Effect of manual diaphragmatic release on ventilatory function and functional capacity in elderly type 2 diabetic women: A randomised controlled trial.

Everyone in the trial was a woman aged 65 to 75, so the results do not tell you anything about men or about younger or frailer patients. It was a single centre in one country, with its own clinic culture and patient mix. The women and the therapists supervising the sessions knew who was getting the manual release, and the person scoring the walking test also knew, so some of the improvement may reflect expectation rather than the technique. The four therapists who delivered the release were never checked against each other for how consistently they did it, so the technique varied between them. Eight weeks may be too short to see the full effect either way. Changes in medication or lifestyle during the 8 weeks were not controlled, and social or financial stress could have coloured the quality of life answers. The forced vital capacity gain was small enough that the authors themselves say its clinical importance should be read with caution.

The authors state they have no conflicts of interest to disclose, and the work received no specific funding from any public, commercial or not-for-profit source.

Do not read this as proof that manual diaphragmatic release works on its own. Every woman in both groups did eight weeks of supervised cycling three times a week, so the release can only be judged as an addition to aerobic training, and the authors themselves say the forced vital capacity difference may be too small to matter clinically.