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Effect of Thoracic Mobilization in People With Central Obesity

17 lipca 2026 zaktualizowane przez: Abd El-Rahman Ayman Mohamed Abd El-Monem, Cairo University

Effect of Mulligan Thoracic Mobilization on Ventilatory Functions and Chest Wall Expansion in Central Obesity

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.

Przegląd badań

Status

Jeszcze nie rekrutacja

Warunki

Interwencja / Leczenie

Szczegółowy opis

The Challenge: Central Obesity and Respiratory Dysfunction

Central obesity is a growing global health concern that affects not only metabolic and cardiovascular health but also respiratory function. Excess accumulation of abdominal and visceral fat mechanically restricts chest wall movement, limits diaphragmatic excursion, and reduces lung volumes, leading to impaired ventilatory function and decreased chest wall expansion. These respiratory limitations can contribute to dyspnea, reduced exercise tolerance, and poorer quality of life. Although weight loss through dietary modification and aerobic exercise remains the cornerstone of obesity management, these approaches do not directly address the mechanical restrictions imposed on the thoracic cage. Therefore, additional physiotherapy interventions targeting thoracic mobility may provide further improvements in respiratory function.

The Goal of the Study

This study aims to determine whether adding Mulligan thoracic mobilization in extension to a standardized low-carbohydrate diet and aerobic exercise program provides greater improvements in ventilatory functions and chest wall expansion than diet and exercise alone in adults with central obesity. The study will also investigate whether this intervention improves functional exercise capacity and health-related quality of life.

How the Study Works

The study will involve 60 adult males with central obesity who meet the study eligibility criteria. Participants will be randomly assigned into two equal groups:

The Mulligan Thoracic Mobilization Group: Participants will receive Mulligan thoracic mobilization in extension performed by a trained physiotherapist five times per week for eight weeks. The mobilization will be applied to the mid-thoracic spine (T6-T8) using the Mobilization with Movement (MWM) concept while participants perform thoracic extension combined with deep inspiration. In addition, participants will follow an individualized low-carbohydrate diet and participate in a supervised aerobic exercise program.

The Control Group: Participants will receive the same individualized low-carbohydrate diet and supervised aerobic exercise program without Mulligan thoracic mobilization.

Both groups will participate in the intervention program for 8 weeks, with regular monitoring to ensure adherence and participant safety.

What Is Being Measured?

To determine the effectiveness of the intervention, the study will evaluate several important clinical outcomes:

Ventilatory Functions: Pulmonary function will be assessed using spirometry by measuring Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV₁), the FEV₁/FVC ratio, and Maximum Voluntary Ventilation (MVV).

Chest Wall Expansion: Chest wall mobility will be measured using a non-elastic tape measure at the fourth intercostal space and at the xiphoid process during maximal inspiration and expiration.

Functional Capacity: The Six-Minute Walk Test (6MWT) will be used to assess participants' functional exercise capacity.

Health-Related Quality of Life: Participants will complete the 36-Item Short Form Health Survey (SF-36) to evaluate physical and mental aspects of quality of life.

Why This Matters

Respiratory impairment associated with central obesity is largely driven by mechanical restriction of the thorax, yet current obesity management strategies rarely address this component directly. By investigating the effects of Mulligan thoracic mobilization in extension, this study aims to identify a safe, non-invasive, and clinically practical physiotherapy intervention that can complement conventional weight management. If effective, this approach may improve respiratory mechanics, enhance chest wall mobility, increase functional capacity, and improve quality of life for adults with central obesity while expanding the evidence base for manual therapy in cardiopulmonary rehabilitation.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

60

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Kopia zapasowa kontaktu do badania

  • Nazwa: Alaa N Abdelhameed
  • Numer telefonu: 00201061382864

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria:

  • 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.

Exclusion Criteria:

  • 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.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Mulligan Thoracic Mobilization
will receive Mulligan thoracic mobilization in extension five times per week for 8 weeks in addition to a standardized diet and aerobic exercise.
Procedura: Mulligan Thoracic Mobilization
  • 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.
Behawioralne: low carbohydrate
Standardized low-carbohydrate dietary program administered for 8 weeks.
Behawioralne: Aerobic Exercise
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.
Aktywny komparator: low carbohydrate and Aerobic Exercises
will receive standardized diet and aerobic exercise.
Behawioralne: low carbohydrate
Standardized low-carbohydrate dietary program administered for 8 weeks.
Behawioralne: Aerobic Exercise
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.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Forced Vital Capacity
Ramy czasowe: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
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
Ramy czasowe: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
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
Ramy czasowe: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Measured as a percentage using spirometry.
Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Maximum Voluntary Ventilation
Ramy czasowe: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
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
Ramy czasowe: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
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
Ramy czasowe: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
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).

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Functional capacity
Ramy czasowe: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
assessed by 6-Minute Walk Test (6MWT)
Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Change in Health-Related Quality of Life
Ramy czasowe: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
using 36 Item Short Form Health Survey (SF 36) Health-related quality of life will be measured using the 36-Item Short Form Health Survey (SF-36). Scores for each domain and the Physical Component Summary (PCS) and Mental Component Summary (MCS) range from 0 to 100. Higher scores indicate better heal
Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Cairo University

Śledczy

  • Krzesło do nauki: Mona A Abdelwahab, Assistant Prof, Cairo University
  • Dyrektor Studium: Shaimaa T Mohamed, Lecturer, Cairo University

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

25 czerwca 2026

Zakończenie podstawowe (Szacowany)

15 grudnia 2026

Ukończenie studiów (Szacowany)

10 lutego 2027

Daty rejestracji na studia

Pierwszy przesłany

14 lipca 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

17 lipca 2026

Pierwszy wysłany (Rzeczywisty)

21 lipca 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

21 lipca 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

17 lipca 2026

Ostatnia weryfikacja

1 lipca 2026

Więcej informacji

Terminy związane z tym badaniem

Dodatkowe istotne warunki MeSH

Inne numery identyfikacyjne badania

  • CU-AA-19052026

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Opis planu IPD

Individual participant data will not be shared to maintain participant privacy and strictly adhere to confidentiality agreements.

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

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