Patient-Reported Outcome Measures for Managing Chronic Respiratory Diseases in Adults Undergoing Manual Therapy Intervention: A Scoping Review

Abstract

Background:

Given the prevalence of asthma and chronic obstructive pulmonary disease (COPD), a proportion of people seeking manual therapy care for musculoskeletal conditions will have a chronic respiratory comorbidity. While there is emerging evidence supporting the use of manual therapy as an adjunct to usual care in the management of some chronic respiratory conditions, manual therapists do not routinely measure the effect of their care on respiratory function.

Objectives:

To identify respiratory patient-reported outcome measures (PROMS) used for managing chronic respiratory diseases in adults receiving manual therapy in primary care practice.

Eligibility:

A scoping review was conducted using the Joanna Briggs Institute (JBI) methodology. The inclusion criteria were as follows: patients aged 18 years or older, experiencing a chronic respiratory condition, managed in a nonhospital environment, the intervention included manual therapy, at least one PROM as an outcome measure, and articles from peer-reviewed primary sources and published in the English language from inception to August 31, 2024. The exclusion criteria were as follows: the care environment was a hospital (i.e., a patient admitted to a hospital), no PROM used, the intervention used exercise or education only, a knowledge synthesis, not peer-reviewed, or not published in the English language (due to funding restrictions and lack of expertise).

Sources:

CINAHL, PubMed, AMED, Scopus, Web of Science, and Google Scholar databases.

Charting Methods:

A data-charting form was jointly developed in Excel by three reviewers to determine which variables to extract. Data were extracted from the included sources of evidence by two reviewers working independently and the results compared. Discrepancies were resolved by a third reviewer.

Results:

Seven articles met the inclusion criteria. The mean number of participants in the included studies was 25 ± 38. Six respiratory PROMS were identified as being used with adults with chronic respiratory conditions undergoing manual therapy treatment in primary care practice: Manchester Respiratory Activities of Daily Living, Dyspnea Visual Analog Scale, COPD Assessment Test (CAT), Modified Borg Dyspnea Scale, Modified Medical Research Council Dyspnea Scale, and Chronic Respiratory Questionnaire.

Conclusions:

Comorbid respiratory complaints are present in a small, but significant, number of manual therapy patients. The CAT appears to be the most appropriate respiratory PROM for primary care manual therapy practice because of its brevity and responsiveness. Respiratory PROMS, such as the CAT, may assist manual therapists to assess the severity of chronic respiratory diseases and quantify patients’ response to manual therapy. The protocol for the study was registered with Open Science Framework (OSF) (https://www.doi.org/10.17605/OSF.IO/F2KQC).