Immediate Effects of Osteopathic Manipulative Treatment on Chest Wall Excursion and Spirometric Measures in Healthy Adults: A Randomized Sham-Controlled Trial

BackgroundBreathing mechanics are influenced by coordinated motion of the ribs, thoracic spine, sternum, diaphragm, and associated musculature.Chest wall excursion is a tape-measured estimate of thoracic mobility and may reflect restrictions in thoracic and rib motion.Osteopathic manipulative treatment (OMT) directed at thoracic and rib somatic dysfunction may influence these mechanics.The immediate effects of an individualized thoracic-and rib-directed OMT strategy on chest excursion and spirometric measures in healthy adults remain incompletely characterized. MethodsThis exploratory randomized sham-controlled study included 41 healthy volunteers assigned to individualized OMT (n = 22) or light-touch sham (n = 19).Upper chest excursion at the manubrial level (M1) and lower chest excursion at the xiphoid level (M2) were measured before and during the same visit shortly after intervention.The OMT strategy could include muscle energy, myofascial release, rib raising, and facilitated positional release.The study record reports a computer-generated allocation process and a lighttouch comparator.Participant-level data and complete spirometric results were not available for additional analysis in this revision. ResultsThe study record reports that mean M1 in the OMT group increased from 2.77 inches (standard error of the mean (SEM) 0.335) before intervention to 3.36 inches (SEM 0.319) during the same visit after intervention (reported p = 0.007 for the within-group comparison).The reported exploratory combined M1 + M2 change was 1.000 inch (SEM 0.316) in the OMT group and -0.053 inches (SEM 0.367) in the light-touch group (reported p = 0.035).Complete numerical forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and ratio of FEV1 and FVC (FEV1/FVC) results were not available; therefore, no effect estimate or conclusion about spirometric change is presented. ConclusionsIn healthy adults, the reported results provide only an exploratory same-visit difference in tape-measured chest excursion after an individualized OMT strategy.They do not establish a physiological mechanism, a durable effect, a spirometric effect, or clinical benefit.Confirmation requires a prospectively registered study with complete outcome data, a prespecified analysis plan, standardized measurement procedures, and blinded outcome assessment.