Thoracic Spine Rotation Stretching and Scapular Retraction in Asthma Patients

Comparative Effects of Thoracic Spine Rotation Stretching and Scapular Retraction on Chest Expansion, Pulmonary Function Test and Dyspnea in Asthma Patients

Patients with asthma frequently experience upper back stiffness and rounded shoulders and tightness in the thoracic region. Rib cage stiffness occurs due to poor posture and muscle tightness, which leads to decreased chest expansion and increased use of accessory muscles during breathing. Additionally, rounded shoulders can hinder proper opening of the chest, preventing the lungs from expanding properly. Thoracic spine rotation stretching targets the thoracic paraspinal muscles, erector spinae, and intercostal muscles. This exercise helps improve thoracic mobility, increases chest expansion and pulmonary function, and reduces dyspnea. The other exercise is Scapular Retraction, which targets the rhomboids, trapezius, and posterior deltoids that help in chest opening and lead to chest expansion and allow lungs to expand more fully during inhalation. Together, these exercises improve chest expansion and pulmonary function, reduce dyspnea, and improve posture.

Study Overview

• Status: Completed
• Conditions: Asthma Chronic
• Intervention / Treatment: Other: Thoracic Spine Rotation Stretching; Other: Scapular retraction

Detailed Description

Asthma is a prevalent chronic respiratory condition that affects millions worldwide, characterized by airway inflammation and reversible airflow obstruction. Patients often experience difficulty in breathing, which can severely impact their quality of life. People with asthma are less active that their peers, and consequently, the patient becomes more sedentary. This study focusses to compare the effects of thoracic spine rotation stretching and Scapular Retraction exercises on chest expansion, pulmonary function, and dyspnea in patients with asthma. By investigating these interventions, the study seeks to provide practical recommendations for enhancing the management of asthma symptoms, ultimately improving respiratory function and mobility may improve asthma control and quality of life.

A randomized clinical trial will enroll participants aged 18 to 50 with a confirmed diagnosis of chronic asthma. The study will take place at Rai Medical College Teaching Hospital Sargodha, utilizing a non- probability convenient sampling technique for participant selection. Participants will be randomly assigned to two groups using a lottery method, ensures a diverse yet unbiased sample. Group A will perform thoracic spine rotation stretching, while Group B will engage in shoulder squeezing exercises, following a standardized warm-up. Baseline treatment will include breathing exercises, postural education, bronchodilators, and nebulization Each group will engage in their respective exercises for a defined duration, focusing on improving respiratory mechanics and muscle flexibility. Study will be completed in 8 weeks (3x/week). After data collection, data will be analyzed using SPSS version 26. Assessments will be conducted before and after the intervention period, measuring chest expansion with a measuring tape, pulmonary function through digital spirometer (including FEV1 and FVC their ratio and peak expiratory flow), and dyspnea levels using the Modified borg dyspnea scale, thoracic rotation range of motion measured with a goniometer. The integration of targeted physical therapy in this study has the potential to significantly improve asthma management by enhancing respiratory function, reducing dyspnea, and increasing chest expansion.

• Study Type: Interventional
• Enrollment (Actual): 54
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Lahore, Pakistan
    • Sehat medical complex hanjerwal

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Age between (18 to 50).
• Confirmed diagnosis of asthma based on clinical guidelines.
• Nonsmoker.
• Chronic asthma.
• Thoracic spine abnormality

Exclusion Criteria:

• Acute asthma
• Recent exacerbations.
• History of sever cardiopulmonary, musculoskeletal, infectious diseases.
• Any neurological condition.
• Cognitive impairment.
• Any recent injury of spine, shoulder, or rib cage that limit mobility or cause pain.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Thoracic Spine Rotation Stretching Group; Participants will undergo thoracic spine rotation stretching exercises to assess their effects on pulmonary function, chest expansion, and dyspnea and also improve thoracic rotation . The intervention will be provided 3 sessions per week for a duration of 8 weeks in individuals with chronic asthma.	Other: Thoracic Spine Rotation Stretching; Thoracic spine rotation stretching consists of controlled rotational movements of the thoracic spine performed to improve thoracic mobility. The exercises are administered under supervision, three sessions per week for eight weeks, using standardized repetitions within a comfortable range of motion.
Experimental: Scapular retraction Group; Participants will perform Scapular Retraction exercises to evaluate their effects on pulmonary function, chest expansion, and dyspnea. The intervention will be provided three sessions per week for a duration of eight weeks in individuals with chronic asthma.	Other: Scapular retraction; Scapular retraction exercises involve active scapular retraction movements performed to improve shoulder and upper thoracic mobility. The intervention is administered under supervision, three sessions per week for eight weeks in individuals with chronic asthma.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Modified borg scale	Dyspnea at rest was assessed using the modified Borg scale. It is a well-validated scoring system using a 0-to-10-point scale.The intensity of dyspnea is most often assessed according to a symptom scale, with the modified Borg scale, which measures dyspnea on a scale of 0-10 arbitrary units, being used most frequently.It is a validated dyspnea scale ranging from 0 ("no shortness of breath") to 10 ("worst shortness of breath") points.	8 Weeks
Digital spirometer:	A digital spirometer will be used to measure pulmonary function tests including FEV1, FVC, FEV1/FVC.The normal values of FEV1/FVC ratio are >0.70 and FVC, FEV1 are >80% or predicted age.	8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Tape measure	Chest expansion was measured using a measurement tape (Baseline 12-1201 with Gulick attachment, Fabrication Enterprises Inc., New York, NY, USA) to determine the difference between rib cage circumference at the end of forced expiration and rib cage circumference at the end of forced inspiration. Chest expansion measurement is highly reliable with an interexaminer intraclass correlation coefficient of 0.99.The chest circumference was measured in cm at maximum inspiration and maximum expiration by horizontally passing through the junction of the xiphoid process and the body of the sternum so that the chest girth was exposed.The tape measure is wrapped around the thorax in a level position and pulled just taut (but not restricting chest expansion) at three anatomic sites.1. The angle of Louis on the sternum .2.The xiphoid process for mid-chest expansion 3.The midpoint between the xiphoid process and the umbilicus for lower chest expansion, where most of the bucket handle motion occur.	8 Weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Goniometer	The goniometer is a tool that can measure angles from 0 to 360 degrees and is marked at intervals of 5 degrees. One of the two arm is fixed and the other arm is moved to the end- range of the movement and the final displayed ROM angle is recorded. The goniometer measurements were made by placing the stationary arm of the goniometer on the T1, T2 (spine of scapula) or T1 and T2 junctions of the subject parallel to the imaginary line connecting the two shoulders, and the mobile arm was aligned parallel to the floor.A goniometer is a device that measures an angle or permits the rotation of an object to a definite position.	8 Weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Riffat Malik, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): April 17, 2025
• Primary Completion (Actual): December 17, 2025
• Study Completion (Actual): December 17, 2025

Study Registration Dates

• First Submitted: March 27, 2026
• First Submitted That Met QC Criteria: March 27, 2026
• First Posted (Actual): April 2, 2026

Study Record Updates

• Last Update Posted (Actual): April 2, 2026
• Last Update Submitted That Met QC Criteria: March 27, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Asthma, Chest Expansion, Dyspnea, Pulmonary Function, Scapular Retraction, Thoracic Spine Rotation
• Additional Relevant MeSH Terms: Immune System Diseases; Respiratory Tract Diseases; Lung Diseases; Respiration Disorders; Bronchial Diseases; Lung Diseases, Obstructive; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Signs and Symptoms, Respiratory; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Asthma; Dyspnea
• Other Study ID Numbers: Mehwish Atta

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