EFFECTIVENESS OF THORACIC EXPANSION EXERCISE OVER RESPIRATORY MUSCLE ENERGY TECHNIQUE IN IMPROVING FUNCTIONAL EXERCISE CAPACITY (SIX-MINUTE WALK TEST) IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

Abstract

Background: Chronic obstructive pulmonary disease (COPD) results in progressive airflow
obstruction, chest wall stiffness and skeletal muscle dysfunction, which combine to reduce
functional exercise capacity. Thoracic expansion exercise (TEE) and respiratory muscle energy
technique (RMET) are two low-cost physiotherapy exercises recommended to enhance the
mobility of the chest wall and ultimately walking endurance in these patients.
Objective: To compare the effectiveness of TEE and RMET on functional exercise capacity,
assessed by Six-Minute Walk Test (6MWT), in patients with COPD.
Methods: 80 patients diagnosed with COPD were randomly allocated by the chit-method into two
groups of 40 patients each. Group A was given thoracic expansion exercise and Group B was
given respiratory muscle energy technique, 30 minutes per day, 5 days per week for 12 weeks. The
6MWT total distance covered (TDC) was recorded at week 0, 4, 8 and 12.
Results: Both groups showed statistically significant increases in 6MWT distance from week on
week ( Group A, F = 8.15, p<0.001; Group B, F = 7.30, p<0.001). Between-group comparison was
non-significant at week 0 (t=0.717, p=0.238) and week 4 (t=1.593, p=0.058) but became
significant at week 8 (t=2.781, p=0.003) and week 12 (t=2.373, p=0.01), and overall (t=3.476,
p<0.001), favouring Group B.
Conclusion: Both TEE and RMET produce clinically meaningful gains in functional exercise
capacity in COPD patients over 12 weeks, but RMET produces a significantly greater
improvement from the eighth week onward.