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

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.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Asthma Bronchial Diseases Hypersensitivity Hypersensitivity, Immediate Immune System Diseases Lung Diseases Lung Diseases, Obstructive Respiratory Hypersensitivity Respiratory Tract Diseases

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Early Phase 1

Primary location

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

Lahore, Punjab Province, Pakistan

About this study

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.

Who can participate

Healthy volunteers accepted: No

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

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.

Treatment and study plan

First Rib Mobilization + Respiratory Physiotherapy

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

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

Primary outcomes

St. George's Respiratory Questionnaire (SGRQ)

Time frame: 6 Month

The total score has a maximum of 100 points, with values ranging from 0 to 100. The higher the number, the more impact the disease has.

Sponsors and collaborators

Lead sponsor

Superior University

Other

Registry information

Important dates

Study start: 2025
Primary completion: 2025
Study completion: 2025
First posted: Jun 25, 2025
Registry last updated: Jun 25, 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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Active, Not Recruiting