, especially over a longer period of treatment. Another small study suggested that osteopathic manipulation coupled with pulmonary rehabilitation improved exercise capacity, as measured by the 6-minute walk test and reduced residual volume in severely impaired patients with COPD.2

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