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Completed

NCT Number: NCT06791239

Comparison of Thoracic Squeeze and Manual Diaphragmatic Release Technique in COPD Patients

The goal of this randomized control trial is to evaluate and compare the efficacy of two physiotherapy techniques-Thoracic Squeeze Technique (TST) and Manual Diaphragmatic Release Technique (MDRT)-on improving respiratory parameters, functional capacity, and quality of life in patients with mild to moderate Chronic Obstructive Pulmonary Disease (COPD).

Objectives:

* Assess the impact of TST and MDRT on respiratory parameters (FEV1, FVC, FEV1/FVC ratio, and chest expansion). * Compare the functional capacity outcomes of the two techniques using the 6-Minute Walk Test (6MWT). * Evaluate the effects of TST and MDRT on patient wellbeing and daily life through the COPD Assessment Test (CAT).

Study Design:

The study involves 34 participants, divided into two groups (n=17 each) via sealed envelope randomization. Both groups will receive their respective interventions (TST or MDRT) alongside a standardized pulmonary rehabilitation protocol (pursed-lip breathing, diaphragmatic breathing, active cycle of breathing, and endurance exercises). The intervention will be conducted three times per week for three weeks.

Outcome Measures:

Primary outcomes include respiratory parameters assessed through spirometry and chest expansion using a measuring tape. Secondary outcomes include functional capacity (6MWT) and patient wellbeing (CAT scores). Baseline and post-intervention measures will be analyzed using SPSS, employing Mixed ANOVA to determine interaction effects.

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Key information

Conditions

COPD (Chronic Obstructive Pulmonary Disease) Chronic Disease Disease Attributes Lung Diseases Lung Diseases, Obstructive Pathologic Processes Pathological Conditions, Signs and Symptoms Pulmonary Disease, Chronic Obstructive Respiratory Tract Diseases

Age range

40 year–60 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Lady Reading Hospital

Peshawar, KPK, Pakistan

About this study

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory condition of the respiratory system that progressively impairs airflow, leading to significant limitations in physical capacity and quality of life. COPD is a global health concern, being the third leading cause of death worldwide, with an increasing prevalence due to aging populations and environmental pollution. Despite advancements in pharmacological treatments, COPD management requires comprehensive rehabilitation strategies, particularly for improving respiratory function and functional capacity.

Two physiotherapy techniques, the Thoracic Squeeze Technique and Manual Diaphragmatic Release Technique, have been individually employed to address respiratory function in COPD patients. However, direct comparisons of their effectiveness on respiratory parameters, functional capacity, and overall quality of life are scarce. This study aims to evaluate and compare the effects of these techniques, combined with conventional pulmonary rehabilitation, to identify the more effective intervention for optimizing COPD treatment.

The trial will be conducted at Lady Reading Hospital, Peshawar, over six months following ethical approval.

This study will provide evidence-based insights into the relative efficacy of Thoracic Squeeze and Manual Diaphragmatic Release techniques. Findings will guide physiotherapists in optimizing rehabilitation protocols for COPD patients, improving respiratory function, functional capacity, and overall quality of life. Moreover, the research aims to contribute to the standardization of physiotherapy practices for COPD management, ensuring consistent and effective patient care.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients with mild or moderate COPD according to the GOLD criteria.GOLD 1: Mild FEV1 ≥ 80% predicted value, GOLD 2: Moderate FEV1 between 50% and 80% predicted value.
  • Age between 40- 60 years.
  • Both male and female.
  • Patients who are willing to give voluntary consent to practice.

Exclusion criteria

  • Patients with unstable hemodynamic parameters (arterial pressure <100mmHg Systolic and <60 mmHg diastolic blood pressure.
  • Patients who have undergone recent 6 to 12 weeks cardio thoracic or abdominal surgery.
  • Patients who have a recent history of chest wall or abdominal trauma; substantial chest wall deformity History of recent fractures and cognitive impairments.

Treatment and study plan

Thoracic squeeze technique

Other

The Thoracic Squeeze Technique is a manual therapy method used primarily in respiratory physiotherapy to improve lung expansion, enhance respiratory function, and facilitate secretion clearance in patients with respiratory conditions.

Manual Diaphragmatic Release Technique

Other

The Manual Diaphragmatic Release Technique is a soft tissue manipulation technique used to improve the mobility, function, and efficiency of the diaphragm. It is commonly applied in physiotherapy, particularly in respiratory, musculoskeletal, and manual therapy practices, to address breathing dysfunctions, postural imbalances, and associated pain or discomfort.

Primary outcomes

  1. Respiratory parameter FEV1/FVC ratio

    Time frame: 1 week

    The Gold standard tool used in the diagnosis of COPD is spirometry. In today GOLD guidelines the diagnosis of pulmonary function test based on a bronchodilator FEV1/FVC ratio of less than 0. 7.

  2. Respiratory parameter Forced Expiratory Volume

    Time frame: 1 week

    Forced Expiratory Volume in 1 Second (FEV1 measures the volume of air that can be forcefully exhaled in the first second serving as an indicator of airway obstruction severity.

  3. Respiratory parameter Forced Vital Capacity (FVC)

    Time frame: 1 week

    Forced Vital Capacity (FVC) the total volume of air exhale during a forced breath assessing overall lung capacity.

  4. Functional capacity

    Time frame: 1 week

    Six Minute walk test:

    The 6-Minute Walk Test (6MWT) is a simple and practical test used to assess the functional exercise capacity of individuals. It measures the distance an individual can walk quickly on a flat hard surface in a period of six minutes. The test is commonly used in patients with chronic respiratory diseases such as COPD.

Secondary outcomes

  1. Chest excursion

    Time frame: 1 week

    Chest excursion measurement is a simple clinical test used to assess the mobility of thoracic cage during respiration. This can be particularly useful in diagnosing and monitoring respiratory conditions such as COPD to measure lung expansion. Chest expansion will be measured at three levels; Upper Lobe: at the level of the fourth rib. Middle Lobe: at the level of the xiphoid process. Lower Lobe: at the level of the tenth rib.

  2. Quality of life self-administered questionnaire

    Time frame: 3 weeks

    The COPD assessment test (CAT) is a self-administered questionnaire that consist of eight questions to explore different symptoms and impacts of COPD. .

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Comparison of Thoracic Squeeze and Manual Diaphragmatic Release Technique on Respiratory Parameters and Functional Capacity in COPD Patients

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jan 24, 2025
Registry last updated
Aug 22, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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