Conservative non-pharmacological evidence-based management options for Chronic Obstructive Pulmonary Disease (COPD) primarily focus on developing physiological capacity. With co-morbidities, including those of the musculoskeletal system, contributing to the overall disease severity, further research was needed. This thesis presents a critical review of musculoskeletal management approaches used in COPD, which concluded there is insufficient evidence for using musculoskeletal interventions in COPD management. With a paucity of literature exploring chest wall flexibility and clinical guidelines advocating research into thoracic mobility exercises in COPD, a focus on thoracic spine motion analysis was taken. Soft tissue artefact (STA) threatens the validity of existing in vivo measurement techniques. Having measured and reported unacceptable levels of STA, an alternative approach was developed and tested for reliability as part of this thesis. This technique, along with other measures, was subsequently used to evaluate cervico-thoracic musculoskeletal changes and their relationship with pulmonary function in COPD. In summary, subjects with COPD had reduced spinal motion, altered posture and increased muscle sensitivity compared to controls. Reduced spinal motion and altered neck posture were associated with reduced pulmonary function and having diagnosed COPD. Results from this thesis provide evidence to support inception of a clinical trial of flexibility exercises in COPD.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:589694 |
| Date | January 2014 |
| Creators | Heneghan, Nicola R. |
| Publisher | University of Birmingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.bham.ac.uk//id/eprint/4779/ |
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