The respiratory muscle stretching were developed bilaterally as follows:

• Upper trapezius: head lateral flexion with a hand therapist supports the the occipital region and his shoulder, promotes the stretching;
• Sternocleidomastoid: was stretched with flexion lateral and rotation of the head to the side which hands on the occipital region and in the sternal region;
• Scalene: with one hand on the occipital region and the other in the sternum, the two points was stretched;
• Pectoralis major: the arm was abducted, flexed the forearm and hand was in the occipital region the therapist hands in the arm and in the side of the upper chest, which was stretched craniocaudal direction;
• Intercostal: therapist performs with both hands to mobilize and stretch the ribs in cranial-caudal directions.

COPD patients were not submitted to any intervention, remaining at rest in the same place, position and time period to the treatment group.

Patients submitted to respiratory muscle stretching related to the increase thoracic mobility. Stretching were performed in the upper trapezius, scalenes, sternocleidomastoids, major pectoral and intercostals. The muscle stretching were performed passively by a single therapist trained and experienced. The subjects were positioned supine or lateral, knees flexed in order to correct the lumbar curve. Stretching occurred during the expiratory phase, leading to muscle maximum length, with two series of ten consecutive incursions for each muscle, with an interval of one minute between series. The patients were properly informed to perform slow exhalations and pursed-lip during stretching.