Patients with asthma frequently experience upper back stiffness and rounded shoulders and tightness in the thoracic region. Rib cage stiffness occurs due to poor posture and muscle tightness, which leads to decreased chest expansion and increased use of accessory muscles during breathing. Additionally, rounded shoulders can hinder proper opening of the chest, preventing the lungs from expanding properly. Thoracic spine rotation stretching targets the thoracic paraspinal muscles, erector spinae, and intercostal muscles. This exercise helps improve thoracic mobility, increases chest expansion and pulmonary function, and reduces dyspnea. The other exercise is Scapular Retraction, which targets the rhomboids, trapezius, and posterior deltoids that help in chest opening and lead to chest expansion and allow lungs to expand more fully during inhalation. Together, these exercises improve chest expansion and pulmonary function, reduce dyspnea, and improve posture.

Asthma is a prevalent chronic respiratory condition that affects millions worldwide, characterized by airway inflammation and reversible airflow obstruction. Patients often experience difficulty in breathing, which can severely impact their quality of life. People with asthma are less active that their peers, and consequently, the patient becomes more sedentary. This study focusses to compare the effects of thoracic spine rotation stretching and Scapular Retraction exercises on chest expansion, pulmonary function, and dyspnea in patients with asthma. By investigating these interventions, the study seeks to provide practical recommendations for enhancing the management of asthma symptoms, ultimately improving respiratory function and mobility may improve asthma control and quality of life.

A randomized clinical trial will enroll participants aged 18 to 50 with a confirmed diagnosis of chronic asthma. The study will take place at Rai Medical College Teaching Hospital Sargodha, utilizing a non- probability convenient sampling technique for participant selection. Participants will be randomly assigned to two groups using a lottery method, ensures a diverse yet unbiased sample. Group A will perform thoracic spine rotation stretching, while Group B will engage in shoulder squeezing exercises, following a standardized warm-up. Baseline treatment will include breathing exercises, postural education, bronchodilators, and nebulization Each group will engage in their respective exercises for a defined duration, focusing on improving respiratory mechanics and muscle flexibility. Study will be completed in 8 weeks (3x/week). After data collection, data will be analyzed using SPSS version 26. Assessments will be conducted before and after the intervention period, measuring chest expansion with a measuring tape, pulmonary function through digital spirometer (including FEV1 and FVC their ratio and peak expiratory flow), and dyspnea levels using the Modified borg dyspnea scale, thoracic rotation range of motion measured with a goniometer. The integration of targeted physical therapy in this study has the potential to significantly improve asthma management by enhancing respiratory function, reducing dyspnea, and increasing chest expansion.

Inclusion Criteria:

• Age between (18 to 50).
• Confirmed diagnosis of asthma based on clinical guidelines.
• Nonsmoker.
• Chronic asthma.
• Thoracic spine abnormality

Exclusion Criteria:

• Acute asthma
• Recent exacerbations.
• History of sever cardiopulmonary, musculoskeletal, infectious diseases.
• Any neurological condition.
• Cognitive impairment.
• Any recent injury of spine, shoulder, or rib cage that limit mobility or cause pain.