Primary objective was to determine the effects of a myofascial release and active exercise therapy programme on level of pain experienced by adult patients recovering from thoracic trauma over six months. Secondary objectives were to determine the effect of the programme on pulmonary function, thoracic cage range of motion (ROM), physical activity, handgrip strength and HRQOL.
A prospective, longitudinal, quasi-experimental repeated measures design with a consecutive sampling method implemented at one month after discharge. The programme consisted of heat therapy, myofascial release of the intercostal muscles and diaphragm, active cycle of breathing technique, incentive spirometry, and active thoracic cage ROM exercises applied during three outpatient contact sessions. Outcomes were assessed at one, three and six months. Descriptive and inferential statistics were done with significance at p0.05. Per-protocol (PP) and intention-to-treat (ITT) analyses were performed.
Thirty-five adults participated of which most were male (n=27; 77%). Mean age was 49 (±15.4; range 24-89) years. Significant reduction in pain was reported from one to six months in most Brief Pain Inventory domains with PP and ITT analyses except for the domains BPI: Relationships and BPI: Walking. Use of analgesia decreased notably over the six months. Thoracic ROM (mean difference left side: 7.4 degrees; right side: 8.4 degrees (both p0.001), maximum inspiratory pressure (mean difference 9.9cmH2O; p0.001), and peak expiratory flow rate (mean difference 25L/min; p0.001) increased from one to three months. Handgrip strength significantly increased by six months (PP: p0.001; ITT: p0.001 left and right). International Physical Activity Questionnaire at six months showed 63% were involved in high levels of physical activity compared to 38% at one month. Improvements in HRQOL were reported by more than 75% participants in all domains of EQ-5D at six months.
Participants had significant improvements in level of pain experienced, pulmonary function, physical function, and HRQOL in the first six months post discharge after receiving a physiotherapy program consisting of myofascial release and active exercises.
Mobilisation of the myofascial structures of the thoracic cage followed by active trunk ROM exercises and deep breathing seem to impact positively on the outcomes of adults recovering from thoracic trauma. Findings are preliminary and need verification through experimental clinical trials.
Maximal inspiratory pressure
Physical activity
