Evaluate the effect of manual diaphragmatic release on ventilatory functions in women with rheumatoid arthritis

Sixty women with rheumatoid arthritis will be sourced from the rheumatology outpatient clinic at Tanta University hospitals in Egypt, with referrals from rheumatologists. Patients will be randomly assigned into two groups.

The study group will include 30 women participating in manual diaphragmatic release plus aerobic training for 12 weeks while the control group will include 30 women participating in aerobic training only for 12 weeks. At baseline and poststudy, the following outcomes will be assessed:

1. Ventilatory functions (Forced vital capacity and total lung capacity).
2. Functional capacity using modified Bruce treadmill incremental exercise test (Maximal oxygen consumption estimation).
3. Quality of life (Short form health survey).

Inclusion Criteria:

• All women will have rheumatoid arthritis for more than 2 years with low-to-moderate disease activity.
• Normal to mildly restrictive lung pattern.
• Their ages will be ranged from 40 to 60 years old.
• Their body mass index will be less than 30 Kg/m2.

Exclusion Criteria:

• Chronic chest diseases.
• Recent parenteral steroid administration.
• Cardiovascular disorders (coronary heart disease, heart failure, cardiac arrhythmia, peripheral arterial disease, uncontrolled hypertension).
• Smokers.
• Joint surgery (in the preceding 6 months).
• Musculoskeletal/ neurological limitations to exercise.
• Pregnancy.

Females