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Comparison of diaphragmatic stretch and manual diaphragmatic release technique along with chest proprioceptive neuromuscular facilitation in mild-to-moderate chronic obstructive pulmonary disease: a randomized clinical trial
Thali S, Ganesh B
Indian Journal of Physical Therapy and Research 2023 Jul-Dec;5(2):169-175
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Diaphragmatic stretch technique, manual diaphragmatic release technique, and chest proprioceptive neuromuscular facilitation (PNF) have been suggested as an alternative method for the treatment of chronic obstructive pulmonary disease (COPD). AIMS: The aim of this study was to compare the effects of diaphragmatic stretch and manual diaphragmatic release technique along with chest PNF on peak expiratory flow rate (PEFR), exercise capacity, dyspnea, chest expansion, and inspiratory pressure in mild-to-moderate COPD participants. Settings and DESIGN: A randomized clinical trial took place on 30 subjects with COPD. MATERIALS AND METHODS: Subjects were divided into two groups, of which Group A received a diaphragmatic stretch technique with chest PNF and Group B received a manual diaphragmatic release technique with chest PNF. Six-day intervention protocol was given to the participants of both the groups and PEFR, maximum inspiratory pressure, chest expansion, exercise capacity, and dyspnea were assessed before the intervention and after 6 days of intervention. Statistical Analysis: Normality of all continuous data was checked using the Kolmogorov-Smirnov test. Independent t-test was used to analyze the parameters between Group A and Group B. Comparison of difference in pre and post within group was done using independent t-test. RESULTS: Data analyzed in Group A as well as in B, when compared within the group, showed highly significant improvements. When compared between the groups, both the groups showed no difference. CONCLUSION: The study concluded that there was statistical significance in improvement of PEFR, exercise capacity, dyspnea, chest expansion, and inspiratory pressure within both the groups, but significant changes were not seen between groups. Hence, diaphragmatic stretch and manual release technique along with chest PNF can be used as an alternative/adjunct for the treatment of COPD.

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