PMID- 34706819
OWN - NLM
STAT- MEDLINE
DCOM- 20220128
LR  - 20220128
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 162
DP  - 2022 Jan 1
TI  - Effects of Adding Respiratory Training to Osteopathic Manipulative Treatment on 
      Exhaled Nitric Oxide Level and Cardiopulmonary Function in Patients With 
      Pulmonary Arterial Hypertension.
PG  - 184-190
LID - S0002-9149(21)00946-2 [pii]
LID - 10.1016/j.amjcard.2021.09.023 [doi]
AB  - Limited research exists regarding nonpharmacologic management of pulmonary 
      arterial hypertension (PAH), except for exercise training. The objective of this 
      study was to investigate the effects of osteopathic manipulative treatment (OMT) 
      alone and combined with respiratory training on fractional exhaled nitric oxide 
      (FeNO), and cardiopulmonary function in patients with PAH. This single-blind, 
      prospective, randomized controlled study included 54 patients with PAH who were 
      randomly allocated to OMT, combined intervention, and control groups. The OMT 
      group (n = 16) and combined intervention group (n = 16) received OMT and yoga 
      respiratory training plus OMT, respectively, twice a week for 8 weeks. The 
      control group (n = 16) received no intervention. All patients undertook an 
      educational lecture. FeNO level, pulmonary function, 6-minute walk distance 
      (6MWD), maximal inspiratory and expiratory pressures, and handgrip strength were 
      assessed at baseline and 8 weeks. Combined intervention and OMT groups 
      significantly improved all outcome measures after 8 weeks of treatment (p <0.01), 
      except mean forced expiratory flow between 25% and 75% of forced vital capacity, 
      which did not change in the OMT group (p >0.05). The control group showed 
      significant deteriorations in 6MWD, inspiratory and peripheral muscle strength, 
      and pulmonary function except peak expiratory flow at 8 weeks (p <0.05). The 
      combined intervention group revealed significantly greater improvements of FeNO, 
      6MWD, respiratory and peripheral muscle strength, and pulmonary function except 
      mean forced expiratory flow between 25% and 75% of forced vital capacity compared 
      with the OMT group (p <0.05). All outcomes significantly improved in both 
      intervention groups versus the control group (p <0.05). Our study demonstrated 
      that adding respiratory training to OMT provided further benefit to FeNO level 
      and cardiopulmonary function compared with OMT alone and that the OMT might be a 
      useful and safe intervention for patients who cannot attend cardiac 
      rehabilitation programs.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Naci, Baha
AU  - Naci B
AD  - Department of Cardiology, Institute of Cardiology, Istanbul 
      University-Cerrahpasa, Istanbul, Turkey; Division of Physiotherapy and 
      Rehabilitation, Faculty of Health Sciences, Fenerbahce University, Istanbul, 
      Turkey.
FAU - Demir, Rengin
AU  - Demir R
AD  - Department of Cardiology, Institute of Cardiology, Istanbul 
      University-Cerrahpasa, Istanbul, Turkey. Electronic address: 
      rengindemir@yahoo.com.
FAU - Onder, Omer O
AU  - Onder OO
AD  - Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, 
      Istanbul Health and Technology University, Istanbul, Turkey.
FAU - Sinan, Umit Yasar
AU  - Sinan UY
AD  - Department of Cardiology, Institute of Cardiology, Istanbul 
      University-Cerrahpasa, Istanbul, Turkey.
FAU - Kucukoglu, Mehmet Serdar
AU  - Kucukoglu MS
AD  - Department of Cardiology, Institute of Cardiology, Istanbul 
      University-Cerrahpasa, Istanbul, Turkey.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20211024
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Adult
MH  - *Breathing Exercises
MH  - Female
MH  - Fractional Exhaled Nitric Oxide Testing
MH  - Humans
MH  - Male
MH  - *Manipulation, Osteopathic
MH  - Middle Aged
MH  - Muscle Strength
MH  - Outcome Assessment, Health Care
MH  - Prospective Studies
MH  - Pulmonary Arterial Hypertension/complications/physiopathology/*rehabilitation
MH  - Recovery of Function
MH  - Respiratory Function Tests
MH  - Single-Blind Method
MH  - Walk Test
MH  - *Yoga
COIS- Disclosures The authors have no conflicts of interest to declare.
EDAT- 2021/10/29 06:00
MHDA- 2022/01/29 06:00
CRDT- 2021/10/28 05:36
PHST- 2021/06/24 00:00 [received]
PHST- 2021/09/14 00:00 [revised]
PHST- 2021/09/17 00:00 [accepted]
PHST- 2021/10/29 06:00 [pubmed]
PHST- 2022/01/29 06:00 [medline]
PHST- 2021/10/28 05:36 [entrez]
AID - S0002-9149(21)00946-2 [pii]
AID - 10.1016/j.amjcard.2021.09.023 [doi]
PST - ppublish
SO  - Am J Cardiol. 2022 Jan 1;162:184-190. doi: 10.1016/j.amjcard.2021.09.023. Epub 
      2021 Oct 24.