Effect of Rib Mobilization and Diaphragm Release Techniques in Patients With Non-Specific Neck Pain

NCT ID: NCT07133646

Last Updated: 2025-12-02

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 100 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-10-01
• Study Completion Date: 2025-12-01

Brief Summary

Rib mobilization is a therapeutic technique aimed at enhancing the mobility of the ribcage, which can have a significant impact on neck pain, even when the pain is classified as non-specific. The ribcage plays a crucial role in maintaining the alignment and posture of the upper body, including the neck. When the ribs are restricted or misaligned, it can lead to compensatory movements and increased strain on the cervical spine, contributing to neck pain. By mobilizing the ribs, we can restore their natural movement, which in turn can release tension in the surrounding musculature and improve the overall biomechanics of the thoracic and cervical regions. This approach not only addresses the immediate symptoms of neck pain but also targets the underlying structural issues that may perpetuate discomfort.

Detailed Description

The diaphragm is a major muscle involved in respiration, but its function extends beyond just breathing. It acts as a core stabilizer and influences the mechanics of the thoracic and cervical areas. Tension or dysfunction in the diaphragm can lead to altered breathing patterns and increased tension in the neck and shoulders, exacerbating non-specific neck pain. Releasing the diaphragm can improve respiratory efficiency and reduce undue stress on the neck. This release helps in re-establishing a more natural breathing pattern, which can alleviate pain and improve overall posture. Additionally, by addressing the diaphragm, we can indirectly affect the autonomic nervous system, promoting relaxation and reducing stress, which are often contributing factors to chronic pain syndromes.

An integrated approach that combines rib mobilization and diaphragm release can be particularly effective for managing non-specific neck pain. This method not only targets the symptoms but also addresses the root causes of neck discomfort. By improving rib and diaphragm function, we enhance the body's ability to maintain proper posture and reduce compensatory strain on the neck. This holistic treatment strategy is essential because it recognizes the interconnectedness of the body's musculoskeletal and respiratory systems. Furthermore, this approach empowers patients by providing them with a deeper understanding of their body mechanics and encouraging active participation in their rehabilitation process. Through this combination of manual therapy techniques, patients are likely to experience improved mobility, reduced pain, and a greater sense of well-being.

Conditions

Neck Pain

Study Design

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

Study Groups

RMT and DRT(Rib Mobilization Technique and Diaphragm Release Technique)

Rib Mobilization Technique and Diaphragm Release Technique(In the seated position, the participants remained seated on the stretcher, keeping the feet on the floor, while the therapist stood in front of him or her. The participant's head (frontal region) was positioned over his or her overlapping arms, which were placed on the therapist's trunk )

Group Type: EXPERIMENTAL

Rib Mobilization Technique and Diaphragm Release Technique

Intervention Type: OTHER

The RMT, adapted from Henderson et al10 and Abdelaal et al,15 was carried out in 2 different participant positions: supine and seated. In the supine position, the therapist was placed next to the participant and positioned the last 4 fingertips of both hands at the rib angles. The therapist mobilized the costal angles in the postero anterior direction accompanying the participant's normal inspiration The movement was performed in 2 series of 10 respiratory cycles in each hemi thorax, with a 1-minute interval between sets.

Diaphragm Release Technique

Intervention Type: OTHER

The DRT was performed according to the protocol described by Rocha et al.13 In this protocol, the participant remains in the supine position so that the therapist is able to maintain manual contact with the bottom edge of the rib cage. During inspiration, the therapist exerts traction after the natural rib-cage movement, then deepens the manual contact and maintains the resistance exerted in the previous phase throughout exhalation. The technique was applied in 2 series of 10 deep respiratory cycles, with a 1-minute interval between the series, under the therapist's verbal command.

DRT(Diaphragm Release Technique)

Diaphragm Release Technique:The DRT was performed according to the protocol described by Rocha et al.13 In this protocol, the participant remains in the supine position so that the therapist is able to maintain manual contact with the bottom edge of the rib cage

Group Type: EXPERIMENTAL

Diaphragm Release Technique

Intervention Type: OTHER

The DRT was performed according to the protocol described by Rocha et al.13 In this protocol, the participant remains in the supine position so that the therapist is able to maintain manual contact with the bottom edge of the rib cage. During inspiration, the therapist exerts traction after the natural rib-cage movement, then deepens the manual contact and maintains the resistance exerted in the previous phase throughout exhalation. The technique was applied in 2 series of 10 deep respiratory cycles, with a 1-minute interval between the series, under the therapist's verbal command.

control

No intervention

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Rib Mobilization Technique and Diaphragm Release Technique

The RMT, adapted from Henderson et al10 and Abdelaal et al,15 was carried out in 2 different participant positions: supine and seated. In the supine position, the therapist was placed next to the participant and positioned the last 4 fingertips of both hands at the rib angles. The therapist mobilized the costal angles in the postero anterior direction accompanying the participant's normal inspiration The movement was performed in 2 series of 10 respiratory cycles in each hemi thorax, with a 1-minute interval between sets.

Intervention Type: OTHER

Diaphragm Release Technique

The DRT was performed according to the protocol described by Rocha et al.13 In this protocol, the participant remains in the supine position so that the therapist is able to maintain manual contact with the bottom edge of the rib cage. During inspiration, the therapist exerts traction after the natural rib-cage movement, then deepens the manual contact and maintains the resistance exerted in the previous phase throughout exhalation. The technique was applied in 2 series of 10 deep respiratory cycles, with a 1-minute interval between the series, under the therapist's verbal command.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Neurological tests will be negative
• Both genders having age between 20 to 45 years
• Participants should have primary complaint of neck pain
• Neck Disability Index (NDI) score of 20% or greater (i.e. 10 points or greater on a 0 to 50 scale)
• A pain intensity of ≥4 on the 10-point Numerical Pain Rating Scale (NPRS)

Exclusion Criteria

• First and second rib fracture and dislocation
• Past surgical history of cervical and thoracic region
• Thoracic Outlet syndrome and cervical radiculopathy
• Congenital anomalies of spine and ribs

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 45 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

MTI University

OTHER

Sponsor Role: lead

Responsible Party

Ahmed Mohamed Ahmed Abd El hady El Fahl,ph.d

Assisstant professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

faculty of physical therapy ,Cairo University

Cairo, , Egypt

Countries

Egypt

Other Identifiers

IRB # 28/7/2024-2025

Identifier Type: -

Identifier Source: org_study_id