Effects of Costovertebral Joint Mobilization on Respiratory Function in Asthmatic Patients

The aim of this randomized controlled trial is to determine the effectiveness of costovertebral joint mobilization on lung function in asthmatics. By targeting the thoracic region, costovertebral mobilization can play a valuable role in enhancing respiratory function and improving the overall well-being of individuals with respiratory conditions.

Study Overview

• Status: Completed
• Conditions: Asthmatic
• Intervention / Treatment: Other: Costovertebral mobilizations + Conventional PT; Other: Conventional treatment

Detailed Description

Costovertebral joint mobilization can help to improve this by increasing the mobility of the ribs and thoracic spine, which can help to expand the chest and improve lung function. Additionally, costovertebral joint mobilization can help to reduce muscle tension in the chest and upper back, which can also contribute to improved respiratory function. This is because tense or tight muscles can restrict the movement of the rib cage, limiting the ability of the lungs to expand and contract. Mobilization are performed in three positions, sitting, supine lying and side lying with arm abducted of the side to be mobilized. The improvement by regular physical training of breathing technique and chest wall mechanics may be explained by mobilization of the costovertebral articulations.

• Study Type: Interventional
• Enrollment (Actual): 28
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Maria Khalid, MS-OMPT; Phone Number: 0331-5369768; Email: maria.khalid@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab
    • Rawalpindi, Punjab, Pakistan, 46000
      • Rahim Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Force Expiratory Volume 1/Force Vital Capacity ratio less than 0.7
• Mild asthma (Force Expiratory Volume 1 over 70% predicted)
• Chest tightness (inspiratory muscle tightness)
• Altered Dyspnea index.

Exclusion Criteria:

• presence of any underlying lung condition other than asthma.
• significant cardiovascular or musculoskeletal disease that may compromise the participant's capacity to participate in physical activity;
• active cancer.
• uncontrolled hypertension or diabetes.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Costovertebral mobilizations + Conventional Physiotherapy; Costovertebral mobilizations along conventional treatment patient would receive costovertebral mobilization in side lying position for 10th to 6th ribs, in sitting position for 10th to 2nd rib and in supine position for 1 rib. Frequency: 5 times/week for 3 weeks. Intensity: moderate intensity (pain free) Time: 20 mins Type: costovertebral joint mobilization to improve respiratory function and chest tightness. Conventional treatment diaphragmatic breathing exercises and pursed-lip expiration exercises. Patient will receive diaphragmatic breathing and pursed lip breathing exercise in sitting position Frequency: 5 times/week for 3 weeks Intensity: moderate intensity (pain free) Time: 30 mins Type: breathing exercises to improve respiratory function and chest tightness.	Other: Costovertebral mobilizations + Conventional PT; Costovertebral mobilizations along conventional treatment patient would receive costovertebral mobilization in side lying position for 10th to 6th ribs, in sitting position for 10th to 2nd rib and in supine position for 1 rib. Frequency: 5 times/week for 3 weeks. Intensity: moderate intensity (pain free) Time: 10 mins Type: costovertebral joint mobilization to improve respiratory function and chest tightness. Conventional treatment diaphragmatic breathing exercises pursed-lip expiration exercises. Patient will receive diaphragmatic breathing and pursed lip breathing exercise in sitting position Frequency: 5 times/week for 3 weeks Intensity: moderate intensity (pain free) Time: 20 mins Type: breathing exercises to improve respiratory function and chest tightness.
Other: Conventional Physiotherapy; diaphragmatic breathing exercises and pursed-lip expiration exercises Patient will receive diaphragmatic breathing and pursed lip breathing exercise in sitting position Frequency: 5 times/week for 3 weeks Intensity: moderate intensity (pain free) Time: 20 mins Type: breathing exercises to improve respiratory function and chest tightness.	Other: Conventional treatment; diaphragmatic breathing exercises pursed-lip expiration exercises. Patient will receive diaphragmatic breathing and pursed lip breathing exercise in sitting position Frequency: 5 times/week for 3 weeks Intensity: moderate intensity (pain free) Time: 20 mins Type: breathing exercises to improve respiratory function and chest tightness.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of respiratory function FEV1 using spirometer.	Spirometry is one of the Pulmonary Function Test; they are useful investigations in the management of patients with respiratory disease or respiratory weakness secondary to neurological impairment. Spirometry will measure FEV1	3 weeks
Assessment of respiratory function FVC using spirometer.	Spirometry is one of the Pulmonary Function Test; they are useful investigations in the management of patients with respiratory disease or respiratory weakness secondary to neurological impairment. Spirometry will measure FVC	3 weeks
Tape for chest expansion	Chest expansion is measured using a measuring tape at 2 different levels of the rib cage. The 2 measurements of chest diameter are taken at the end of deep inspiratory and expiratory maneuvers. Upper and lower chest expansion are obtained by subtracting the inspiratory diameter from the expiratory diameter, according to the designated anatomical markers. The assessment is performed 1 measurement of upper chest expansion and then 1 measurement of the lower chest expansion consecutively, holding the measuring tape at both ends with thumb and index finger around the patient body.	3 weeks
Dyspnea index	It is used to describe their sense of breathlessness and breathing problem, and the effects of their breathing on their lives.	3 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Asghar Khan, DPT,DSc PT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2023
• Primary Completion (Actual): February 1, 2024
• Study Completion (Actual): February 1, 2024

Study Registration Dates

• First Submitted: October 25, 2023
• First Submitted That Met QC Criteria: November 15, 2023
• First Posted (Actual): November 18, 2023

Study Record Updates

• Last Update Posted (Actual): March 5, 2024
• Last Update Submitted That Met QC Criteria: March 4, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: asthma; respiratory function; costovertebral joint mobilization; chest tightness
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Immune System Diseases; Lung Diseases; Hypersensitivity, Immediate; Bronchial Diseases; Lung Diseases, Obstructive; Respiratory Hypersensitivity; Hypersensitivity; Asthma
• Other Study ID Numbers: REC -01680 Bushra Ali Syed

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No