Physical therapy for the treatment of respiratory issues using Systemic Manual Therapy protocols

BACKGROUND: The emergence of the Coronavirus (COVID-19) pandemic increased the need for an effective treatment for respiratory conditions exponentially. To meet this challenge, we reevaluated the effectiveness of our physical therapy protocols for respiratory conditions. Protocols of interest were categorized as decongestive, neurogenic, mechanical, and immune modulating. OBJECTIVE: The objective of this study is to evaluate which of our existing treatment protocols or protocol combinations produce the best outcome. To do so, we analyzed which ones can meet the following criteria when compared to all other treatments: test statistic (>2.0) in parametric and non-parametric tests, [statistical significance (p < 0.05)], effect size larger than 0.2, difference in the Patient Identified Problem Scale (PIP) score above Minimal Clinically Important Difference (MCID), and sample size minimum 15 treatments. DESIGN: Retrospective multivariate analysis using a modified adaptive platform design. METHODS: A computerized sampling using respiratory related key words from a blinded dataset yielded 178 patients with respiratory complaints or pain in the chest area. Additional statistical analysis using parametric and non-parametric tests evaluated the difference between each treatment protocol and the rest of the treatments provided. RESULTS: Several protocol combinations and one individual protocol passed the study criteria. Cardiac vascular venous thoracic (CVVT) protocol was used most frequently within these combinations (7), followed by Urinary Drainage (UD) (4). Other protocols in this group were Cardiac Cervical Cranial Vascular (CCCV), Venous Thoracic Cardiopulmonary (VTCP), and Diaphragm Cranial Sinus (DCS). Among the respiratory specific protocols, CVVT was significantly better than VTCP (0.40, p < 0.001). DISCUSSION AND CONCLUSION: For the patient population studied, CVVT appears to be the primary protocol to consider, followed by UD, CCCV, VTCP, and DCS. Combining CVVT with Barral Abdominal Motility protocol (Barral) or VTCP with Lower Abdominal Urogenital (LAUG) on the same day might be required with acute patients.