Effect of Thoracic Mobilization in People With Central Obesity

NCT07718178 | Not Yet Recruiting

• 1 other identifier: CU-AA-19052026
• Study Type: interventional
• Target: 60
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical trial is to learn whether Mulligan thoracic mobilization in extension improves ventilatory functions and chest wall expansion in adults with central obesity. It will also evaluate whether adding Mulligan thoracic mobilization to a low-carbohydrate diet and aerobic exercise provides greater benefits than diet and exercise alone. The main questions it aims to answer are: Does Mulligan thoracic mobilization improve ventilatory functions (FVC, FEV₁, FEV₁/FVC ratio, and MVV) in adults with central obesity? Does Mulligan thoracic mobilization improve chest wall expansion, functional capacity, and health-related quality of life? Researchers will compare Mulligan thoracic mobilization combined with a low-carbohydrate diet and aerobic exercise to a low-carbohydrate diet and aerobic exercise alone to determine whether the addition of thoracic mobilization improves respiratory outcomes. Participants will: Be randomly assigned to either the intervention group or the control group. Receive an individualized low-carbohydrate diet and supervised aerobic exercise for 8 weeks. Receive Mulligan thoracic mobilization in extension five times per week for 8 weeks if assigned to the intervention group. Undergo assessments of ventilatory functions, chest wall expansion, functional capacity, and quality of life before and after the intervention.

Conditions

Ventilatory Function; Central Obesity

Outcome Measures

Primary Outcomes (6)

• Forced Vital Capacity

  Measured in liters using spirometry.

  Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

• Forced Expiratory Volume in One Second

  Measured in liters using spirometry.

  Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

• Ratio of Forced Expiratory Volume in One Second to Forced Vital Capacity

  Measured as a percentage using spirometry.

  Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

• Maximum Voluntary Ventilation

  Measured in liters per minute using spirometry.

  Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

• Chest Wall Expansion at the Fourth Intercostal Space

  Chest wall expansion measured in centimeters using a non-elastic tape measure at the fourth intercostal space.

  Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

• Chest Wall Expansion at the Xiphoid Process Level

  Chest wall expansion measured in centimeters using a non-elastic tape measure at the level of the xiphoid process.

  Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

Secondary Outcomes (2)

• Functional capacity

  Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

• Change in Health-Related Quality of Life

  Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

Study Arms (2)

Mulligan Thoracic Mobilization

EXPERIMENTAL

will receive Mulligan thoracic mobilization in extension five times per week for 8 weeks in addition to a standardized diet and aerobic exercise.

Procedure: Mulligan Thoracic Mobilization; Behavioral: low carbohydrate; Behavioral: Aerobic Exercise

low carbohydrate and Aerobic Exercises

ACTIVE COMPARATOR

will receive standardized diet and aerobic exercise.

Behavioral: low carbohydrate; Behavioral: Aerobic Exercise

Interventions

low carbohydrate BEHAVIORAL

Standardized low-carbohydrate dietary program administered for 8 weeks.

Mulligan Thoracic Mobilization; low carbohydrate and Aerobic Exercises

Aerobic Exercise BEHAVIORAL

Moderate-intensity aerobic exercise program for 8 weeks, 5 sessions per week, at 55-69% HRmax or Borg RPE 12-14, progressing from 30 to 45 minutes per session.

Mulligan Thoracic Mobilization; low carbohydrate and Aerobic Exercises

Mulligan Thoracic Mobilization PROCEDURE

* Technique: Thoracic mobilization with movement (MWM) in extension performed by a trained physiotherapist. * Performed 5×/week. * Total program duration: 8 weeks. * 3 sets × 10 repetitions per spinal level per session. * Hold time: thoracic extension maintained for approximately 6 seconds at the end of the movement. * Participant position: sitting at the edge of the treatment table with hands behind the neck. * Therapist technique: mobilizing force applied using the ulnar border of the hand over the spinous process in a cephalic-anterior direction. * Movement performed: deep inspiration combined with thoracic extension during the mobilization. * Target levels: Mid-thoracic region (T6-T8). * Session duration: The session duration was based on three sets of ten repetitions per spinal level, with each repetition held for approximately 6 seconds. A 30-second rest interval was provided between sets, resulting in an effective application time of about 4-5 minutes per level.

Mulligan Thoracic Mobilization

Eligibility Criteria

• Age: 25 Years - 35 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Males aged 25-35 years.
• Presence of central obesity, defined as:
• Waist circumference ≥102 cm in males.
• Waist-hip ratio (WHR) ≥0.90 in males.
• BMI from 30-39.9 kg/m².
• Willing to comply with conventional physiotherapy (diet and exercise) and mobilization programs.
• Medically stable individuals with a restrictive lung pattern (Normal FEV₁/FVC ratio and FVC \< 80% of predicted).
• Low level physical activity (using the International Physical Activity Questionnaire-Short Version).
• Non-smokers.

You may not qualify if:

• Diagnosed COPD, asthma, or other chronic respiratory diseases.
• Recent thoracic spine or rib injury/surgery.
• Cardiovascular instability or uncontrolled hypertension.
• Contraindications to manual therapy (e.g., osteoporosis, rib fractures, or spinal tumors).
• Participation in any structured weight loss program or exercise regimen in the past 6 months.
• History of bariatric surgery (e.g., gastric sleeve, gastric bypass).
• Use of medications that affect body weight or metabolism (e.g., corticosteroids, antipsychotics, weight loss drugs).
• Neurological or musculoskeletal conditions that limit mobility or exercise participation and interfere with gait.
• Any acute respiratory infections in the past 6 weeks.

Sponsors & Collaborators

• Cairo University: lead

MeSH Terms

Conditions

Obesity, Abdominal

Interventions

Exercise

Condition Hierarchy (Ancestors)

Obesity; Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Mona A Abdelwahab, Assistant Prof

  Cairo University

  STUDY CHAIR

• Shaimaa T Mohamed, Lecturer

  Cairo University

  STUDY DIRECTOR

Central Study Contacts

Abd El-Rahman A Abd El-Monem

CONTACT

00201124079292; abdelrahmanayman199810@gmail.com

Alaa N Abdelhameed

CONTACT

00201061382864

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Teaching Assistant

Study Record Dates

• First Submitted: July 14, 2026
• First Posted: July 21, 2026
• Study Start: July 25, 2026
• Primary Completion (Estimated): December 15, 2026
• Study Completion (Estimated): February 10, 2027
• Last Updated: July 29, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share