Additive effect of proprioceptive neuromuscular facilitation stretching along with aerobic training and breathing exercise on functional capacity in COPD patients

Chronic obstructive pulmonary disease (COPD) is a condition which is caused by constant pulmonary symptoms and airway obstruction that is due to inflammation of the airways, chronic in nature, and damage to parenchyma of lung which leads to anatomical variations and collapse in alveoli. COPD patients will have a hyperinflated chest, which shortens their muscles and decreases the suppleness of their chest wall, increasing the effort required to breathe. As the severity grows, using the upper limbs for functional tasks becomes more challenging, which will again cause stiffness and tightness in the muscles. Some techniques are externally applied proprioceptive and tactile stimuli that produce reflex respiratory movement responses that appear to alter the rate and depth of breathing. Proprioceptive Neuromuscular Facilitation (PNF) is a facilitative technique designed to enhance chest wall mobility, thereby promoting improved chest expansion. PNF stretching focuses mostly on the musculoskeletal system, it may also improve posture and thoracic mobility, which may have an indirect effect on respiratory function. Breathing mechanics can be optimized with improved posture. To improve passive range of motion and lengthen out tense muscles, apply the hold - relax technique.

Participants will meet the inclusion criteria will be briefed about the study and written consent will be taken. Demographic data will be documented .E ach participant will be pre - assessed with  6MWT and PFTs (FVC, FEV1 and FEV1/FVC).6MWT and PFTs (FVC, FEV1 and FEV1/FVC) evaluated pre and post intervention. participants were given Pursed lip breathing+ aerobic training (Stair climbing - 10reps ,3sets) with PNF stretching Muscles: scalenus, STM, Trapezius, pectoralis major & minor ,intercostal, ant. Serratus, Rectus abdominis HOLD RELAX METHOD 30 min/day+ 10 min , 3 times per session (5 days per week for 4 weeks).