The Journal of manual & manipulative therapy · 2025
Short-term effect of respiratory muscle and diaphragmatic mobilization on pulmonary function, respiratory muscle strength, and functional capacity in hemodialysis patients with chronic kidney disease: a randomized controlled trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Vishwakarma Neeraj S, Shukla Manish Prannath, Dobhal Santosh P
Аннотация
BACKGROUND: Chronic kidney disease (CKD) patients receiving hemodialysis often present with impaired pulmonary function, weakened respiratory muscles, and reduced functional capacity. Manual therapy techniques that target respiratory muscles and the diaphragm may enhance respiratory mechanics and exercise tolerance in this population.To determine the short-term effects of respiratory muscle and diaphragmatic mobilization combined with conventional physiotherapy on pulmonary function, respiratory muscle strength, and functional capacity in hemodialysis patients with CKD.
METHODS: A two-arm, parallel, randomized controlled trial was conducted with 70 hemodialysis patients aged 18-65 years. Participants were randomized to either the intervention group (respiratory muscle and diaphragmatic mobilization plus conventional physiotherapy) or the control group (conventional physiotherapy alone) for one week on non-dialysis days. Primary outcomes included maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP); secondary outcomes were pulmonary function tests (FEV₁, FVC, FEV₁/FVC) and the 6-minute walk distance (6MWD). Analyses followed the intention-to-treat (ITT) principle using last observation carried forward (LOCF) for missing data. Correlational analyses assessed relationships between changes in respiratory and functional measures.
RESULTS: Of 86 screened participants, 70 were randomized and 67 completed the study. The intervention group showed significantly greater improvements in MIP, MEP, FEV₁/FVC, and 6MWD (all p < 0.01) compared with controls. Strong positive correlations were observed between ΔMIP, ΔMEP, and Δ6MWD (p < 0.001).
CONCLUSION: Respiratory muscle and diaphragmatic mobilization significantly improve respiratory muscle strength, pulmonary function, and functional capacity in CKD patients undergoing hemodialysis. These findings support incorporating targeted manual therapy into physiotherapy for enhancing respiratory efficiency and exercise performance.
METHODS: A two-arm, parallel, randomized controlled trial was conducted with 70 hemodialysis patients aged 18-65 years. Participants were randomized to either the intervention group (respiratory muscle and diaphragmatic mobilization plus conventional physiotherapy) or the control group (conventional physiotherapy alone) for one week on non-dialysis days. Primary outcomes included maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP); secondary outcomes were pulmonary function tests (FEV₁, FVC, FEV₁/FVC) and the 6-minute walk distance (6MWD). Analyses followed the intention-to-treat (ITT) principle using last observation carried forward (LOCF) for missing data. Correlational analyses assessed relationships between changes in respiratory and functional measures.
RESULTS: Of 86 screened participants, 70 were randomized and 67 completed the study. The intervention group showed significantly greater improvements in MIP, MEP, FEV₁/FVC, and 6MWD (all p < 0.01) compared with controls. Strong positive correlations were observed between ΔMIP, ΔMEP, and Δ6MWD (p < 0.001).
CONCLUSION: Respiratory muscle and diaphragmatic mobilization significantly improve respiratory muscle strength, pulmonary function, and functional capacity in CKD patients undergoing hemodialysis. These findings support incorporating targeted manual therapy into physiotherapy for enhancing respiratory efficiency and exercise performance.