Patients with asthma frequently experience upper back stiffness and rounded shoulders and tightness in the thoracic region. Rib cage stiffness occurs due to poor posture and muscle tightness, which leads to decreased chest expansion and increased use of accessory muscles during breathing. Additionally, rounded shoulders can hinder proper opening of the chest, preventing the lungs from expanding properly. Thoracic spine rotation stretching targets the thoracic paraspinal muscles, erector spinae, and intercostal muscles. This exercise helps improve thoracic mobility, increases chest expansion and pulmonary function, and reduces dyspnea. The other exercise is Scapular Retraction, which targets the rhomboids, trapezius, and posterior deltoids that help in chest opening and lead to chest expansion and allow lungs to expand more fully during inhalation. Together, these exercises improve chest expansion and pulmonary function, reduce dyspnea, and improve posture.
Asthma is a prevalent chronic respiratory condition that affects millions worldwide, characterized by airway inflammation and reversible airflow obstruction. Patients often experience difficulty in breathing, which can severely impact their quality of life. People with asthma are less active that their peers, and consequently, the patient becomes more sedentary. This study focusses to compare the effects of thoracic spine rotation stretching and Scapular Retraction exercises on chest expansion, pulmonary function, and dyspnea in patients with asthma. By investigating these interventions, the study seeks to provide practical recommendations for enhancing the management of asthma symptoms, ultimately improving respiratory function and mobility may improve asthma control and quality of life. A randomized clinical trial will enroll participants aged 18 to 50 with a confirmed diagnosis of chronic asthma. The study will take place at Rai Medical College Teaching Hospital Sargodha, utilizing a non- probability convenient sampling technique for participant selection. Participants will be randomly assigned to two groups using a lottery method, ensures a diverse yet unbiased sample. Group A will perform thoracic spine rotation stretching, while Group B will engage in shoulder squeezing exercises, following a standardized warm-up. Baseline treatment will include breathing exercises, postural education, bronchodilators, and nebulization Each group will engage in their respective exercises for a defined duration, focusing on improving respiratory mechanics and muscle flexibility. Study will be completed in 8 weeks (3x/week). After data collection, data will be analyzed using SPSS version 26. Assessments will be conducted before and after the intervention period, measuring chest expansion with a measuring tape, pulmonary function through digital spirometer (including FEV1 and FVC their ratio and peak expiratory flow), and dyspnea levels using the Modified borg dyspnea scale, thoracic rotation range of motion measured with a goniometer. The integration of targeted physical therapy in this study has the potential to significantly improve asthma management by enhancing respiratory function, reducing dyspnea, and increasing chest expansion.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
54
Thoracic spine rotation stretching consists of controlled rotational movements of the thoracic spine performed to improve thoracic mobility. The exercises are administered under supervision, three sessions per week for eight weeks, using standardized repetitions within a comfortable range of motion.
Scapular retraction exercises involve active scapular retraction movements performed to improve shoulder and upper thoracic mobility. The intervention is administered under supervision, three sessions per week for eight weeks in individuals with chronic asthma.
Sehat medical complex hanjerwal
Lahore, Pakistan
Modified borg scale
Dyspnea at rest was assessed using the modified Borg scale. It is a well-validated scoring system using a 0-to-10-point scale.The intensity of dyspnea is most often assessed according to a symptom scale, with the modified Borg scale, which measures dyspnea on a scale of 0-10 arbitrary units, being used most frequently.It is a validated dyspnea scale ranging from 0 ("no shortness of breath") to 10 ("worst shortness of breath") points.
Time frame: 8 Weeks
Digital spirometer:
A digital spirometer will be used to measure pulmonary function tests including FEV1, FVC, FEV1/FVC.The normal values of FEV1/FVC ratio are \>0.70 and FVC, FEV1 are \>80% or predicted age.
Time frame: 8 weeks
Tape measure
Chest expansion was measured using a measurement tape (Baseline 12-1201 with Gulick attachment, Fabrication Enterprises Inc., New York, NY, USA) to determine the difference between rib cage circumference at the end of forced expiration and rib cage circumference at the end of forced inspiration. Chest expansion measurement is highly reliable with an interexaminer intraclass correlation coefficient of 0.99.The chest circumference was measured in cm at maximum inspiration and maximum expiration by horizontally passing through the junction of the xiphoid process and the body of the sternum so that the chest girth was exposed.The tape measure is wrapped around the thorax in a level position and pulled just taut (but not restricting chest expansion) at three anatomic sites.1. The angle of Louis on the sternum .2.The xiphoid process for mid-chest expansion 3.The midpoint between the xiphoid process and the umbilicus for lower chest expansion, where most of the bucket handle motion occur.
Time frame: 8 Weeks
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