Effectiveness of 1st Rib Mobilization and Scalene Muscles Muscle Energy Technique Among Patients With Asthma

Patients were given post isometric relaxation for restricted first rib in sitting position and therefore the affected elevated first rib, opposite foot of therapist was placed on the table and patient non affected arm is 'dropped' on the therapist flexed knee. The practitioner's conjointly flexes the elbow on the non-affected side placed anterior to shoulder with the hand supporting the patient facet of head. Then therapist makes contact with the tubercle of the first rib with fingers or thumb of affected side (patient) disposing of available soft tissue. slack as steady force is applied in inferior direction. The therapist eases his flexed leg and uses his supported hand to encourage patient's neck into a side flexion and rotation to affected side thus unloading the scalene tension thereon side and encourage the first rib to move anteriorly and inferiorly

MET for the scalene muscle, the participants were made to lie supine with a cushion or towel under the upper thoracic area. The PT placed his hand on the side of the participant's face/forehead to resist the isometric contraction and the other hand on the sternum. The participants were asked to perform the action of the anterior scalene muscle against PT resistance and hold it for 7-8 seconds followed by relaxation. (42) Along with the same respiratory physiotherapy protocol used in Group A. The treatment protocol was given for three sessions per week for four weeks