Immediate Effect of Mulligan Therapy on Pulmonary Function and Chest Expansion in Healthy Individuals: A Quasi-experimental Study

Abstract

Introduction: Mulligan therapy includes Sustained Natural Apophyseal Glides (SNAGs) and Mobilisation With Movement (MWM), which can be applied for spinal pain and Range of Motion (ROM). It helps to stretch the structures on the convex side of the offending movement and opens the intervertebral foramen. Pulmonary Function Test (PFT) is an important diagnostic test that helps guide decisions for management. Normal chest expansion is crucial for respiratory system function and tissue oxygenation. The contraction of external intercostal muscles moves the ribs upwards and outwards, causing the rib cage to expand, which increases the volume of the thoracic cavity. After the age of 25 years, normal pulmonary function begins to decline. Inappropriate posture leads to reduced thoracic cage mobility, thereby decreasing chest expansion. Thoracic SNAGs and MWM help stretch the structures, which will aid in chest expansion. Aim: To determine the effect of Mulligan therapy on pulmonary function and chest expansion in healthy individuals. Materials and Methods: A quasi-experimental study was conducted at Ramaiah Hospitals in Bengaluru, Karnataka, India over an 11-month period between July 2021 and June 2022. Based on the inclusion criteria, 103 participants were included, and Mulligan therapy was performed. Pre- and post-PFT and chest expansion measurements were taken and analysed using Student's t-test. Results: The results showed a statistically significant difference in chest expansion at all three levels (p<0.001) and Forced Expiratory Volume (FEV1) in the first second/Forced Vital Capacity (FVC) (p=0.04), Peak Expiratory Flow (PEF) (p=0.03), Forced Inhibitory Volume in the first second (FIV1) (p=0.01), and FIV1/FIVC (p=0.03) values in the PFTs. Conclusion: Chest expansion and FEV1/FVC, PEF, FIV1, and FIV1/FIVC show a significant change post thoracic SNAGs, intercostal MWM, costochondral, and costovertebral MWM. However, no significant changes have been observed in the other parameters of pulmonary function.

Keywords

• costochondral joints
• intercostal muscles
• pulmonary function test
• mulligan therapy
• thoracic sustained natural apophyseal glides