]>
IRCT20191117045462N20 IRCT 2024-07-27 Riphah International University Effects of Manual Diaphragm Manipulation and Diaphragm Release Technique in COPD Effects Of Manual Diaphragm Manipulation And Diaphragm Release In COPD Effects of Manual Diaphragm Manipulation and Diaphragm Release Technique in COPD 2024-07-16 anticipated 60 Complete https://irct.ir/trial/77948 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: Taking into account the above mentioned inclusion and exclusion criteria, patients will be recruited into two groups labeled as 0 for group A and 1 for group B by simple random sampling through sealed opaque enveloped, Blinding description: The assessor physiotherapist and the patient both will be blinded. Although the consent form will be taken from the patient. But the patient will not be aware of the study. Accessor physiotherapist will be involved in the study. He or She must have 2 or 3 year experience in relevant domain. He will access the patient by defined outcome measure tools before the start of study at the end. N/A Chronic Obstructive Pulmonary Disease. Intervention 1: Intervention group A: Manual Diaphragm Manipulation: Manual Diaphragm Manipulation will be performed four days a week on a regular basis for four weeks. Each session will consist of three sets of four repetitions, with a two minute break in between each set. Patient will be in supine position۔ Therapist positioned at the head side of the patient ۔ The therapist’s forearms will aligned towards the patient shoulders. Therapist made manual contact with the hypothenar region and the last three fingers bilaterally on the underside of the seventh to tenth rib costal cartilages. During the inspiratory phase, the therapist gently pulled the points of contact with both hands in the direction of the head and slightly laterally, facilitating the elevation of the ribs. During exhalation, the therapist deepened the contact towards the inner costal margin, maintaining resistance. In the subsequent respiratory cycles, the therapist further deepened the contact inside the costal margin, adjusting it at specific points to ensure proper technique and effectiveness. Intervention 2: Intervention group B: Diaphragm Release Technique: Diaphragm release techniques focus on stretching and mobilizing the diaphragm muscle to enhance its flexibility and function. This can include stretching exercises such as  Breath-hold Stretch، side stretch، seated diaphragmatic stretch، deep breathing and other therapeutic interventions aimed at improving diaphragmatic excursion and respiratory efficiency. The diaphragm release technique will be performed four days a week, with a rest period of two minutes in between each set of three sets of four repetitions. Every patient will be instructed to breathe as deeply and quietly as possible throughout the sessions, and they will all be attentively watched to look for any indicators that could compromise the study's ongoing continuity. No - There is not a plan to make this available Justification or reason for not sharing IPD is There is no further information
public Muhammad Umer Arshad
EXPERT CONSULTANT CLINIC 627, Khayaban e Jinnah, Iqbal Avenue Cooperative Housing Society - Phase 1, Airline Society, Lahore Punjab.
Lahore Pakistan 57600 +92 42 111 747 424 omerkhushi0101@gmail.com Riphah International University scientific Wajeeha Zia
25 Raza Saeed Rd, Bhabra Block M Gulberg III, Lahore, Punjab 25-M Block, Lahore
Lahore Pakistan 54660 +92 42 111 747 424 wajeeha_z@yahoo.com Riphah International University Pakistan Patients with COPD according to the GOLD criteria Age ranged from 45-65 years Moderate COPD (50% <Forced expiratory volume in first second "FEV1"<80%, Forced expiratory volume in first second per forced vital capacity FEV1/FVC <70% of predicted reversible airway obstruction) Person who is not involved in any rehabilitation program at least 4 months prior to the study No recent infectious exacerbations for the 2 months preceding the study 45 years 65 years Both History of gastroesophageal reflux of any degree Persistent hiccups within the previous three months History of serious injury to the spine or thorax, including costal or spinal fractures or history of diaphragm surgery Receiving long-term oxygen therapy Patients with unstable hemodynamic parameters (HR, BP, Cardiac output and Stroke volume) Patients who have undergone recent cardiothoracic or abdominal surgery Patients with a recent history of chest wall or abdominal trauma History of psychiatric illness J44.8 Chronic bronchitis Rehabilitation Rehabilitation Intervention group A: Manual Diaphragm Manipulation: Manual Diaphragm Manipulation will be performed four days a week on a regular basis for four weeks. Each session will consist of three sets of four repetitions, with a two minute break in between each set. Patient will be in supine position۔ Therapist positioned at the head side of the patient ۔ The therapist’s forearms will aligned towards the patient shoulders. Therapist made manual contact with the hypothenar region and the last three fingers bilaterally on the underside of the seventh to tenth rib costal cartilages. During the inspiratory phase, the therapist gently pulled the points of contact with both hands in the direction of the head and slightly laterally, facilitating the elevation of the ribs. During exhalation, the therapist deepened the contact towards the inner costal margin, maintaining resistance. In the subsequent respiratory cycles, the therapist further deepened the contact inside the costal margin, adjusting it at specific points to ensure proper technique and effectiveness. Intervention group B: Diaphragm Release Technique: Diaphragm release techniques focus on stretching and mobilizing the diaphragm muscle to enhance its flexibility and function. This can include stretching exercises such as  Breath-hold Stretch، side stretch، seated diaphragmatic stretch، deep breathing and other therapeutic interventions aimed at improving diaphragmatic excursion and respiratory efficiency. The diaphragm release technique will be performed four days a week, with a rest period of two minutes in between each set of three sets of four repetitions. Every patient will be instructed to breathe as deeply and quietly as possible throughout the sessions, and they will all be attentively watched to look for any indicators that could compromise the study's ongoing continuity. Pulmonary function. Timepoint: Pre- Post Treatment. Method of measurement: Spirometer ( Diagnostic). Dyspnea. Timepoint: Pre- Post Treatment. Method of measurement: Modified Medical Research Council Scale (MMRC). Chest expansion. Timepoint: Pre- Post Treatment. Method of measurement: Measuring Tape. Exercise capacity. Timepoint: Pre- Post Treatment. Method of measurement: Six Minute Walk Test (6MWT). Riphah International University Approved 2024-07-16 Riphah college of rehabilitation & Allied Health Sciences 25 Raza Saeed Rd, Bhabra Block M Gulberg III, Lahore, Punjab 25-M Block, Lahore Lahore Punjab Pakistan