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Effect of Thoracic Mobilization in People With Central Obesity

2026年9月11日 更新者：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 three 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.

研究概览

地位

主动，不招人

条件

干预/治疗

详细说明

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 three 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.

研究类型

介入性

注册 (估计的)

60

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

  • 埃及
      • Minya、埃及
        • Deraya University

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人

接受健康志愿者

不

描述

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.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
有源比较器：low carbohydrate and Aerobic Exercises
will receive standardized diet and aerobic exercise.
行为的：low carbohydrate
Standardized low-carbohydrate dietary program administered for 8 weeks.
行为的：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.
实验性的：Mulligan Thoracic Mobilization
will receive Mulligan thoracic mobilization in extension three times per week for 8 weeks in addition to a standardized diet and aerobic exercise.
行为的：low carbohydrate
Standardized low-carbohydrate dietary program administered for 8 weeks.
行为的：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.
程序：Mulligan Thoracic Mobilization
  • Technique: Thoracic mobilization with movement (MWM) in extension performed by a trained physiotherapist.
  • Performed 3×/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.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Forced Vital Capacity
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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).

次要结果测量

结果测量
措施说明
大体时间
Functional capacity
大体时间：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
大体时间：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).

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Cairo University

调查人员

  • 学习椅：Mona A Abdelwahab, Assistant Prof、Cairo University
  • 研究主任：Shaimaa T Mohamed, Lecturer、Cairo University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2026年7月25日

初级完成 (估计的)

2026年12月15日

研究完成 (估计的)

2027年2月10日

研究注册日期

首次提交

2026年7月14日

首先提交符合 QC 标准的

2026年7月17日

首次发布 (实际的)

2026年7月21日

研究记录更新

最后更新发布 (实际的)

2026年9月15日

上次提交的符合 QC 标准的更新

2026年9月11日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

其他相关的 MeSH 术语

其他研究编号

  • P.T.REC/012/006582

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

不

IPD 计划说明

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

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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