The effect of manual therapy and exercise on age-dependent lung function: a randomised controlled trial.

INTERVENTION: Intervention groups: Group 1: Exercise Group 2: Thoracic mobilisation + exercise Group 3: Thoracic manipulation + exercise Exercise will involve a standardised 10 minute treadmill walking program at a speed and inclination that is considered 'comfortable' for the participant. Thoracic mobilisation will involve soft tissue therapy followed by a joint mobilisation protocol administered to the muscles of the posterior chest wall and the thoracic spine T2‐T12), costo‐vertebral and costo‐transverse joints (2nd‐10th) respectively. This protocol will include 5 minutes of soft tissue therapy to the muscles of the posterior chest wall followed by 5 repetitions of joint mobilisation (Maitland Grades III‐IV) in each of the following 4 directions: flexion/extension, left and right rotation, left and right transverse, and left and right ribs. The total time for a mobilisation session is 15 minutes. Thoracic manipulation will involve soft tissue therapy followed by a joint manipulation protocol administered to the muscles of the posterior chest wall and the thoracic spine T2‐T12), costo‐vertebral and costo‐transverse joints (2nd‐10th) respectively. This protocol will include 5 minutes of soft tissue therapy to the muscles of the posterior chest wall followed by 2 manipulations (Maitland Grade V) administered to the upper/middle and middle/lower thoracic spine and ribs. Each manipulation will be administered as a 'group' manipulation that involves multiple thoracic inter‐vertebral, cost‐vertebral and costo‐transverse joints The total time for a mobilisation session is 15 minutes. A register of attendance at the intervention sessions (exercise, mobilisation and manipulation) will be kept for each participant. Masters of Osteopathy interns will deliver mobilisation and manipulation intervention. Master of Clinical Exercise Physiology interns will supervise exercise performance. All three interventions will be administered 6 times over a 3 week period @ 2 times per week. The trial will be conducted in Southern Cross University's Lismore and Gold Coast Health Clinics. CONDITION: Lung function PRIMARY OUTCOME: Change in chest expansion as measured by tape measure. ; Change in lung function as measured by spirometry. ; Change in quality of life as measured by SF‐36. SECONDARY OUTCOME: Occurrence of adverse event following mobilisation or manipulation intervention. ; Known adverse events include localised muscle soreness and/or pain, restriction in movement, radiating pain or bone fracture. The presence of these will be assessed through self‐reporting by participant in the study and confirmed on X‐Ray where appropriate. INCLUSION CRITERIA: i. No history of respiratory disease ii. Currently non‐smoking (preceding 6 months) iii. Able to walk unaided and unassisted on a treadmill for 10 minutes