Asthma is characterized by airway inflammation and hyperinflation that flattens the diaphragm and increases reliance on accessory neck muscles. Chronic overuse shortens these muscles and promotes forward head posture (FHP), which in turn compromises rib-cage motion and respiratory mechanics. Correcting FHP alongside breathing retraining may therefore improve lung function and symptoms in asthma. This interventional, parallel-group study investigates the combined effects of McKenzie neck exercises with two different breathing approaches on lung function, chest expansion, posture, and quality of life in adults with asthma. Participants are allocated to two groups for a 4-week program: Group A performs McKenzie neck exercises plus Pilates-based breathing; Group B performs McKenzie neck exercises plus Buteyko breathing.
Asthma is a chronic inflammatory condition characterized by airway narrowing, hyperinflation, and increased airway resistance. Over time, these changes flatten the diaphragm, leading to reduced efficiency of the primary respiratory muscle. As a compensatory mechanism, asthmatic patients rely heavily on accessory muscles, particularly the sternocleidomastoid and scalene muscles. Prolonged overuse of these muscles contributes to shortening, tightness, and altered biomechanics of the cervical region, resulting in forward head posture (FHP). FHP negatively influences respiratory mechanics by reducing rib cage mobility, altering muscle recruitment patterns, and impairing effective exhalation. It is also associated with musculoskeletal discomfort and cervical spine stress, which further compound the challenges faced by asthmatic individuals. Correcting FHP is therefore an important therapeutic target. Evidence suggests that restoring cervical alignment improves lung function parameters and breathing mechanics in patients with asthma. McKenzie neck exercises are a widely recognized approach for postural correction. These exercises aim to normalize cervical spine position, reduce stress on accessory muscles, and promote improved head and neck alignment. By addressing postural deviations, McKenzie exercises may indirectly enhance diaphragmatic function and overall ventilatory efficiency. Breathing retraining techniques such as Pilates breathing and Buteyko breathing have also been shown to provide benefits for patients with asthma. Pilates-based breathing emphasizes controlled inhalation and exhalation with engagement of the diaphragm and rib cage expansion, promoting better respiratory coordination and relaxation. Buteyko breathing, in contrast, focuses on reducing hyperventilation and breath-holding techniques to optimize carbon dioxide levels and minimize airway irritation. Both methods target abnormal breathing patterns commonly found in asthma but through different mechanisms. This study is designed to examine the combined effect of postural correction and breathing retraining. Participants are randomly allocated into two groups, both receiving McKenzie neck exercises but paired with different breathing methods. Group A performs McKenzie exercises alongside Pilates-based breathing, while Group B combines McKenzie exercises with Buteyko breathing.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
22
Participants in this group will undergo a four-week intervention program combining McKenzie neck exercises with Pilates-based breathing techniques. The McKenzie exercises will be performed at an intensity of five repetitions per exercise during the first two weeks, progressing to ten repetitions per exercise in the third and fourth weeks. Pilates breathing will begin with two sets of ten repetitions in the first and second weeks, progress to three sets of ten repetitions in the third week, and further increase to four sets of ten repetitions in the fourth week. The intervention will be carried out three days per week on alternate days.
Participants in this group will undergo a four-week intervention program combining McKenzie neck exercises with Pilates-based breathing techniques. The McKenzie exercises will be performed at an intensity of five repetitions per exercise during the first two weeks, progressing to ten repetitions per exercise in the third and fourth weeks. Pilates breathing will begin with two sets of ten repetitions in the first and second weeks, progress to three sets of ten repetitions in the third week, and further increase to four sets of ten repetitions in the fourth week. The intervention will be carried out three days per week on alternate days
Foundation University College of Physical Therapy, Islamabad, 44000
Islamabad, Pakistan
RECRUITINGChest Expansion
Description: Chest expansion will be measured in centimeters using a standard measuring tape at the level of the 4th intercostal space.
Time frame: 4 weeks
Lung Functions
Lung function will be assessed using a spirometer. The parameters recorded will be FEV1 (Forced Expiratory Volume in 1 second), FVC (Forced Vital Capacity) and FEV1/FVC ratio.
Time frame: 04 weeks
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