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

NCT06791239 | Completed DMC

• 1 other identifier: Sabaoon Ijaz
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

COPD (Chronic Obstructive Pulmonary Disease)

Keywords

Thoracic squeeze technique; Manual diaphragmatic release technique; COPD; digital spirometry; functional capacity; quality of life

Outcome Measures

Primary Outcomes (4)

• Respiratory parameter FEV1/FVC ratio

  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.

  1 week

• Respiratory parameter Forced Expiratory Volume

  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.

  1 week

• Respiratory parameter Forced Vital Capacity (FVC)

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

  1 week

• Functional capacity

  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.

  1 week

Secondary Outcomes (2)

• Chest excursion

  1 week

• Quality of life self-administered questionnaire

  3 weeks

Study Arms (2)

Thoracic squeeze technique

EXPERIMENTAL

The Thoracic Squeeze Technique is a manual physiotherapy intervention aimed at improving lung function, airway clearance, and respiratory mechanics. It involves the application of gentle, rhythmic compression to the chest wall during the exhalation phase of breathing, followed by a release. This technique can be performed with the patient in a sitting, semi-reclined, or supine position, depending on their condition and comfort level.

Other: Thoracic squeeze technique

Manual Diaphragmatic release technique

EXPERIMENTAL

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.

Other: Manual diaphragmatic release technique

Interventions

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.

Thoracic squeeze technique

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.

Manual Diaphragmatic release technique

Eligibility Criteria

• Age: 40 Years - 60 Years
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Lady Reading Hospital

Peshawar, KPK, Pakistan

Location

Related Publications (1)

• Braz Junior DS, Dornelas de Andrade A, Teixeira AS, Cavalcanti CA, Morais AB, Marinho PE. Whole-body vibration improves functional capacity and quality of life in patients with severe chronic obstructive pulmonary disease (COPD): a pilot study. Int J Chron Obstruct Pulmon Dis. 2015 Jan 12;10:125-32. doi: 10.2147/COPD.S73751. eCollection 2015.

  PMID: 25624756 BACKGROUND

MeSH Terms

Conditions

Pulmonary Disease, Chronic Obstructive

Condition Hierarchy (Ancestors)

Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Maria Naeem, DPT, MS-CPPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 14, 2025
• First Posted: January 24, 2025
• Study Start: February 1, 2025
• Primary Completion: May 30, 2025
• Study Completion: June 30, 2025
• Last Updated: August 22, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)