Chest mobility exercise versus proprioceptive neuromuscular facilitation in patients with chronic obstructive pulmonary disease

The purpose of this study is designed to compare the therapeutic effect of chest mobility exercises and proprioceptive neuromuscular facilitation stretching on improving chest expansion and functional capacity in patients with chronicobstructivepulmonarydisease?

Inclusion Criteria:

All patients will have the following criteria:

1. Age: 50-60 years old
2. All patients will be in mild to moderate of COPD. In accordance with criteria of Global Initiative for Chronic Obstructive Lung Disease (GOLD) (GOLD I-II).
3. BMI: obese class 1 (30-34.9).
4. Sex: male
5. They suffered from mild dyspnea, chronic cough and expectorations, with forced expiratory volume in one second (FEV1sec) from 50% to 80% of predicted value.

Exclusion criteria:

Patients with the following criteria will excluded from the study:

1. Severe psychiatric or cognitive impairments.
2. Progressive neuromuscular disorders.
3. Decreased level of consciousness.
4. Unstable fracture.
5. pacemaker inserted for fewer than 2 days
6. Deep-venous thrombosis (to minimize risk for pulmonary embolism from being in a prone position.
7. Mean arterial blood pressure of less than 65 mm Hg with or without vasopressors.
8. Tracheal surgery or sternotomy in the last 15 days.
9. Massive haemoptysis.
10. Intracranial pressure of more than 30 mm Hg or cerebral perfusion pressure of less than 60 mm Hg.