Effect of Thoracic Mobilization in People With Central Obesity

Condition(s) studied

Investigational drug(s) / intervention(s)

Mulligan Thoracic Mobilization: * Technique: Thoracic mobilization with movement (MWM) in extension performed by a trained physiotherapist. * Performed 3×/week. * Total program duration: 8 weeks. * 3 sets × 10 repetitions per spinal level per session. * Hold time: thoracic extension maintained for approximately 6 seconds at the end of the movement. * Participant position: sitting at the edge of the treatment table with hands behind the neck. * Therapist technique: mobilizing force applied using the ulnar border of the hand over the spinous process in a cephalic-anterior direction. * Movement performed: deep inspiration combined with thoracic extension during the mobilization. * Target levels: Mid-thoracic region (T6-T8). * Session duration: The session duration was based on three sets of ten repetitions per spinal level, with each repetition held for approximately 6 seconds. A 30-second rest interval was provided between sets, resulting in an effective application time of about 4-5 minutes per level.

low carbohydrate: Standardized low-carbohydrate dietary program administered for 8 weeks.

Aerobic Exercise: Moderate-intensity aerobic exercise program for 8 weeks, 5 sessions per week, at 55-69% HRmax or Borg RPE 12-14, progressing from 30 to 45 minutes per session.

Study summary

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.

Eligibility

Primary outcome measure(s)

• Forced Vital Capacity — 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 — 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 — Baseline (pre-intervention) and at the end of the 8-week training period (post-intervention).
  Measured as a percentage using spirometry.
• Maximum Voluntary Ventilation — 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 — 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 — 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.

Trial sites (1)

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