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Manual noninvasive respiratory techniques gained interest to treat respiratory pathologies related to COVID 19. This study designed to determine the combined effect of manual diaphragmatic release technique with the effect of conventional breathing exercises and prone positioning on pulmonary function parameters (FVC, FEV1, PEF, FEV1/FVC, FEF25, FEF50, FEF75, FEF25/75).
Forty females were randomly assigned to two groups. Group A received manual diaphragm release with conventional breathing exercises and prone positioning. Group B received conventional breathing exercises and prone positioning. Both groups took their prescribed medications. Their ages ranged from 35 to 45 years and with moderate COVID-19 illness. Any cases with mild and severe COVID-19 illness, ICU admission, and chest diseases were excluded.
Main measures: pulmonary function parameters (FVC, FEV1, PEF, FEV1/FVC, FEF25, FEF50, FEF75, FEF25/75).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study group | Experimental | they received manual diaphragm release with conventional breathing exercises and prone positioning in addition to their prescribed medications. |
|
| Control group | Active Comparator | they received conventional breathing exercises and prone positioning alone in addition to their prescribed medications. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| manual therapy | Other | manual diaphragmatic release technique combined with breathing exercise |
|
| Measure | Description | Time Frame |
|---|---|---|
| forced vital capacity FVC | the amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible which is a common breathing test to check lung function. | pre study and 3 weeks post study for all participants |
| FEV1 | the maximum amount of air that the subject can forcibly expel during the first second following maximal inhalation | pre study and 3 weeks post study for all participants |
| PEF | show the amount and rate of air that can be forcefully breathed out of the lungs. | pre study and 3 weeks post study for all participants |
| FEV1/FVC | FEV1/FVC, also known as FEV1%) can help distinguish obstructive and restrictive lung diseases. | pre study and 3 weeks post study for all participants |
| PEF25% | Peak expiratory flow at 25% of fvc and the most sensitive measure of airflow in peripheral airways where primary airflow obstruction originates. | pre study and 3 weeks post study for all participants |
| PEF50% | Peak expiratory flow at 50% ofFVC | pre study and 3 weeks post study for all participants |
| PEF 75% | Peak expiratory flow at 75% of FVC | pre study and 3 weeks post study for all participants |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| mona M ghallab, doctoral | PHD and lecturer of physical therapy for cardiovascular disease and geriatrics,cairo univeristy | Principal Investigator |
| neveen M nawar, master | master degree of physical therapy for cardiovascular disease and geriatrics, cairo univeristy | Study Chair |
| karim I safaan, doctoral | PHD and lecturer of physical therapy for Surgery, cairo univeristy | Study Director |
| kerolous I shehata, doctoral | PHD and lecturer Department of women health/ faculty of physical therapy /cairo university | Study Director |
| Amira I mostafa, doctoral | PHD and Assistant professor of chest disease Faculty of medicine cairo univeristy | Study Director |
| mona A mohamed, doctoral | PHD and lecturer of physical therapy for cardiovascular disease and geriatrics,cairo univeristy | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo Univeristy | Multiple Locations | Giza Governorate | 12613 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26386894 | Background | Rocha T, Souza H, Brandao DC, Rattes C, Ribeiro L, Campos SL, Aliverti A, de Andrade AD. The Manual Diaphragm Release Technique improves diaphragmatic mobility, inspiratory capacity and exercise capacity in people with chronic obstructive pulmonary disease: a randomised trial. J Physiother. 2015 Oct;61(4):182-9. doi: 10.1016/j.jphys.2015.08.009. Epub 2015 Sep 19. | |
| 37330786 |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D026201 | Musculoskeletal Manipulations |
| D001945 | Breathing Exercises |
| D016684 | Prone Position |
| ID | Term |
|---|---|
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
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Forty females were randomly assigned to two groups. Group A received manual diaphragm release with conventional breathing exercises and prone positioning. Group B received conventional breathing exercises and prone positioning. Both groups took their prescribed medications. Their ages ranged from 35 to 45 years and with moderate COVID-19 illness. Any cases with mild and severe COVID-19 illness, ICU admission, and chest diseases were excluded.
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| breathing exercise and prone position alone | Other | deep breathing exercise and prone position |
|
| PEF 25%/75% | Maximum flow rate in the middle 50% of forced expiration. | pre study and 3 weeks post study for all participants |
| Ahmad AM, Nawar NM, Dabess HM, Gallab MA. Effect of diaphragm manual release versus conventional breathing exercises and prone positioning on physical functional performance in women with COVID-19: A randomized trial. J Bodyw Mov Ther. 2023 Jul;35:311-319. doi: 10.1016/j.jbmt.2023.04.064. Epub 2023 Apr 21. |
| 31337743 | Background | Elnaggar RK, Shendy MA, Mahmoud MZ. Prospective Effects of Manual Diaphragmatic Release and Thoracic Lymphatic Pumping in Childhood Asthma. Respir Care. 2019 Nov;64(11):1422-1432. doi: 10.4187/respcare.06716. Epub 2019 Jul 23. |
| 27333481 | Background | Gonzalez-Alvarez FJ, Valenza MC, Torres-Sanchez I, Cabrera-Martos I, Rodriguez-Torres J, Castellote-Caballero Y. Effects of diaphragm stretching on posterior chain muscle kinematics and rib cage and abdominal excursion: a randomized controlled trial. Braz J Phys Ther. 2016 Jun 16;20(5):405-411. doi: 10.1590/bjpt-rbf.2014.0169. |
| Background | Courtney R., Biland G., Ryan A., et al. Improvements in multi-dimensional measures of dysfunctional breathing in asthma patients after a combined manual therapy and breathing retraining protocol: a case series report. International Journal of Osteopathic Medicine 2019: (31) 36-43. |
| 36121338 | Background | Nagy EN, Elimy DA, Ali AY, Ezzelregal HG, Elsayed MM. Influence of Manual Diaphragm Release Technique Combined with Inspiratory Muscle Training on Selected Persistent Symptoms in Men with Post-Covid-19 Syndrome: A Randomized Controlled Trial. J Rehabil Med. 2022 Oct 20;54:jrm00330. doi: 10.2340/jrm.v54.3972. |
| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D026441 |
| Mind-Body Therapies |
| D026241 | Exercise Movement Techniques |
| D011187 | Posture |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |