Effectiveness of 1st Rib Mobilization and Scalene Muscles Muscle Energy Technique Among Patients With Asthma

NCT ID: NCT07036887

Last Updated: 2025-06-25

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: EARLY_PHASE1
• Total Enrollment: 47 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-03-04
• Study Completion Date: 2025-09-30

Brief Summary

This randomized controlled trial aims to evaluate the effectiveness of first rib mobilization and scalene muscle energy technique (MET) in improving respiratory function and reducing symptoms in patients with asthma. Asthma is a chronic inflammatory condition of the airways characterized by bronchoconstriction, airway hyperresponsiveness, and mucus overproduction, often leading to respiratory difficulty and increased use of accessory muscles such as the scalene.

Detailed Description

Manual therapy techniques like first rib mobilization and scalene MET are believed to restore upper thoracic mobility, reduce muscle tightness, and optimize breathing mechanics. In this study, 47 asthmatic patients will be randomly assigned into two groups: Group A will receive first rib mobilization combined with respiratory physiotherapy, while Group B will receive scalene MET along with the same physiotherapy protocol. Treatment will be administered three times a week for four weeks.

Conditions

Asthma

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

First Rib Mobilization + Respiratory Physiotherapy

Group Type: EXPERIMENTAL

First Rib Mobilization + Respiratory Physiotherapy

Intervention Type: DIAGNOSTIC_TEST

Patients were given post isometric relaxation for restricted first rib in sitting position and therefore the affected elevated first rib, opposite foot of therapist was placed on the table and patient non affected arm is 'dropped' on the therapist flexed knee. The practitioner's conjointly flexes the elbow on the non-affected side placed anterior to shoulder with the hand supporting the patient facet of head. Then therapist makes contact with the tubercle of the first rib with fingers or thumb of affected side (patient) disposing of available soft tissue. slack as steady force is applied in inferior direction. The therapist eases his flexed leg and uses his supported hand to encourage patient's neck into a side flexion and rotation to affected side thus unloading the scalene tension thereon side and encourage the first rib to move anteriorly and inferiorly

Scalene Muscle Energy Technique (MET) + Respiratory Physiotherapy

Group Type: ACTIVE_COMPARATOR

Scalene Muscle Energy Technique (MET) + Respiratory Physiotherapy

Intervention Type: COMBINATION_PRODUCT

MET for the scalene muscle, the participants were made to lie supine with a cushion or towel under the upper thoracic area. The PT placed his hand on the side of the participant's face/forehead to resist the isometric contraction and the other hand on the sternum. The participants were asked to perform the action of the anterior scalene muscle against PT resistance and hold it for 7-8 seconds followed by relaxation. (42) Along with the same respiratory physiotherapy protocol used in Group A. The treatment protocol was given for three sessions per week for four weeks

Interventions

First Rib Mobilization + Respiratory Physiotherapy

Patients were given post isometric relaxation for restricted first rib in sitting position and therefore the affected elevated first rib, opposite foot of therapist was placed on the table and patient non affected arm is 'dropped' on the therapist flexed knee. The practitioner's conjointly flexes the elbow on the non-affected side placed anterior to shoulder with the hand supporting the patient facet of head. Then therapist makes contact with the tubercle of the first rib with fingers or thumb of affected side (patient) disposing of available soft tissue. slack as steady force is applied in inferior direction. The therapist eases his flexed leg and uses his supported hand to encourage patient's neck into a side flexion and rotation to affected side thus unloading the scalene tension thereon side and encourage the first rib to move anteriorly and inferiorly

Intervention Type: DIAGNOSTIC_TEST

Scalene Muscle Energy Technique (MET) + Respiratory Physiotherapy

MET for the scalene muscle, the participants were made to lie supine with a cushion or towel under the upper thoracic area. The PT placed his hand on the side of the participant's face/forehead to resist the isometric contraction and the other hand on the sternum. The participants were asked to perform the action of the anterior scalene muscle against PT resistance and hold it for 7-8 seconds followed by relaxation. (42) Along with the same respiratory physiotherapy protocol used in Group A. The treatment protocol was given for three sessions per week for four weeks

Intervention Type: COMBINATION_PRODUCT

Eligibility Criteria

Inclusion Criteria

• Both male and female age range: 18-65 years.
• Diagnosed with asthma according to the Global Initiative for Asthma criteria.
• Presence of musculoskeletal symptoms; Complaints of chest tightness, neck stiffness, or restricted upper thoracic mobility, often associated with dysfunctional breathing patterns.
• Ability to provide informed consent and comply with the treatment protocol.

Exclusion Criteria

• clinically unstable or had a neuromuscular disease, unstable cardiovascular disease, or musculoskeletal disease that may interfere with exercise
• History of thoracic or cervical spine surgery, trauma, or fractures
• Pregnancy or postpartum status
• Rheumatologic diseases, a history of musculoskeletal trauma, or musculoskeletal malformations.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Superior University

OTHER

Sponsor Role: lead

Responsible Party

Muhammad Naveed Babur

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Chaudary Muhammad Akram Teaching Hospital, Azra Naheed Medical College, Superior University

Lahore, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

DPT/Batch-Fall20/1001

Identifier Type: -

Identifier Source: org_study_id