Effect of Mulligan Thoracic Mobilization on Ventilatory Functions and Chest Wall Expansion in Central Obesity
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Forced Vital Capacity
研究概览
简要总结
The goal of this clinical trial is to learn whether Mulligan thoracic mobilization in extension improves ventilatory functions and chest wall expansion in adults with central obesity. It will also evaluate whether adding Mulligan thoracic mobilization to a low-carbohydrate diet and aerobic exercise provides greater benefits than diet and exercise alone.
The main questions it aims to answer are:
Does Mulligan thoracic mobilization improve ventilatory functions (FVC, FEV₁, FEV₁/FVC ratio, and MVV) in adults with central obesity? Does Mulligan thoracic mobilization improve chest wall expansion, functional capacity, and health-related quality of life?
Researchers will compare Mulligan thoracic mobilization combined with a low-carbohydrate diet and aerobic exercise to a low-carbohydrate diet and aerobic exercise alone to determine whether the addition of thoracic mobilization improves respiratory outcomes.
Participants will:
Be randomly assigned to either the intervention group or the control group. Receive an individualized low-carbohydrate diet and supervised aerobic exercise for 8 weeks.
Receive Mulligan thoracic mobilization in extension three times per week for 8 weeks if assigned to the intervention group.
Undergo assessments of ventilatory functions, chest wall expansion, functional capacity, and quality of life before and after the intervention.
详细描述
The Challenge: Central Obesity and Respiratory Dysfunction
Central obesity is a growing global health concern that affects not only metabolic and cardiovascular health but also respiratory function. Excess accumulation of abdominal and visceral fat mechanically restricts chest wall movement, limits diaphragmatic excursion, and reduces lung volumes, leading to impaired ventilatory function and decreased chest wall expansion. These respiratory limitations can contribute to dyspnea, reduced exercise tolerance, and poorer quality of life. Although weight loss through dietary modification and aerobic exercise remains the cornerstone of obesity management, these approaches do not directly address the mechanical restrictions imposed on the thoracic cage. Therefore, additional physiotherapy interventions targeting thoracic mobility may provide further improvements in respiratory function.
The Goal of the Study
This study aims to determine whether adding Mulligan thoracic mobilization in extension to a standardized low-carbohydrate diet and aerobic exercise program provides greater improvements in ventilatory functions and chest wall expansion than diet and exercise alone in adults with central obesity. The study will also investigate whether this intervention improves functional exercise capacity and health-related quality of life.
How the Study Works
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 25 Years 至 35 Years（Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Males aged 25-35 years.
- •Presence of central obesity, defined as:
- •Waist circumference ≥102 cm in males.
- •Waist-hip ratio (WHR) ≥0.90 in males.
- •BMI from 30-39.9 kg/m².
- •Willing to comply with conventional physiotherapy (diet and exercise) and mobilization programs.
- •Medically stable individuals with a restrictive lung pattern (Normal FEV₁/FVC ratio and FVC < 80% of predicted).
- •Low level physical activity (using the International Physical Activity Questionnaire-Short Version).
- •Non-smokers.
排除标准
- •Diagnosed COPD, asthma, or other chronic respiratory diseases.
- •Recent thoracic spine or rib injury/surgery.
- •Cardiovascular instability or uncontrolled hypertension.
- •Contraindications to manual therapy (e.g., osteoporosis, rib fractures, or spinal tumors).
- •Participation in any structured weight loss program or exercise regimen in the past 6 months.
- •History of bariatric surgery (e.g., gastric sleeve, gastric bypass).
- •Use of medications that affect body weight or metabolism (e.g., corticosteroids, antipsychotics, weight loss drugs).
- •Neurological or musculoskeletal conditions that limit mobility or exercise participation and interfere with gait.
- •Any acute respiratory infections in the past 6 weeks.
研究组 & 干预措施
low carbohydrate and Aerobic Exercises
will receive standardized diet and aerobic exercise.
干预措施: low carbohydrate (Behavioral)
Mulligan Thoracic Mobilization
will receive Mulligan thoracic mobilization in extension three times per week for 8 weeks in addition to a standardized diet and aerobic exercise.
干预措施: low carbohydrate (Behavioral)
low carbohydrate and Aerobic Exercises
will receive standardized diet and aerobic exercise.
干预措施: Aerobic Exercise (Behavioral)
Mulligan Thoracic Mobilization
will receive Mulligan thoracic mobilization in extension three times per week for 8 weeks in addition to a standardized diet and aerobic exercise.
干预措施: Mulligan Thoracic Mobilization (Procedure)
Mulligan Thoracic Mobilization
will receive Mulligan thoracic mobilization in extension three times per week for 8 weeks in addition to a standardized diet and aerobic exercise.
干预措施: Aerobic Exercise (Behavioral)
结局指标
主要结局
Forced Vital Capacity
时间窗: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Measured in liters using spirometry.
Forced Expiratory Volume in One Second
时间窗: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Measured in liters using spirometry.
Ratio of Forced Expiratory Volume in One Second to Forced Vital Capacity
时间窗: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Measured as a percentage using spirometry.
Maximum Voluntary Ventilation
时间窗: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Measured in liters per minute using spirometry.
Chest Wall Expansion at the Fourth Intercostal Space
时间窗: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Chest wall expansion measured in centimeters using a non-elastic tape measure at the fourth intercostal space.
Chest Wall Expansion at the Xiphoid Process Level
时间窗: Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
Chest wall expansion measured in centimeters using a non-elastic tape measure at the level of the xiphoid process.
次要结局
- Functional capacity(Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).)
- Change in Health-Related Quality of Life(Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).)
研究者
Abd El-Rahman Ayman Mohamed Abd El-Monem
Teaching Assistant
Cairo University