Background: Manual Therapy has recently gained popularity and interests from health care
providers in the field of Pulmonary Rehabilitation programs for COPD patients as it has proved to
have great health and clinical benefits. Additional benefits in clinical outcomes may be obtained by
adding therapeutic exercise to manual therapy.
Objective: The aim of this research was to study the acute effect of combined myofascial release
based-manual therapy for pectoralis minor muscle and therapeutic strengthening exercises for
shoulder depressors and scapular adductors, compared to the effect of a single administration of shortacting
bronchodilator in COPD patients.
Method: Fifty four male patients with COPD were equally divided into two groups; group A (n=27)
received one physiotherapy treatment session combining pectoralis minor muscle myofacial release
and therapeutic strengthening exercises for shoulder depressors & scapular adductors, while group B
(n=27) received an inhaled short-acting bronchodilator for one time. Measurement included
ventilatory function as the main outcome, and chest expansion & Verbal Descriptor Scale (VDS) of
muscle pain as secondary outcomes.
Results: FEV1, FVC, MVV, chest expansion, and VDS of pectoralis minor muscle tightness pain
significantly improved only in group A (P ˂ 0.05). Nevertheless, there was no statistically significant
difference between the two groups except for VDS.
Conclusion: a single physiotherapy intervention of myofascial release-based manual therapy
combined with therapeutic exercise has succeeded to induce some clinical benefits in patients with
COPD. This protocol may represent an alternatively novel physiotherapy intervention that can be
included in pulmonary rehabilitation programs for COPD patients.