The effect of combining manual therapy with exercise for stable mild chronic obstructive pulmonary disease: a

INTERVENTION: Arm 1: Exercise Arm 2: Manual therapy and exercise Exercise: 36 x 30 minute exercise sessions over an 18 week period at an average rate of 2x/week. Administered by respiratory physiotherapists. Exercise consists of gentle aerobic exercise routines. Manual Therapy: 15 x 20 minute manual therapy sessions over a 6 week period at an average rate of 2‐3x/week. Administered by chiropractors and/or osteopaths. Manual therapy consists of massage and thoracic spinal manipulation. CONDITION: Chronic obstructive pulmonary disease PRIMARY OUTCOME: Lung function assessed by spirometry SECONDARY OUTCOME: C‐Reactive protein and leukocyte levels assessed through blood samples (10ml) Exercise capacity as measured by 6 minute walking test Quality of Life measured by St Georges Respiratory Questionnaire (SGRQ) and Hospital of Anxiety and Depression (HAD) scale. INCLUSION CRITERIA: 1. Existing diagnosis of mild COPD (60% < FEV1 < 80%) 2. Stable COPD (no exacerbations for preceding 6 months) 3. Current non‐smoker (non‐smoking for > 6 months)