Biomechanical Approaches
It has been a long held view within manual therapy circles, including osteopaths and chiropracters, that chronic asthma can lead to abnormal breathing mechanics. In particular, the respiratory cycle is restricted due to limited FVC capacity, which can lead to general rib cage muscle contracture. This mechanical limitation further prevents the asthma sufferer from being able to inhale and exhale fully and contributes to a subjective sense of dyspnea.
Various manual therapy methods have been studied in the treatment of asthma. Massage was shown to be positive in one small trial in children. Two negative studies exist for chiropractic therapy. A recent trial published by Guinea 2005 demonstrated a positive effect of osteopathic manual therapy (OMT). This was an RCT of 140 children, which compared OMT to sham manipulation performed by untrained MDs. Pulmonary function improved with a mean increase in PEFs of 13L per minute while the control group showed no improvements whatsoever.