The immediate effects of rib cage joint mobilization and chest wall stretch on muscle tone and stiffness of respiratory muscles and chest expansion ability in patients with chronic stroke.
Shin-Jun Park, Soon-Hee Kim, Kyung-Ok Min
PMID 29200634WHAT IT FOUND
Neither rib cage mobilization nor chest wall stretch was better than the other for chronic stroke patients.
Both increased chest expansion immediately, but neither produced a clear change in respiratory muscle tone or stiffness.
Key findings
01The two groups did not differ after intervention in respiratory muscle tone, stiffness, or chest expansion.
02Chest expansion increased immediately after intervention.
03Respiratory muscle tone and stiffness differed between the affected and non-affected sides for several muscles.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Thirty patients were divided into two groups of 15, and the outcomes were measured only immediately after intervention. The authors could not control psychological factors that may affect muscle tone. Chest expansion was measured while standing, so the results may not apply to patients who cannot stand. The participants had to be at least 6 months after stroke, score more than 24 on the mental status examination, be at stage IV or above in the Brunnstrom stage, and be at stage II or below on the Modified Ashworth Scale. These criteria limit the patients to whom the results apply.
The easy way to misread this
Do not conclude that rib cage joint mobilization or chest wall stretch improves respiratory muscle tone or stiffness. The average tone and stiffness changes were not clear, and the only clear immediate change was increased chest expansion, with no difference between the two groups.