the Effectivness of the Thoracic Cage Mobilization on COPD Patients

NCT ID: NCT05448235

Last Updated: 2023-02-17

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 30 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-10-21
• Study Completion Date: 2022-12-01

Brief Summary

the study aims to investigate effectiveness of thoracic cage mobilizations on the chronic obstructive pulmonary diseases.

Detailed Description

COPD is a term for airflow restriction and growing shortness of breath caused by physiological deterioration. Elderly persons endure reduced respiratory function, stiffness in the joints and connective tissues of the rib cage, and increased thoracic Kyphosis as a result of COPD .breathlessness, cough, and sputum production are the most prevalent symptoms of COPD, while wheezing, chest tightness, and chest congestion are less common but nevertheless bothersome. The reported frequency, on the other hand, varies depending on the patient demographic and the severity of the disease. COPD is now the world's fourth greatest cause of mortality, but it is expected to rise to the third position by 2020.

Due to the obstruction and exhalation airflow is reduced, resulting in air trapping and hyperinflation. When the rate of minute ventilation or respiration is increased, for as during exercise, this becomes more apparent. Hyperinflation puts more strain on the respiratory muscles, forcing them to function in a restricted range of motion with a negative pressure/effort ratio, resulting in fatigue and increased shortness of breath. COPD patients avoid physical activity and adopt a more sedentary lifestyle than healthy older adults in order to prevent the distressing feeling of breathlessness. This, in turn, causes a vicious cycle of decreased exercise capacity, increased breathlessness during exercise, and more avoidance of exercise, and so on.

Active expiration, slow and deep breathing, pursed lips breathing, relaxation therapy, body positions such as forward leaning, inspiratory and expiratory muscle training, and diaphragmatic breathing are all examples of breathing techniques. Improvement of (regional) ventilation and gas exchange, decrease of dynamic hyperinflation, enhancement of respiratory muscle function, reduction of breathlessness, and improvement of exercise tolerance and quality of life are some of the goals of these procedures. Exercise capacity is impaired in COPD, both peak exercise capacity and functional exercise capacity. Besides lung hyperinflation and physical inactivity, ventilation-perfusion mismatch, hypoxemia, cardiovascular problems and muscular changes Reduced exercise capacity is a factor. One of the most important predictors of morbidity and mortality in COPD is functional exercise ability. and has a direct connection to everyday physical activities. Because rib cage mobility tends to be diminished with obstructive lung illness, PT appears to have a specific goal of rib cage joint mobility. Chest wall mobilization enhances chest wall mobility, lowers respiratory rate, raises tidal volume, improves ventilation gas exchange, reduces breathlessness, reduces work of breathing, and helps you relax. The rib cage mobilization is applied in three positions, supine ling, side lying and siding with arm abducted of the side to be mobilized.

Conditions

Chronic Obstructive Pulmonary Disease

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

conventional treatment

the patient will receive conventional treatment daily for up to one week

Group Type: EXPERIMENTAL

conventional treatment

Intervention Type: OTHER

the patient will be asked to make pursed lip breathing (Breathe in for 2 seconds through his nose and Breathe out for 4 seconds through pursed lips)for 5-10 min ,3-4 times , 8-10 rep each cycle then asked to make diaphragmatic breathing exercise (Lie on his/her back and Inhale deeply through his/her nose for a count of three)for 5-10 min , 3-4 times , 8-10 repetition then postural drainage , furthermore the patient takes different position (prone to make percussion on lower lobes, side lying on anterior basal segment then sitting position on the upper lobe). After that a vibration on the chest (place a flat hand firmly atop the lung segment to be drained., and should apply light pressure and create a rapid, shaking movement) 1 min inhale and 5 time of repetition at the exhale and finally asked the patient to make productive cough for 5 times to get out the sputum.

thoracic cage mobilization

the patient will receive thoracic cage mobilization added to conventional treatment daily for up to one week

Group Type: EXPERIMENTAL

conventional treatment

Intervention Type: OTHER

the patient will be asked to make pursed lip breathing (Breathe in for 2 seconds through his nose and Breathe out for 4 seconds through pursed lips)for 5-10 min ,3-4 times , 8-10 rep each cycle then asked to make diaphragmatic breathing exercise (Lie on his/her back and Inhale deeply through his/her nose for a count of three)for 5-10 min , 3-4 times , 8-10 repetition then postural drainage , furthermore the patient takes different position (prone to make percussion on lower lobes, side lying on anterior basal segment then sitting position on the upper lobe). After that a vibration on the chest (place a flat hand firmly atop the lung segment to be drained., and should apply light pressure and create a rapid, shaking movement) 1 min inhale and 5 time of repetition at the exhale and finally asked the patient to make productive cough for 5 times to get out the sputum.

thoracic mobilization

Intervention Type: OTHER

we will use A SNAG to mobilization using type 3 oscillatory and sustain for 90 second, at first put the patient in 3 position (side lying to make mobilization of upper 6 ribs in downward direction then make on lower 6 ribs ,furthermore flexion of the thoracic and next rotation toward the midline then ask the patient to transfer to supine lying position and mobilize the sternum in downward direction the next mobilize the clavicle and ask the patient to take sitting position and put his hand on his head in adduction position and make extension on the thoracic vertebrae with inward mobilize with the investigator knees ,take each 4 vertebrae along the 12 thoracic vertebrae.

Interventions

conventional treatment

the patient will be asked to make pursed lip breathing (Breathe in for 2 seconds through his nose and Breathe out for 4 seconds through pursed lips)for 5-10 min ,3-4 times , 8-10 rep each cycle then asked to make diaphragmatic breathing exercise (Lie on his/her back and Inhale deeply through his/her nose for a count of three)for 5-10 min , 3-4 times , 8-10 repetition then postural drainage , furthermore the patient takes different position (prone to make percussion on lower lobes, side lying on anterior basal segment then sitting position on the upper lobe). After that a vibration on the chest (place a flat hand firmly atop the lung segment to be drained., and should apply light pressure and create a rapid, shaking movement) 1 min inhale and 5 time of repetition at the exhale and finally asked the patient to make productive cough for 5 times to get out the sputum.

Intervention Type: OTHER

thoracic mobilization

we will use A SNAG to mobilization using type 3 oscillatory and sustain for 90 second, at first put the patient in 3 position (side lying to make mobilization of upper 6 ribs in downward direction then make on lower 6 ribs ,furthermore flexion of the thoracic and next rotation toward the midline then ask the patient to transfer to supine lying position and mobilize the sternum in downward direction the next mobilize the clavicle and ask the patient to take sitting position and put his hand on his head in adduction position and make extension on the thoracic vertebrae with inward mobilize with the investigator knees ,take each 4 vertebrae along the 12 thoracic vertebrae.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Clinical diagnosis of chronic obstructive pulmonary disease.
• Age >35 years.
• Received conventional medical treatment.
• the presence of at least two of the following three clinical criteria: a recent increase in breathlessness, sputum volume or sputum purulence.
• All enrolled patients either had previously been given a diagnosis of COPD by a physician or had at least a one-year history of chronic breathlessness or cough with sputum production

Exclusion Criteria

• Admitted to the hospital, had been given a diagnosis of asthma or atrophy.
• Patients who had received oral or intravenous corticosteroid in the emergency department within the preceding 30 days.
• patient put on the mechanical ventilation.

• Minimum Eligible Age: 35 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Mariam omran Grase

principle investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Mariam omran Grase

Giza, , Egypt

Countries

Egypt

Other Identifiers

P. T. REC/012/003514

Identifier Type: -

Identifier Source: org_study_id