Costovertebral mobilizations along conventional treatment patient would receive costovertebral mobilization in side lying position for 10th to 6th ribs, in sitting position for 10th to 2nd rib and in supine position for 1 rib.

Frequency: 5 times/week for 3 weeks. Intensity: moderate intensity (pain free) Time: 20 mins Type: costovertebral joint mobilization to improve respiratory function and chest tightness.

Conventional treatment diaphragmatic breathing exercises and pursed-lip expiration exercises. Patient will receive diaphragmatic breathing and pursed lip breathing exercise in sitting position Frequency: 5 times/week for 3 weeks Intensity: moderate intensity (pain free) Time: 30 mins Type: breathing exercises to improve respiratory function and chest tightness.

diaphragmatic breathing exercises and pursed-lip expiration exercises Patient will receive diaphragmatic breathing and pursed lip breathing exercise in sitting position Frequency: 5 times/week for 3 weeks Intensity: moderate intensity (pain free) Time: 20 mins Type: breathing exercises to improve respiratory function and chest tightness.

Costovertebral mobilizations along conventional treatment patient would receive costovertebral mobilization in side lying position for 10th to 6th ribs, in sitting position for 10th to 2nd rib and in supine position for 1 rib.

Frequency: 5 times/week for 3 weeks. Intensity: moderate intensity (pain free) Time: 10 mins Type: costovertebral joint mobilization to improve respiratory function and chest tightness.

Conventional treatment diaphragmatic breathing exercises pursed-lip expiration exercises. Patient will receive diaphragmatic breathing and pursed lip breathing exercise in sitting position Frequency: 5 times/week for 3 weeks Intensity: moderate intensity (pain free) Time: 20 mins Type: breathing exercises to improve respiratory function and chest tightness.

Spirometry is one of the Pulmonary Function Test; they are useful investigations in the management of patients with respiratory disease or respiratory weakness secondary to neurological impairment. Spirometry will measure FEV1

Spirometry is one of the Pulmonary Function Test; they are useful investigations in the management of patients with respiratory disease or respiratory weakness secondary to neurological impairment. Spirometry will measure FVC

Chest expansion is measured using a measuring tape at 2 different levels of the rib cage. The 2 measurements of chest diameter are taken at the end of deep inspiratory and expiratory maneuvers. Upper and lower chest expansion are obtained by subtracting the inspiratory diameter from the expiratory diameter, according to the designated anatomical markers. The assessment is performed 1 measurement of upper chest expansion and then 1 measurement of the lower chest expansion consecutively, holding the measuring tape at both ends with thumb and index finger around the patient body.

It is used to describe their sense of breathlessness and breathing problem, and the effects of their breathing on their lives.