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This study aims to evaluating and contrasting the effects of posture correction and papworth technique on dyspnea, chest expansion and quality of life in asthmatic patients with forward head.
Asthma is a chronic inflammatory airway disease characterized by airway hyperresponsiveness, reversible air flow obstruction , and bronchial inflammation, resulting in episodic symptoms such as dyspnea, wheezing, chest tightness and cough. In addition to airway pathology, respiratory mechanics and postural deviations can significantly influence disease severity and functional capacity. Forward head posture is a common postural dysfunction that alters cervical- thoracic alignment, increase upper chest dominance during breathing, reduces rib cage mobility and compromises diaphragmatic efficiency. Correction of forward head posture is expected to improve thoracic expansion, optimize musculoskeletal alignment, and facilitate more efficient breathing mechanics, thereby reducing the work of breathing and improving ventilatory efficiency in asthmatic individuals. The papworth breathing technique is a structured respiratory retraining approach that emphasizes diaphragmatic breathing, nasal breathing, and relaxation strategies to reduce dysfunctional breathing patterns and hyperventilation. it has been shown to improve ventilatory control and may enhance expiratory efficiency, potenitally improving physiological parameters such as positive end expiratory pressure. This study will compare the effects of these two interventions on pulmonary function, asthma control , and postural alignment in asthmatic patients with forward head posture , aiming to determine their relative efficacy in improving respiratory mechanics and functional outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Posture correction | Experimental | posture correction exercises |
|
| Papwoth technique | Experimental | papworth technique |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| papworth teachnique | Other | papworth three sessions per week approximately 30 minutes diaphragmatic breathing 10 minutes per session sow breathing practice 1-2 minutes breath control and breath holding muscle relaxation techniques |
| Measure | Description | Time Frame |
|---|---|---|
| Universal goniometer | Forward head posture was assessed using a universal goniometer by measuring the craniovertebral angle .The CVA is defined as the angle formed between a horizontal line passing through the spinous process of the seventh cervical vertebra(c7) and a line connecting to the tragus of the ear. A smaller CVA reflects increased anterior head displacement and reduced cervical lordosis. A CVA of >50 considered normal , values between 40 to 49 considered mild forward head posture while a CVA <40 represents moderate to severe forward head posture. | 1st day |
| Measure | Description | Time Frame |
|---|---|---|
| Borg dyspnea scale | The borg dyspnea scale is a subjective tool for assessing the intensity of breathessness in patients, often used in fields like pulmonology, cardiology and sport medicine. it ranges from 0 to 10. 0 very slight and 10 very severe.this scale helps clinicians mointor a patients respiratory symptoms during activities like exercises or rehabilitation and adjust treatment plans accordingly. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Qurat ul Ain, MS | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sheikh Zaid Hospital Lahore | Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Tian QS, Zhou XH kim T-HJAS the effects of combined cervical and scapular stabilization exercises on muscle tone, pain and cervical range of motion in cervical extension type A controlled experimental study 2025 | ||
| 38610914 | Background | Oakley PA, Moustafa IM, Haas JW, Betz JW, Harrison DE. Two Methods of Forward Head Posture Assessment: Radiography vs. Posture and Their Clinical Comparison. J Clin Med. 2024 Apr 8;13(7):2149. doi: 10.3390/jcm13072149. | |
| 40012039 |
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| ID | Term |
|---|---|
| D001249 | Asthma |
| D004194 | Disease |
| D004417 | Dyspnea |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
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| posture correction exercises | Other | posture correction exercises three sessions per week 30-40 minutes Mckenzie exercises three sets of ten repetitions scapular retraction exercises three sets of ten repetitions thoracic extension exercises pectoral muscle stetching 20-30 seconds upper trapezius and Levator scapulae stretching three times per sessions |
|
| 1st day |
| Asthma control questionnaire | The asthma control questionnaire is a widely used tool for assessing asthma control in patients. It measures various aspects of asthma, including symptoms, frequency of rescue inhaler use, and lung function over the past week. the ACQ includes questions rated on a 7 point scale, with higher scores indicating proorer asthma control. this questionnaire helps clinicians guage treatment effectiveness, track symptom progression and adjust care strategies to improve patient quality of life. | 1st day |
| Background |
| Maddah T, Daneshmandi H, Alizade MH, Rahmati MB. The investigation of relationship between allergic rhinitis with forward head posture and anxiety in children. BMC Pediatr. 2025 Feb 26;25(1):143. doi: 10.1186/s12887-025-05473-3. |
| Background | Dongare S, Rathi K, Rathi GJPM,Journal P. Inhaled coticosteroids its evolution and step wise phramacological treatment strategies for all levels of asthma 2024 |
| 37334374 | Background | Plichta J, Kuna P, Panek M. Biologic drugs in the treatment of chronic inflammatory pulmonary diseases: recent developments and future perspectives. Front Immunol. 2023 Jun 2;14:1207641. doi: 10.3389/fimmu.2023.1207641. eCollection 2023. |
| 31690376 | Background | Padem N, Saltoun C. Classification of asthma. Allergy Asthma Proc. 2019 Nov 1;40(6):385-388. doi: 10.2500/aap.2019.40.4253. |
| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012120 | Respiration Disorders |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |