To determine the effects of manual diaphragmatic release technique (MDRT) versus chest wall expansion exercises on pulmonary function, chest wall expansion and asthma control in patients with asthma.
Patients who will meet the inclusion criteria will be recruited by convenient sampling technique and allocated to groups by simple randomization process by sealed opaque enveloped labeled as A for Group A and B for group B. At the beginning of the study, a formal educational session, lasting about 30 minutes will be given by the physiotherapist dealing with the treatment/interventions. Group A: It will receive MDRT and generalized body stretching. Group B: It will receive Chest Expansion Exercises and generalized body stretching. Frequency of patient's visit will be tailored with minimum of 2-3 visits per week for 4 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
58
Manual Diaphragmatic Breathing Technique, 2 sets with a 5 min rest interval between sets will be given, patient will lie supine in a relaxed position, Therapist will stand behind the patients head with the therapist forearm aligned towards patient shoulders, the hypothenar and the last three fingers of therapist hand will make contact bilaterally with underside of 7th, 8th, 9th, and 10th ribs costal cartilages, Patient is instructed to inhale deeply, therapist will pull the contact sites towards head and slightly in a lateral direction, during expiration therapist increases the contact depth beneath costal margins and maintain the resistance, therapist will continue to increase the depth of contact in the coming deep breath. Initially patient will be asked to take 5 deep breath/ set in the first week then it will progress to 10 deep breaths in the second,third and fourth week.
Four different types of chest exercises will be given to second group for 2-3 days/week for 4 weeks along with generalized body stretching
Zohra Shafi Free Trust Hospital
Lahore, Punjab Province, Pakistan
RECRUITINGPulmonary Function
Changes from baseline Pulmonary function test will be measured through Digital SpirometerDigital Spirometer is a hand held device that measures Forced Expiratory Volume 1 (FEV1) in the first second patient exhale and Forced Vital Capacity (FVC).
Time frame: 4th week
Chest Expansion
Changes from baseline Chest expansion is measured by using a measuring tape at 2 different levels of rib cage, upper chest expansion is measured at the third intercostal space at the level of clavicular line and spinous process of fifth thoracic vertebra. Lower chest expansion is measured at the tip of xiphoid process and the spinous process of tenth thoracic vertebra measurements will be taken at the end of deep inspiration and expiration.
Time frame: 4th week
Asthma Control Test
Changes from baseline will be measured through Asthma Control Test (ACT) is a questionnaire that consists of 5 questions on a scale from 1 to 5 of symptoms. The questions are about limitations due to asthma and symptoms in the past 4 week. A lower score then 19 corresponds with poor asthma control.
Time frame: 4th week
Modified Borg Scale
Changes from baseline will be measured through The modified Borg scale is an 11-point numerical scale rating the difficulty of breathing from "breathing is causing no difficulty at all" (zero point) to "breathing difficulty is maximal" (10 points).
Time frame: 4th week
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