A novel breathing retraining and osteopathic manual therapy intervention, and its effect on cardiac autonomic activity and breathing symptoms

Interventions entailing clinical management of dysfunctional breathing are thought to improve cardiac autonomic activity and breathing symptoms. Literature investigating such interventions in healthy individuals or in those with subclinical breathing disorders is sparse. The aims of this thesis were to develop a complex breathing management intervention and analyse its effects on cardiac autonomic measures and breathing symptom questionnaires in healthy adults. This thesis comprises three chapters. The first details an exploration of literature surrounding breathing retraining (BRT) and manual therapy (MT) directed at breathing in healthy individuals. In this review, an organisational structure for categorising relevant intervention studies is presented, setting a context for the clinical trial undertaken as part of this thesis. The second chapter describes an iterative process employed in the development and evaluation of a dual-protocol complex intervention administering BRT and MT. The third chapter is a report of randomised controlled trial, in which the complex intervention was carried out on a cohort of healthy active individuals, who perceived that breathing might be limiting their sporting performance. Outcomes presented in this report are cardiac autonomic measures and breathing questionnaire scores. Participants randomised to receive the complex intervention immediately demonstrated 3 – 4% improvements in cardiac autonomic variables, compared to reductions of 2% in the same variables for those in the control group who had not received treatment up to that point. This thesis resulted in the development of a clinically-applicable complex intervention for management of breathing, which was shown to improve cardiac autonomic measures in healthy active individuals. Further implementation of the BRT and MT protocols in clinical practice to alter cardiac autonomic measures is warranted. Further research is required to examine the efficacy and effectiveness of this intervention on various outcome measures and health state