This study will investigate the immediate and longer-term effects of integrated myofascial release therapy on breathing-related outcomes in healthy adults. Participants will receive integrated myofascial release therapy twice a week for 6 weeks, for a total of 12 treatment sessions. Assessments will be performed before treatment, immediately after the first treatment session, at the end of the 6-week treatment period, and 1 month and 3 months after treatment. The study will evaluate pulmonary function, cough strength, and chest mobility. The aim is to determine both the immediate response to a single treatment session and whether repeated treatment produces effects that are maintained during follow-up.
Myofascial release therapy is a manual therapy approach intended to reduce restrictions in fascial tissues and improve tissue mobility. Fascial structures surrounding the thorax, neck, shoulder, and upper extremity may contribute to chest wall mechanics and movements associated with breathing. Previous studies have mainly focused on immediate or short-term responses to myofascial release techniques, while evidence regarding cumulative and sustained effects remains limited. Therefore, this prospective single-group interventional study is designed to evaluate both the immediate response to the first treatment session and the effects of repeated treatment over time. Integrated myofascial release therapy will be applied to fascial structures associated with the upper extremity, neck-shoulder region, and pectoral/anterior chest region. Treatment will be administered twice weekly for 6 weeks, for a total of 12 sessions. Assessments will be conducted at five time points: before treatment (T0), immediately after the first treatment session (T1), at the end of the 6-week treatment period (T2), 1 month after treatment (T3), and 3 months after treatment (T4). Pulmonary function will be evaluated using spirometry, including forced vital capacity, forced expiratory volume in 1 second, the FEV1/FVC ratio, and peak expiratory flow. Cough strength will be assessed using peak cough flow. Thoracic mobility will be evaluated using chest expansion measurements at the axillary, xiphoid/epigastric, and subcostal levels. The study is intended to distinguish the acute response to a single session from the cumulative effect of repeated treatment and the persistence of any observed effects after treatment has ended.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
40
Integrated myofascial release therapy will be administered twice weekly for 6 weeks, for a total of 12 sessions. Each session will last approximately 20-30 minutes. The intervention will include single arm pull, lateral neck-shoulder myofascial release, and pectoral-anterior chest cross-hand release techniques. Techniques will be applied using slow, low-intensity, pain-free manual contact while following tissue resistance and release. The sequence and target regions will be standardized across sessions.
Karabuk University
Karabük, Karabük Province, Turkey (Türkiye)
Change in Xiphoid-Level Chest Expansion
Chest expansion will be measured at the xiphoid/epigastric level using a non-elastic measuring tape. The difference between chest circumference at maximal inspiration and maximal expiration will be calculated in centimeters. Measurements will be repeated using the same anatomical landmarks and standardized participant position across assessment time points.
Time frame: Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Forced Vital Capacity (FVC)
Forced vital capacity will be assessed using spirometry and recorded in liters. Participants will perform repeated acceptable forced expiratory maneuvers according to the standardized measurement procedure, and the highest acceptable FVC value will be used for analysis.
Time frame: Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Forced Expiratory Volume in 1 Second (FEV1)
Forced expiratory volume in 1 second will be assessed using spirometry and recorded in liters. Participants will perform repeated acceptable forced expiratory maneuvers, and the highest acceptable FEV1 value will be used for analysis.
Time frame: Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in FEV1/FVC Ratio
The FEV1/FVC ratio will be calculated automatically by the spirometry device from acceptable forced expiratory maneuvers and recorded as a percentage.
Time frame: Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Peak Expiratory Flow (PEF)
Peak expiratory flow will be assessed during standardized spirometry maneuvers. The highest technically acceptable PEF value will be recorded and used for analysis, expressed according to the spirometry device output.
Time frame: Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Peak Cough Flow (PCF)
Peak cough flow will be assessed using a portable peak flow meter and recorded in liters per minute. Participants will perform at least three technically appropriate voluntary cough maneuvers after a deep inspiration, and the highest technically acceptable PCF value will be used for analysis.
Time frame: Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Axillary-Level Chest Expansion
Chest expansion at the axillary level will be measured using a non-elastic measuring tape positioned approximately at the level of the third rib. The difference between chest circumference at maximal inspiration and maximal expiration will be calculated in centimeters. The same participant position and anatomical landmarks will be used across all assessment time points
Time frame: Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Subcostal-Level Chest Expansion
Chest expansion at the subcostal level will be measured using a non-elastic measuring tape. The difference between chest circumference at maximal inspiration and maximal expiration will be calculated in centimeters. The same standardized participant position and anatomical landmarks will be used at each assessment time point.
Time frame: Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
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