Effect of Diaphragmatic Strengthening Exercises on Diaphragm Muscle Function in Patients With Post Covid-19 Syndrome.

Study Overview
=================
Brief Summary
-----------------
The aim of this work is to study the incidence of diaphragmatic dysfunction after COVID 19 infection and the efficacy of different types of diaphragmatic strengthening exercises on diaphragm muscle function.

Official Title
-----------------
Effect of Different Types of Diaphragmatic Strengthening Exercises on Diaphragm Muscle Function in Patients With Post Covid Syndrome. A Randomized Control Trail

Conditions
-----------------
Corona Virus Infection

Intervention / Treatment
-----------------
* Other: diaphragmatic positioning
* Other: incentive spirometer
* Other: Control


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Male and female above 18 years old history of probable or confirmed SARS-CoV-2 infection 3 months from the onset of symptoms or at least 2 months from the end of symptoms . Exclusion Criteria: Subjects under 18. Patients known to have chronic lung disease . Patients known to have neuromuscular disorder. Patients known to have diaphragmatic hernia. Patients known to have malignancy. Patients with clinical evidence of phrenic nerve injury. Patients with recent abdominal or thoracic surgery, Patients with history of traumatic lesion possibly affecting diaphragm. Subjects with severe malnutrition. Patients with BMI more than 30

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control<br>received, traditional medical treatment and no exercise | Other: Control<br>* Traditional medical treatment<br>|
| Experimental: diaphragmatic positioning group<br>received diaphragmatic strengthening exercises through patient self-positioning in prone on elbows then do diaphragmatic breathing 10-15 min ,twice/day, 7days/ weak | Other: diaphragmatic positioning<br>* Traditional medical treatment plus diaphragmatic strengthening exercises through patient self-positioning in prone on elbows then do diaphragmatic breathing 10-15 min ,twice/day, 7days/ weak<br>|
| Experimental: incentive spirometer group<br>received diaphragmatic strengthening exercises through using of incentive spirometer 10-15 min ,twice/day, 7days/ weak | Other: incentive spirometer<br>* Traditional medical treatment plus diaphragmatic strengthening exercises through using of incentive spirometer 10-15 min ,twice/day, 7days/ weak<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diaphragmatic thickness | Measured by ultrasonography | 6 weeks | 
| Pulmonary Function Test | MVV | 6 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Diaphragmatic function, Post Covid, Exercises