Acute and Long-Term Effects of Integrated Myofascial Release Therapy on Respiratory Function in Healthy Adults (EMGT-RESP)

Acute and Long-Term Effects of Integrated Myofascial Release Therapy on Pulmonary Function, Thoracic Mobility, and Cough Strength in Healthy Adults

This study will investigate the immediate and longer-term effects of integrated myofascial release therapy on breathing-related outcomes in healthy adults.

Participants will receive integrated myofascial release therapy twice a week for 6 weeks, for a total of 12 treatment sessions. Assessments will be performed before treatment, immediately after the first treatment session, at the end of the 6-week treatment period, and 1 month and 3 months after treatment.

The study will evaluate pulmonary function, cough strength, and chest mobility. The aim is to determine both the immediate response to a single treatment session and whether repeated treatment produces effects that are maintained during follow-up.

Study Overview

• Status: Not yet recruiting
• Conditions: Respiratory Function
• Intervention / Treatment: Other: Other

Detailed Description

Myofascial release therapy is a manual therapy approach intended to reduce restrictions in fascial tissues and improve tissue mobility. Fascial structures surrounding the thorax, neck, shoulder, and upper extremity may contribute to chest wall mechanics and movements associated with breathing.

Previous studies have mainly focused on immediate or short-term responses to myofascial release techniques, while evidence regarding cumulative and sustained effects remains limited. Therefore, this prospective single-group interventional study is designed to evaluate both the immediate response to the first treatment session and the effects of repeated treatment over time.

Integrated myofascial release therapy will be applied to fascial structures associated with the upper extremity, neck-shoulder region, and pectoral/anterior chest region. Treatment will be administered twice weekly for 6 weeks, for a total of 12 sessions.

Assessments will be conducted at five time points: before treatment (T0), immediately after the first treatment session (T1), at the end of the 6-week treatment period (T2), 1 month after treatment (T3), and 3 months after treatment (T4).

Pulmonary function will be evaluated using spirometry, including forced vital capacity, forced expiratory volume in 1 second, the FEV1/FVC ratio, and peak expiratory flow. Cough strength will be assessed using peak cough flow. Thoracic mobility will be evaluated using chest expansion measurements at the axillary, xiphoid/epigastric, and subcostal levels.

The study is intended to distinguish the acute response to a single session from the cumulative effect of repeated treatment and the persistence of any observed effects after treatment has ended.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ece Acar, Assist Prof; Phone Number: 05457925035; Email: acarkosanece@gmail.com

Study Locations

• Turkey (Türkiye)
  • Karabük Province
    • Karabük, Karabük Province, Turkey (Türkiye), 78050
      • Karabuk University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age 18 years or older.
• Ability to communicate in Turkish.
• Voluntary agreement to participate in the study.
• Ability to attend the scheduled assessment and treatment sessions regularly.

Exclusion Criteria:

• Asthma, clinically significant dyspnea, or chronic pulmonary disease.
• Influenza, COVID-19, or another acute respiratory tract infection within the previous 6 weeks that may affect respiratory function.
• Recent surgery involving the neck, shoulder, or thoracic region.
• History of rib fracture or an acute musculoskeletal condition that would make manual therapy inappropriate.
• Serious cardiovascular, neurological, or systemic disease that could prevent safe participation in the assessments.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Integrated Myofascial Release Therapy; Participants in this arm will receive integrated myofascial release therapy twice weekly for 6 weeks, for a total of 12 sessions. Each session will last approximately 20-30 minutes. The intervention will include single arm pull, lateral neck-shoulder myofascial release, and pectoral-anterior chest cross-hand release techniques applied in a standardized sequence.

Other: Other; Integrated myofascial release therapy will be administered twice weekly for 6 weeks, for a total of 12 sessions. Each session will last approximately 20-30 minutes. The intervention will include single arm pull, lateral neck-shoulder myofascial release, and pectoral-anterior chest cross-hand release techniques. Techniques will be applied using slow, low-intensity, pain-free manual contact while following tissue resistance and release. The sequence and target regions will be standardized across sessions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Xiphoid-Level Chest Expansion	Chest expansion will be measured at the xiphoid/epigastric level using a non-elastic measuring tape. The difference between chest circumference at maximal inspiration and maximal expiration will be calculated in centimeters. Measurements will be repeated using the same anatomical landmarks and standardized participant position across assessment time points.	Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Forced Vital Capacity (FVC)	Forced vital capacity will be assessed using spirometry and recorded in liters. Participants will perform repeated acceptable forced expiratory maneuvers according to the standardized measurement procedure, and the highest acceptable FVC value will be used for analysis.	Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Forced Expiratory Volume in 1 Second (FEV1)	Forced expiratory volume in 1 second will be assessed using spirometry and recorded in liters. Participants will perform repeated acceptable forced expiratory maneuvers, and the highest acceptable FEV1 value will be used for analysis.	Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in FEV1/FVC Ratio	The FEV1/FVC ratio will be calculated automatically by the spirometry device from acceptable forced expiratory maneuvers and recorded as a percentage.	Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Peak Expiratory Flow (PEF)	Peak expiratory flow will be assessed during standardized spirometry maneuvers. The highest technically acceptable PEF value will be recorded and used for analysis, expressed according to the spirometry device output.	Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Peak Cough Flow (PCF)	Peak cough flow will be assessed using a portable peak flow meter and recorded in liters per minute. Participants will perform at least three technically appropriate voluntary cough maneuvers after a deep inspiration, and the highest technically acceptable PCF value will be used for analysis.	Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Axillary-Level Chest Expansion	Chest expansion at the axillary level will be measured using a non-elastic measuring tape positioned approximately at the level of the third rib. The difference between chest circumference at maximal inspiration and maximal expiration will be calculated in centimeters. The same participant position and anatomical landmarks will be used across all assessment time points	Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).
Change in Subcostal-Level Chest Expansion	Chest expansion at the subcostal level will be measured using a non-elastic measuring tape. The difference between chest circumference at maximal inspiration and maximal expiration will be calculated in centimeters. The same standardized participant position and anatomical landmarks will be used at each assessment time point.	Baseline (T0), immediately after the first treatment session (T1), at the end of 6 weeks of treatment (T2), 1 month after treatment (T3), and 3 months after treatment (T4).

Collaborators and Investigators

• Sponsor: Karabuk University

Publications and helpful links

General Publications

• Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, Hallstrand TS, Kaminsky DA, McCarthy K, McCormack MC, Oropez CE, Rosenfeld M, Stanojevic S, Swanney MP, Thompson BR. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019 Oct 15;200(8):e70-e88. doi: 10.1164/rccm.201908-1590ST.
• Bohunicky S, Rutherford L, Harrison KL, Malone Q, Glazebrook CM, Scribbans TD. Immediate effects of myofascial release to the pectoral fascia on posture, range of motion, and muscle excitation: a crossover randomized clinical trial. J Man Manip Ther. 2024 Oct;32(5):495-505. doi: 10.1080/10669817.2024.2316414. Epub 2024 Feb 16.
• Marizeiro DF, Florencio ACL, Nunes ACL, Campos NG, Lima POP. Immediate effects of diaphragmatic myofascial release on the physical and functional outcomes in sedentary women: A randomized placebo-controlled trial. J Bodyw Mov Ther. 2018 Oct;22(4):924-929. doi: 10.1016/j.jbmt.2017.10.008. Epub 2017 Oct 25.

Study record dates

Study Major Dates

• Study Start (Estimated): October 16, 2026
• Primary Completion (Estimated): February 12, 2027
• Study Completion (Estimated): June 29, 2027

Study Registration Dates

• First Submitted: September 10, 2026
• First Submitted That Met QC Criteria: September 10, 2026
• First Posted (Actual): September 16, 2026

Study Record Updates

• Last Update Posted (Actual): September 16, 2026
• Last Update Submitted That Met QC Criteria: September 10, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Keywords: Pulmonary Function; Myofascial Release; Healthy Adults; Manual Therapy; Peak Cough Flow; Chest Expansion; Thoracic Mobility; Integrated Myofascial Release Therapy
• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Respiration Disorders; Pathological Conditions, Signs and Symptoms; Respiratory Aspiration
• Other Study ID Numbers: KBU-EMGT-RESP-2026-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data underlying the results reported in publications from this study may be shared with qualified researchers upon reasonable request. Shared data will not include information that could directly identify individual participants.
• IPD Sharing Time Frame: Data will be available beginning 6 months after publication of the main study results and for 5 years thereafter.
• IPD Sharing Access Criteria: Data may be made available to qualified researchers who submit a methodologically sound proposal with a clearly defined scientific purpose. Requests will be reviewed by the study investigators. Approved requestors may be required to sign a data use agreement before access is granted.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

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