Influence of Manual Diaphragm Release on Pulmonary Functions in Women With COVID-19

Study Overview
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Brief Summary
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Manual noninvasive respiratory techniques gained interest to treat respiratory pathologies related to COVID 19. This study designed to determine the combined effect of manual diaphragmatic release technique with the effect of conventional breathing exercises and prone positioning on pulmonary function parameters (FVC, FEV1, PEF, FEV1/FVC, FEF25, FEF50, FEF75, FEF25/75).

Detailed Description
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Forty females were randomly assigned to two groups. Group A received manual diaphragm release with conventional breathing exercises and prone positioning. Group B received conventional breathing exercises and prone positioning. Both groups took their prescribed medications. Their ages ranged from 35 to 45 years and with moderate COVID-19 illness. Any cases with mild and severe COVID-19 illness, ICU admission, and chest diseases were excluded. Main measures: pulmonary function parameters (FVC, FEV1, PEF, FEV1/FVC, FEF25, FEF50, FEF75, FEF25/75).

Official Title
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Influence of Manual Diaphragm Release Combined With Conventional Breathing Exercises and Prone Positioning on Pulmonary Functions in Women With COVID-19

Conditions
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COVID-19 Pneumonia

Intervention / Treatment
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* Other: manual therapy
* Other: breathing exercise and prone position alone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: women with moderate COVID-19 illness diagnosed by a physician. Patients with o2 saturation >94%Nonsmoker subjects. age ranging from 35-45 years. body mass index from 25 to 34 kg/m2. Exclusion Criteria: Unstable hemodynamic status. Acute respiratory failure requiring intubation and impaired consciousness. Inability to collaborate with prone positioning with refusal. Change of mental status hindering response to instructions. Poorly controlled hypertension (Mean systolic BP > 140 mmhg and \or diastolic BP > 40 mmhg). Patients who take continuous o2 supplementation. Smoking. Other chest diseases as (COPD-asthma-tuberculosis-cancer). Male patients.

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Forty females were randomly assigned to two groups. Group A received manual diaphragm release with conventional breathing exercises and prone positioning. Group B received conventional breathing exercises and prone positioning. Both groups took their prescribed medications. Their ages ranged from 35 to 45 years and with moderate COVID-19 illness. Any cases with mild and severe COVID-19 illness, ICU admission, and chest diseases were excluded.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Study group<br>they received manual diaphragm release with conventional breathing exercises and prone positioning in addition to their prescribed medications. | Other: manual therapy<br>* manual diaphragmatic release technique combined with breathing exercise<br>Other: breathing exercise and prone position alone<br>* deep breathing exercise and prone position<br>|
| Active Comparator: Control group<br>they received conventional breathing exercises and prone positioning alone in addition to their prescribed medications. | Other: breathing exercise and prone position alone<br>* deep breathing exercise and prone position<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| forced vital capacity FVC | the amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible which is a common breathing test to check lung function. | pre study and 3 weeks post study for all participants | 
| FEV1 | the maximum amount of air that the subject can forcibly expel during the first second following maximal inhalation | pre study and 3 weeks post study for all participants | 
| PEF | show the amount and rate of air that can be forcefully breathed out of the lungs. | pre study and 3 weeks post study for all participants | 
| FEV1/FVC | FEV1/FVC, also known as FEV1%) can help distinguish obstructive and restrictive lung diseases. | pre study and 3 weeks post study for all participants | 
| PEF25% | Peak expiratory flow at 25% of fvc and the most sensitive measure of airflow in peripheral airways where primary airflow obstruction originates. | pre study and 3 weeks post study for all participants | 
| PEF50% | Peak expiratory flow at 50% ofFVC | pre study and 3 weeks post study for all participants | 
| PEF 75% | Peak expiratory flow at 75% of FVC | pre study and 3 weeks post study for all participants | 
| PEF 25%/75% | Maximum flow rate in the middle 50% of forced expiration. | pre study and 3 weeks post study for all participants | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Breathing Exercise, COVID-19, manual diaphragmatic release, Pulmonary function parameters