The PNF combination of scapular and pelvic pattern intervention was conducted for 30 minutes per session, three times per week, for four weeks. The PNF combination of scapular and pelvic pattern was applied by combining scapular posterior depression with pelvic anterior elevation, and scapular anterior elevation with pelvic posterior depression.

During scapular anterior elevation combined with pelvic posterior depression, the therapist placed their hands on the shoulder joint and acromion, and on the ischial tuberosity to provide resistance. During scapular posterior depression combined with pelvic anterior elevation, resistance was applied by placing the hands on the inferior angle of the scapula and the anterior superior iliac spine.

Among the PNF techniques, rhythmic initiation was first used to facilitate movement education and enhance kinesthetic awareness. Afterward, dynamic reversals were applied to promote muscle strengthening in the participants.

The chest expansion exercise was performed in a seated upright position. The participant interlocked their fingers behind the head and, during exhalation, brought both elbows together while flexing the trunk muscles. During inhalation, the participant moved the elbows outward while extending the trunk to expand the chest wall.

The trunk rotation exercise was performed from the same starting position as the chest expansion exercise. During exhalation, the participant rotated and flexed the trunk, lowering the elbow toward the opposite knee. During inhalation, the participant returned to the starting position. This exercise was performed alternately on both sides.

The PNF combination of scapular and pelvic pattern intervention was conducted for 30 minutes per session, three times per week, for four weeks. The PNF combination of scapular and pelvic pattern was applied by combining scapular posterior depression with pelvic anterior elevation, and scapular anterior elevation with pelvic posterior depression.

During scapular anterior elevation combined with pelvic posterior depression, the therapist placed their hands on the shoulder joint and acromion, and on the ischial tuberosity to provide resistance. During scapular posterior depression combined with pelvic anterior elevation, resistance was applied by placing the hands on the inferior angle of the scapula and the anterior superior iliac spine.

Among the PNF techniques, rhythmic initiation was first used to facilitate movement education and enhance kinesthetic awareness. Afterward, dynamic reversals were applied to promote muscle strengthening in the participants.

ulmonary function was measured using a diagnostic spirometer (PONY FX, Italy). To ensure accurate measurement, sufficient explanation and demonstration were provided so that the participants could fully understand the procedure prior to testing. For the assessment, participants were seated comfortably in a chair. To prevent air leakage through the nose, a nose clip was applied, and a personal mouthpiece was held firmly between the teeth with the lips sealed tightly around it. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, and peak expiratory flow (PEF) were measured. Participants were instructed to perform three normal resting breaths, followed by a maximal inhalation. They were then encouraged to exhale as forcefully and rapidly as possible into the spirometer turbine and to maintain exhalation for 5-6 seconds. After one demonstration and practice trial, a total of four measurements were performed, and the best value was used for analysis.

For the chest cage expansion test, the participant was positioned in a supine position with the legs extended and the head and trunk aligned in a straight line. Using a measuring tape, the circumference of the chest was measured horizontally at the level of the xiphoid process and the junction of the body of the sternum. Measurements were taken during maximal inhalation and maximal exhalation while the participant maintained stable breathing, and the values were recorded.

Chest cage expansion was calculated as the difference between the measurement at maximal inhalation and the measurement at maximal exhalation. The measurement was performed four times, and the average value was used for data analysis.