Comparative Effects of Buteyko Versus Pilates Breathing Combined With McKenzie Neck Exercises on Lung Function and Chest Expansion in Asthmatic Patients With Forward Head Posture

December 4, 2025 updated by: Foundation University Islamabad
Asthma is characterized by airway inflammation and hyperinflation that flattens the diaphragm and increases reliance on accessory neck muscles. Chronic overuse shortens these muscles and promotes forward head posture (FHP), which in turn compromises rib-cage motion and respiratory mechanics. Correcting FHP alongside breathing retraining may therefore improve lung function and symptoms in asthma. This interventional, parallel-group study investigates the combined effects of McKenzie neck exercises with two different breathing approaches on lung function, chest expansion, posture, and quality of life in adults with asthma. Participants are allocated to two groups for a 4-week program: Group A performs McKenzie neck exercises plus Pilates-based breathing; Group B performs McKenzie neck exercises plus Buteyko breathing.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Asthma is a chronic inflammatory condition characterized by airway narrowing, hyperinflation, and increased airway resistance. Over time, these changes flatten the diaphragm, leading to reduced efficiency of the primary respiratory muscle. As a compensatory mechanism, asthmatic patients rely heavily on accessory muscles, particularly the sternocleidomastoid and scalene muscles. Prolonged overuse of these muscles contributes to shortening, tightness, and altered biomechanics of the cervical region, resulting in forward head posture (FHP). FHP negatively influences respiratory mechanics by reducing rib cage mobility, altering muscle recruitment patterns, and impairing effective exhalation. It is also associated with musculoskeletal discomfort and cervical spine stress, which further compound the challenges faced by asthmatic individuals.

Correcting FHP is therefore an important therapeutic target. Evidence suggests that restoring cervical alignment improves lung function parameters and breathing mechanics in patients with asthma. McKenzie neck exercises are a widely recognized approach for postural correction. These exercises aim to normalize cervical spine position, reduce stress on accessory muscles, and promote improved head and neck alignment. By addressing postural deviations, McKenzie exercises may indirectly enhance diaphragmatic function and overall ventilatory efficiency.

Breathing retraining techniques such as Pilates breathing and Buteyko breathing have also been shown to provide benefits for patients with asthma. Pilates-based breathing emphasizes controlled inhalation and exhalation with engagement of the diaphragm and rib cage expansion, promoting better respiratory coordination and relaxation. Buteyko breathing, in contrast, focuses on reducing hyperventilation and breath-holding techniques to optimize carbon dioxide levels and minimize airway irritation. Both methods target abnormal breathing patterns commonly found in asthma but through different mechanisms. This study is designed to examine the combined effect of postural correction and breathing retraining. Participants are randomly allocated into two groups, both receiving McKenzie neck exercises but paired with different breathing methods. Group A performs McKenzie exercises alongside Pilates-based breathing, while Group B combines McKenzie exercises with Buteyko breathing.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
22

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Pakistan
      • Islamabad, Pakistan, 44000
        • Recruiting
        • Foundation University College of Physical Therapy, Islamabad, 44000
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age group 18-40years
  • Both males and females
  • Individuals clinically diagnosed with asthma that is well controlled (Level 1 and Level 2) with FHP
  • Not participated in any structured exercise regime for improving lung function during the past 6 months.
  • Individuals well tolerated with a current exercise plan of combination exercises. (Buteyko breathing/Pilate breathing and McKenzie neck exercises

Exclusion Criteria:

  • -Level 3 and 4 asthma or status asthmatics.
  • Any congenital deformity of the chest wall
  • Any active infections like fever, TB
  • Those with any contraindication to exercise testing or training.
  • Recent history of any chest wall trauma
  • Any abdominal or cardio thoracic surgery
  • Any psychiatric illness
  • Unstable Cardiopulmonary disease i.e. unstable angina, heart failure, recent MI.
  • Unstable hemodynamic parameters (arterial pressure >140mmhg systolic and >90mmhg for diastolic
  • Pregnancy
  • Previous or parallel participation in interventional programs.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: McKenzie neck exercises with Pilates-based breathing
Participants in this group will perform McKenzie neck exercises in combination with Pilates-based breathing techniques, along with their usual pharmacological management for asthma. The program will run for 4 weeks with progressive intensity. McKenzie exercises will start with 5 repetitions per exercise in Weeks 1-2 and progress to 10 repetitions in Weeks 3-4. Pilates breathing will begin with 2 sets of 10 repetitions in Weeks 1-2, progress to 3 sets in Week 3, and 4 sets in Week 4.
Procedure: Pilates Breathing Combined with McKenzie Neck Exercises
Participants in this group will undergo a four-week intervention program combining McKenzie neck exercises with Pilates-based breathing techniques. The McKenzie exercises will be performed at an intensity of five repetitions per exercise during the first two weeks, progressing to ten repetitions per exercise in the third and fourth weeks. Pilates breathing will begin with two sets of ten repetitions in the first and second weeks, progress to three sets of ten repetitions in the third week, and further increase to four sets of ten repetitions in the fourth week. The intervention will be carried out three days per week on alternate days.
Experimental: McKenzie neck exercises with Buteyko breathing technique
Participants in this group will perform McKenzie neck exercises in combination with Buteyko breathing techniques, along with their usual pharmacological management for asthma. The program will run for 4 weeks with progressive intensity. McKenzie exercises will start with 5 repetitions per exercise in Weeks 1-2 and progress to 10 repetitions in Weeks 3-4. Buteyko breathing will begin with 2 sets of 10 repetitions in Weeks 1-2, progress to 3 sets in Week 3, and 4 sets in Week 4.
Procedure: McKenzie Neck Exercises with Buteyko Breathing
Participants in this group will undergo a four-week intervention program combining McKenzie neck exercises with Pilates-based breathing techniques. The McKenzie exercises will be performed at an intensity of five repetitions per exercise during the first two weeks, progressing to ten repetitions per exercise in the third and fourth weeks. Pilates breathing will begin with two sets of ten repetitions in the first and second weeks, progress to three sets of ten repetitions in the third week, and further increase to four sets of ten repetitions in the fourth week. The intervention will be carried out three days per week on alternate days

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Chest Expansion
Time Frame: 4 weeks
Description: Chest expansion will be measured in centimeters using a standard measuring tape at the level of the 4th intercostal space.
4 weeks
Lung Functions
Time Frame: 04 weeks
Lung function will be assessed using a spirometer. The parameters recorded will be FEV1 (Forced Expiratory Volume in 1 second), FVC (Forced Vital Capacity) and FEV1/FVC ratio.
04 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Foundation University Islamabad

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 20, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
January 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
February 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
September 12, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 4, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 17, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
December 17, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
December 4, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • FUI/CTR/2025/94

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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