EFFECTIVENESS OF THORACIC EXTENSION EXERCISES ON
CHEST EXPANSION IN ELDERLY INDIVIDUALS
By
LINCY MARIYA
LEON Reg No .210110599
Project work Submitted to the
Kerala
University of Health Sciences, Thrissur, Kerala
In partial fulfillment of the requirements for the degree
of
BACHELOR OF PHYSIOTHERAPY
UNDER THE
GUIDANCE OF
Ms.
BINI SEBASTIAN, MPT
ASSISTANT PROFESSOR
DEPARTMENT
OF PHYSIOTHERAPY
SCHOOL
OF MEDICAL EDUCATION
CPAS,
ANGAMALY, ERNAKULAM - 683572
2021
– 2025
KERALA UNIVERSITY OF HEALTH SCIENCES
THRISSUR KERALA
DECLARATION BY THE CANDIDATE
I hereby declare that this project work entitled EFFECTIVENESS
OF THORACIC EXTENSION EXERCISES ON CHEST EXPANSION IN ELDERLY INDIVIDUALS is a bonafide and genuine project
work carried out by me under the guidance of Ms. BINI SEBASTIAN, MPT Assistant
Professor Department of Physiotherapy SME CPAS Angamaly.
PLACE:
SIGNATURE
OF THE CANDIDATE
DATE :
AYFA C K
ADHITH K
SHYJU
LINCY
MARIYA LEON
KERALA UNIVERSITY OF HEALTH SCIENCES
THRISSUR KERALA
CERTIFICATE
This
is to certify that the project work titled “EFFECTIVENESS
OF THORACIC EXTENSION EXERCISES ON CHEST EXPANSION IN ELDERLY INDIVIDUALS
"is
a bonafide work done by AYFA C K Reg.
No. 210110592, ADHITH K SHYJU Reg. No. 210110577, LINCY MARIYA LEON Reg. No.
210110599 in the partial fulfilment for the degree of bachelor of
physiotherapy.
GUIDE HEAD OF THE DEPT PRINCIPAL
KERALA UNIVERSITY OF HEALTH SCIENCES
THRISSUR KERALA
This is to certify that AYFA
C K Reg. No. 210110592,ADHITH K SHYJU
Reg. 210110577,LINCY MARIYA LEON Reg .210110599 has done a bonafide project work
titled “EFFECTIVENESS OF THORACIC
EXTENSION EXERCISES ON CHEST EXPANSION IN ELDERLY INDIVIDUALS”, and evaluated as per curriculum
subscribed for the fourth year bpt
course by kuhs in the final exam
January 2026.
INTERNAL EXAMINER EXTERNAL EXAMINER
(Name and signature with
date) (Name
and signature with date)
ACKNOWLEDGEMENT
Firstly,
we take this opportunity to thank almighty God, who showered his blessings on
us and helped us to complete this project.
I
own a considerable depth of gratitude to our project GUIDE Ms. BINI
SEBASTIAN MPT, Orthopedic Physiotherapy Asst.
Professor who helped us
tremendously by giving proper guidelines and suggestions on completing our
project.
I
am thankful to our DEPUTY DIRECTOR Ms. BINITTA CHERIAN MPT
Cardiorespiratory Physiotherapy and our PRINCIPAL Prof. MAYA K MATHEW and
our, VICE PRINCIPAL Ms. BINI SEBASTIAN MP Cardiorespiratory Physiotherapy
and our Head of the Department Prof. SUDEEP K MPT Advanced Physiotherapy
in Orthopedics.
I
also extend my sincere gratitude to our CLASS COORDINATOR Mrs.
ANJU N.V MPT Community physiotherapy.
Prof. DEEPU C.B MPT .M.Phil.,Ms. JEMI THOMAS MPT Musculoskeletal and Sports Physiotherapy, Ms.
KASHMEERA V PRAMOD MPT Musculoskeletal and Sports Physiotherapy
Mrs. BESSY BABY MPT
Musculoskeletal and Sports Physiotherapy,
Ms. AVANI M BPT, Ms. ATHIRA
THAMPI BPT, Mrs.
ATHIRA R Orthopedic Physiotherapy, Mrs.
REMYA R VARMA MPT Community
physiotherapy, Mrs. SUMITHRA SUDAKARAN MPT Orthopedic Physiotherapy
who also gave us valuable opinions, without which our project would have
remained incomplete.
Our
heartfelt thanks also go to our librarian Ms. ROICY SHIJU MLISC.
I
am deeply thankful to my lovely parents and friends for their valuable support
and cooperation throughout the study. I thank all who have helped me all the
while.
TABLE OF CONTENTS
|
SL.NO |
TITLE |
Page.No |
|
1 |
INTRODUCTION |
1 |
|
2 |
AIMS AND
OBJECTIVES |
6 |
|
3 |
REVIEW OF
LITERATURE |
8 |
|
4 |
METHODOLOGY |
10 |
|
5 |
ANALYSIS
AND RESULT |
13 |
|
6 |
DISCUSSION |
21 |
|
7 |
CONCLUSION |
24 |
|
8 |
REFERANCE |
26 |
|
9 |
ANNEXURES |
29 |
LIST OF TABLES
|
SL.NO |
NAME OF TABLES |
Page No |
|
1 |
Age
Distribution |
13 |
|
2 |
Gender
Distribution |
13 |
|
3 |
Distribution
of central tendency and dispersion for all the possible variables |
13 |
|
4 |
Test of normality |
14 |
|
5 |
Paired t
test for chest expansion at axillary level |
15 |
|
6 |
Paired t
test for chest expansion at xiphoid level |
15 |
|
7 |
Paired t
test for chest expansion at 4th intercostal level |
15 |
|
8 |
Correlation
between pre and post axillary level chest expansion |
16 |
|
9 |
Correlation
between pre and post xiphoid level chest expansion |
16 |
|
10 |
Correlation
between pre and post 4th intercostal chest expansion |
16 |
LIST OF GRAPHS
|
Sl.No |
NAME OF
GRAPHS |
PAGE No |
|
1 |
Graphical
representation of Age distribution |
17 |
|
2 |
Graphical
representation of Gender |
17 |
|
3 |
Graphical
representation of pre and post axillary level chest expansion |
18 |
|
4 |
Graphical
representation of pre and post 4th intercostal chest expansion |
18 |
|
5 |
Graphical
representation of pre and post xiphoid level chest expansion |
19 |
EFFECTIVENESS OF THORACIC EXTENSION EXERCISES IN
ELDERLY INDIVIDUALS
INTRODUCTION
Introduction
Breathing is unquestionably a key function of the human
body; it sustains life by providing oxygen needed for metabolism and removing
the by-product of these reactions, carbon dioxide¹
Normal breathing, also known as diaphragmatic breathing,
involved synchronized movements of upper rib cage, lower rib cage and abdomen.
individuals with poor posture, scapular dyskinesis, low back pain and neck pain
can exabit signs of faulty breathing mechanics²
Chest expansion is defined as chest wall mobility or
excursion between a maximum voluntary inspiration and a maximum voluntary
expiration³ Inspiration causes enlargement of thoracic cage. In general change
in thoracic cavity occurs because of 4 unit of structures including thoracic lid,
upper costal Series, lower costal Series. Chest expansion during breathing
involved 2 primary rib cage movements they are pump handle movement and bucket
handle movement. Pump handle movement refers to contraction of external
intercostal muscles causing elevation of ribs and upward and forward movement
of sternum, it increases anteroposterior diameter of thoracic cage. Bucket
handle movement involves simultaneously central portion of these ribs moves
upward and outward to a more horizontal positions it increases transverse
diameter of thoracic cage ⁴
Various cardio-respiratory , neurological, orthopedic and
other conditions effect and alter thoracic mobility, chest expansion and excursion.
Chest expansion is found to be different due to factors like gender ,and
advancing age .chest expansion is greater in males than females .chest
expansion declines with advancing age. Alteration in chest expansion leads to
symptoms such as shortness of breath, fatigue , wheeze, sensations such as
tightness of chest and decreased exercise tolerance ³
When chest expansion decreases, lungs cannot expand the fully,
resulting in reduced inhalation air volume. Due to loss of lung compliance ,the
total lung capacity ,forced vital capacity and residual volume reduces5
.Low lung volumes result in less alveolar tension pulling the lung airway open
,and the airway narrowing results in increased airway resistace 6.In
older, more obese patients and those with lung diseases this decrease in FRC may
be sufficient to induce airway closure and atelectasis in the dependent parts
of lung resulting in disordered gas exchange due to increased physiological shunt. The decrease in lung
volumes is also a factor that contribute to increased upper airway collapsibility
as it results in a decrease in longitudinal traction on the upper airway7
There are different tools available in market to measure
chest expansion such as measure tape chest caliper, and various sophisticated
measurement instruments .Among chest caliper and other instruments, a simple
and inexpensive tool for measurement of chest expansion is measure tape .With
measure tape ,the circumference of thorax is measured during maximal inspiration
and maximal expiration at special levels .The levels of measurement commonly
used are axillary level ,third or fourth intercostal space and xiphoid process
³
In elderly individuals, age related changes in respiratory
system primarily arise from loss of elasticity and decline in chest wall
compliance, making an increase in work of breathing, residual volume, and
functional resuidal capacity8.Age related osteoporosis results in
reduced height of thoracic vertebrae. Stiffening of thoracic cage from
calcification of rib cage and age-related kyphosis from osteoporosis reduces
ability of thoracic cage to expand during inspiration and places the diaphragm
at a mechanical disadvantage to generate effective contraction9
Thoracic extension exercises increase mobility of thoracic
spine by promoting posterior rotation and depression of posterior ribs along
with elevation of the anterior ribs .This movement facilitates greater
expansion of rib cage during inhalation10 Regular thoracic mobilization
exercise enhance the mobility of rib cage by normalizing the joint capsules and
increasing facet joint sliding of thoracic vertebrae ,this lead to improved
thoracic movement during inhalation and overall chest expansion11 chest exercises particularly those involving
resistance, strengthens the respiratory muscles including diaphragm and
intercostal muscles .This increased strength enhance maximal inspiratory
pressure (MIP),allowing for more effective chest expansion12 individuals often exhibit increased thoracic
kyphosis,which restrict chest expansion.Thoracic extension exercises help to
correct this flexed posture , leading to more upright thoracic spine and
allowing greater rib cage expansion during breathing13
The study focuses on elderly individuals with decreased
chest expansion. Inadequately managed decreased chest expansion can adversely
affect the quality of life by limiting respiratory function and increasing risk
of respiratory complications. Studies have been conducted among various
population such as patients with respiratory disorder,post operative patients,
and individuals with neuromuscular conditions, but studies are limited among
elderly
population.Therefore,it
is important to understand the impact of decreased chest expansion in elderly
individuals. By Identifying and addressing this issue ,this study seeks to raise awareness and promote
preventive and therapeutic strategies, with ultimate goal of improving quality
of life.it will be highly beneficial to elderly population and health care
providers involved in geriatric care.
AIMS AND OBJECTIVES
2.AIMS AND OBJECTIVES
AIMS
To study effectiveness of thoracic extension exercise on
chest expansion in elderly individuals
OBJECTIVES
To study effectiveness of thoracic extension exercise on
chest expansion in elderly individuals
HYPOTHESIS
ALTERNATIVE HYPOTHESIS
There is significant improvement of chest expansion among
Elderly individuals after performing thoracic extension exercises
NULL HYPOTHESIS
There is no significant improvement of chest expansion among
Elderly individuals after performing thoracic extension exercises
REWIEW OF LITERATURE
3.REWIEW OF LITERATURE
1.Nandini kushwaha(2023) did a study on chest expansion
measurement in healthy adults with two different instruments. This study states
that chest expansion is defined as chest wall mobility or excursion between a
maximum voluntary inspiration and a maximum voluntary expiration
2.Nidhi Ved(2022) did a study on
challenges and importance of thoracic expansion measuring device .This study states that thoracic expansion is defined as the difference in chest
circumference between maximal exhalation
and maximal inhalation and this study also states that normal
range of thoracic expansion decreases
with age (50%-60% between 15 and 75 years)and chest expansion is 20%
more in men than women
3.Daiki
adachi et.al (2015)did a study on age related decline in chest wall mobility
among community dwelling elderly women .This study concluded that chest wall
mobility and respiratory functions decreased with age in community - dwelling
women aged 65years or older
3.hyun-jeong
jang et.al(2015) did a study on effect of thorax correction exercise in elderly
women with hyperkyphosis and found that there is an improvement of chest
expansion by 24.27%
4.
Won- gyu-yoo(2013)did a study on effect of thoracic extension exercise on
thoracic kyphosis angle and found that the kyphotic angle decreased by 46
degree
5.Delgado
bj et.al(2023),in statpearls ,provided a concise overview of capacity .The
article shows that when chest expansion decreses ,the lungs cannot expand fully
which results in reduced total lung capacity,forced vital capacity,and resuidal
volume
5.phulgirkar
et.al(2023)did a study on reference values of chest expansion among healthy children
:A cross-sectional study they uses measuring tape for assessing chest expansion
6.
S Jamaluddin et.al(2011)did a study on reliability and accuracy of tape
measurement method with a nearest reading of 5 mm in the assessment of leg
length discrepancy.This study showed that tape measurement method is reliable
and accurate
METHODOLOGY
4.METHODOLOGY
STUDY
DESIGN
Experimental
study design
STUDY
SETTING
Different
places in kerala
SAMPLING
SAMPLING
SIZES
Study
conducted on 30 elderly individuals
INCLUSION
CRITERIA
Age
between 60-70 yrs
Reduced
respiratory function (FVC<80% predicted )with < 3 cm of chest expansion
EXCLUSION
CRITERIA
Age
below 60 yrs
Individuals
with cardiac and respiratory disease
Individuals
undergone recent thoracic or spinal surgery
Pathology
of spine such as disc protrusion, spondylolisthesis
Individuals
diagnosed with spinal fracture within 6 months of study
METHOD
OF DATA COLLECTION
This
study is conducted on 30 elderly individuals who fulfill the inclusion
criteria.The procedure is explained to each patient in detail and informed
consent is obtained in prior to participation. The pre chest expansion
measurement is recorded during maximal inspiration and maximal level, third or
fourth intercostal space and xiphoid process followed by thoracic extension exercise
. Thoracic extension exercise conducted over 6weeks with 3 sessions per week, 2
set of 15 repetition and exercise include seated thoracic extension exercise, prone
press up and thoracic extension over Swiss ball or chair At end of final session
of 6 th week,post chest expansion is measured to observe any changes in values
OUTCOME MEASURES
Measuring tape
MATERIALS USED
Pen
Paper
Consent
form
Measuring
tape
Pencil
STATISTICAL
TOOL USED
Paired
T test
ANALYSIS AND RESULT
ANAYLASIS
Descriptive Statistics
Table 1: Age
Distribution
|
Age |
Frequency |
Percentage |
|
51-60 |
1 |
6.67 |
|
61-70 |
8 |
53.33 |
|
71-80 |
6 |
40 |
|
Total |
15 |
100 |
Table 2: Gender
Distribution
|
Gender |
Frequency |
Percentage |
|
Male |
5 |
40 |
|
Female |
10 |
60 |
|
Total |
15 |
100 |
Table 3: Distribution
of Central Tendency and Dispersion for all the possible variables
|
Variables |
Mean |
Median |
SD |
Minimum Value |
Maximum Value |
|
Age |
68 |
67 |
5.36 |
60 |
75 |
|
Pre Axillary chest expansion |
2.53 |
3 |
0.52 |
2 |
3 |
|
Post Axillary chest expansion |
3.53 |
4 |
0.52 |
3 |
4 |
|
Pre Xiphoid chest expansion |
2.13 |
2 |
0.35 |
2 |
3 |
|
Post Xiphoid chest expansion |
2.87 |
3 |
0.52 |
2 |
4 |
|
Pre 4th Intercostal chest expansion |
1.67 |
2 |
0.49 |
1 |
2 |
|
Post 4th Intercostal chest expansion |
2.33 |
2 |
0.49 |
2 |
3 |
Normality Test
Table 4: Tests of Normality
|
Tests of Normality |
||||||
|
|
Kolmogorov-Smirnov |
Shapiro-Wilk |
||||
|
Statistic |
df |
Sig. |
Statistic |
df |
Sig. |
|
|
Pre Axillary chest
expansion |
0.102 |
15 |
0.200 |
0.932 |
15 |
0.295 |
|
Post Axillary chest
expansion |
0.171 |
15 |
0.200 |
0.933 |
15 |
0.301 |
|
Pre Xiphoid chest
expansion |
0.184 |
15 |
0.185 |
0.924 |
15 |
0.219 |
|
Post Xiphoid chest
expansion |
0.141 |
15 |
0.200 |
0.944 |
15 |
0.435 |
|
Pre 4th
Intercostal chest expansion |
0.116 |
15 |
0.200 |
0.943 |
15 |
0.418 |
|
Post 4th
Intercostal chest expansion |
0.166 |
15 |
0.200 |
0.937 |
15 |
0.350 |
We use Kolmogorov-Smirnov Test and Shapiro-Wilk Test for normality
check.
In the case of Pre and post values of 3 variables, the
p value is less than 0.05 for both Kolmogorov-Smirnov Test and Shapiro-Wilk
Test. This means all these variables are normally distributed. If the data is
normally distributed, we can use paired t test.
Paired Test
Table 5: Paired t test for chest expansion at Axillary
level
|
Axillary level |
N |
Mean |
Std. Deviation |
Paired Test |
p-Value |
|
Pre |
15 |
2.57 |
0.34 |
31.231 |
0.000 |
|
Post |
15 |
3.59 |
0.41 |
Here
the p value is 0.000, which means that there is a statistically significant
increase in scores from pre-test (Mean=2.57) to post-test (Mean=3.59). The
post-test scores are significantly higher than pre-test scores.
Table 6: Paired t test for chest expansion at Xiphoid level
|
Xiphoid level |
N |
Mean |
Std. Deviation |
Paired Test |
p-Value |
|
Pre |
15 |
2.11 |
0.32 |
31 |
0.000 |
|
Post |
15 |
2.94 |
0.36 |
Here
the p value is 0.000, which means that there is a statistically significant
increase in scores from pre-test (Mean=2.11) to post-test (Mean=2.94). The
post-test scores are significantly higher than pre-test scores.
Table 7: Paired t test for chest expansion at 4th Intercostal level
|
4th
Intercostal level |
N |
Mean |
Std. Deviation |
Paired Test |
P Value |
|
Pre |
15 |
1.61 |
0.31 |
29.714 |
0.000 |
|
Post |
15 |
2.43 |
0.31 |
Here
the p value is 0.000, which means that there is a statistically significant
increase in scores from pre-test (Mean=1.61) to post-test (Mean=2.43). The
post-test scores are significantly higher than pre-test scores.
Correlation
Table 8: Correlation between pre and post Axillary
level chest expansion
|
|
N |
Correlation |
Sig. |
|
Pre Axillary & Post Axillary chest expansion |
15 |
0.962 |
0.000 |
Here
the correlation value is 0.962, which means there is a strong positive
correlation between pre and post test scores. This means participants who
scored higher in the pre test also tends to score higher in the post test.
Table 9: Correlation between pre and post Xiphoid
level chest expansion
|
|
N |
Correlation |
Sig. |
|
Pre Xiphoid & Post Xiphoid level chest expansion |
15 |
0.962 |
0.000 |
Here
the correlation value is 0.962, which means there is a strong positive
correlation between pre and post test scores. This means participants who
scored higher in the pre test also tends to score higher in the post test.
Table 10: Correlation between pre and post 4th
Intercostal
|
|
N |
Correlation |
Sig. |
|
Pre 4th Intercostal & Post 4th
Intercostal level chest expansion |
15 |
0.943 |
0.000 |
Here
the correlation value is 0.943, which means there is a strong positive
correlation between pre and post test scores. This means participants who
scored higher in the pre test also tends to score higher in the post test.
Graphical Representation
Graph 1: Graphical
representation of Age distribution
Graph 2: Graph
Graphical representation of Age distribution
Graph 3: Graphical Representation of Pre and post
Axillary level chest expansion
Graph 4: Graphical Representation of Pre and post
Xiphoid level chest expansion
Graph 5: Graphical Representation of Pre and post 4th
Intercostal level chest expansion
DISCUSSION
DISCUSSION
This study aimed
to determine the
effectiveness of thoracic extension exercises on chest expansion in elderly
individuals .Age related decline in chest expansion and respiratory function
provided important context for baseline restriction observed in some
participants .physiological ageing was associated with decreased lung elastic
recoil ,increased chest wall stiffness ,loss of intervertebral disc height and
increased kyphosis9.cardiorespiratory ,neurological, orthopaedic and
other conditions also effect and alter
chest expansion .Alteration in chest expansion leads to symptoms such as
shortness of breath ,fatigue ,wheeze, sensations such as tightness of chest and
decreased exercise tolerance 3
A total of 15 elderly participants aged 60-75 years were
selected for this study .Chest expansion was measured using inch tape at axillary,4th
intercostal and xiphoid levels.pre measurements were taken before intervention
.After baseline assessment ,all participants underwent a six weeks exercise
program consisting of thoracic extension exercises.The intervention was
performed 3 times per week,and each session included 2 set of 15
repetitions.The exercise program included seated thoracic extension on chair
,cat and camel exercise and prone pressup.After 6 weeks of training post
measurements of chest expansion were taken at same anatomical levels using the
same procedure
Stastistical analysis revealed a significant improvement in
chest expansion after 6 weeks of thoracic extension exercises .At axillary
level means chest expansion increased from 2.57cm to 3.59cm.At the xiphoid
level ,the mean chest expansion increased from 2.11 cm to 2.94cm and at 4th
intercostal levelit rose from 1.61cm to 2.43cm.The paired t- test produced a
p-value of 0.000 at all three levels,indicating that difference where
statistically significant.Correlation analysis also showed a strong
relationship between pre and post test values ,confirming consistent improvements
in all participants
Similar findinsgs wre reported by patil et.al (2018) in the
study effect ot thoracic mobility exercises on chest expansion and pulmonary
function in elderly individuals, observed that thoracic mobility exercises
significantly improved chest expansion and lung capacity in elderly subjects14.Rathore
et al (2020) in the study effect of postural correction and thoracic extension
exercises on chest expansion in elderly women ,observed that thoracic extension and postural correction exercises respiratory efficiency and chest wall
mobility15.Kim et al(2016) in the study effect of thoracic extension
and breathing exercise on pulmonary function and thoracic shape in older adult,
found that combining thoracic extension with deep breathing exercise led to
improvement in vital capacity and thoracic flexibility16 .Bhambure
et al(2024) in the study, effect of thoracic mobility with breathe stacking
exercise on chest expansion ,reported that combining thoracic mobility with
breathe stacking teachniques produced clinically significant gains at axillary
and xiphoid levels17.Although these
previous studies demonstrated improvement in chest expansion through
chest resistance ,self- mobilization,breathe stacking exercises respectively
,the present project focused solely on thoracic extension movements ,which
directly target postural correction and spinal mobility .Unlike resistance or
breathing specific protocols ,this approach emphasized mechanical restoration
of thoracic extension and scapular retractions ,there by addressing one of the
primary biomechanical limitations of chest expansion in older
individuals-excessive thoracic kyphosis.Thus ,while previous studies improved
chest wall mobility mainly through respiratory muscle activation or stretching
,the present program combined postural correction and mobility training
,producing both structural and functional gains.
In the present study
, improvement in chest expansion
attributed to a combination of mechanical and neuromuscular changes produced by
repeated thoracic extension movements .Thoracic extension increased mobility of
costovertebral and costotransverse joints,reduced thoracic kyphosis and
permitted greater rib upward rotation during inspiration,the exercise reduced
anterior chest wall tightness and improved activation and endurance of
posterior thoracic musculature that assist inspiration9
The study had certain
limitations include the sample size was small which limited generalization of
results,a control group was not included ,performing alternative or no exercise
,making it difficult to attribute the observed improvement solely to thoracic
extension exercise and the duration of the study was relatively short ,lasting
only 6 weeks ,so long term effect of exercise could not be determined
Further studies can be included a larger same size,longer intervention and
inclusion of both genders in equal propotions and studies incorporating control
group with alteranative exercises could be counducted to explore the other
variance
Conclusion
Conclusion
Chest expansion declined with increase in age ,due to
progressive stiffening of thoracic cage ,reduced lung elastic recoil and
weakening of respiratory muscles .Simple ,low- cost interventions including
thoracic extension and mobility exercises ,pectoral stretching,targeted
scapular and posterior chain strengthening,segmental /diaphragmatic breathing
and adjuctive techniques such as breathe- stacking or inspiratory muscle
traning were effective approaches to improve chest expansion and should be
incorporated into physiotherapy program for older adults.
REFERENCE
REFERENCE
1.
Courtney R. The fuctions of breathing and its dysfunctions and their
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H, Esformes J D.Breathing Pattern Disorders and Functional
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3.Kushwaha
N, Satani K,Parmar DL. A study of Chest expansion measurement in healthy adults
with two different Instructions. 2023 Aug[cited 2025 Sep 10];7(8):42-48
4.
K Sembulingam, Prema Sembulingam.Essentials of medical physiology. 6th
ed. New Delhi:Jaypee Brothers Medical Publishers; 2012
5.Delgado
BJ, Bajaj T.Physiology, Lung Capacity. StatPearls;updated 24 July 2023
6. Hopkins E, Sharma S.Physiology
,Functional Resuidal Capacity .StatPearls[Internet]2025 Jan –[ updated 26
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10]
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10.Hampton L Thoracic Manual
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11.Physiopedia.Thoracic mobilization
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Effect of chest resistance exercise on chest expansion and maximal respiratory
pressure in elderly with inspiratory muscle weakness.2016;28(3):845-850
13.Jang HJ ,Kim MJ,Kim SY.Effect of
thorax correction exercises on flexed posture and chest function in older women
with age –related hyperkyphosis.2015;27(4):1121-1124
14.Patil S.S, and Anap,D.B .Effect
of thoracic mobility exercises on chest expansion and pulmonary function in
elderly individuals.International journal of health Science and Research
,8(6),120-126
15.Rathore N,and Singh P.Effect of
Postural Correction and Thoracic extension Exercise on chest expansion in
elderly women.International journal of physiotherapy ,7(2),45-50
16.Kim,J.H,Park,S.Y,and Lee
,M.H.Effect of thoracic extension and breathing exercise on pulmonary function
and thoracic shape in older adults.2016,28(2),478-482
17.Bhambure ,Malti
Vijay;Yadav,Trupti S.Effect of thoracic mobility with breath stacking exercise
on chest expansion in post surgery breast cancer patients.Indian journal of
physical therapy and research. 2024, 6(1):p 65-70
ANNEXURE
ANNEXURE-1
PROFOMA
NAME :
AGE
GENDER
DATE OF PRE TEST
PRETEST INCHTAPE
VALUE
DATE
OF POST TEST
POST TEST INCHTAPE VALUE
ANNEXURE -2
MASTER SHEET
|
sl |
Name |
Age |
Gender |
Occupation |
Pre Value |
Post Value |
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Axillary level |
Xiphoid level
|
4th Inter costal |
Axillary level |
Xiphoid level
|
4th Inter costal |
|
1 |
Silvy Francis |
62 |
F |
Housewife |
2.4 |
1.9 |
1.4 |
3.3 |
2.7 |
2.2 |
|
2 |
Francis |
67 |
M |
Retired |
2.8 |
2.3 |
1.8 |
3.9 |
3.2 |
2.7 |
|
3 |
Varghese |
67 |
M |
Retired |
3 |
2.5 |
1.9 |
4.1 |
3.4 |
2.9 |
|
4 |
Omana |
63 |
F |
Housewife |
2.6 |
2 |
1.5 |
3.5 |
2.9 |
2.3 |
|
5 |
Phoncy |
60 |
F |
Office staff |
2.3 |
1.8 |
1.3 |
3.2 |
2.6 |
2.1 |
|
6 |
Annie Sunny |
66 |
F |
House wife |
2.5 |
1.9 |
1.4 |
3.4 |
2.8 |
2.2 |
|
7 |
Joy C.D. |
70 |
M |
Diary farmer |
2.7 |
2.2 |
1.6 |
3.7 |
3.1 |
2.5 |
|
8 |
Tony |
62 |
M |
Sales |
2.9 |
2.4 |
1.7 |
4 |
3.3 |
2.6 |
|
9 |
Saleena |
75 |
F |
Housewife |
2.2 |
1.7 |
1.2 |
3.1 |
2.5 |
2 |
|
10 |
Omana Paul |
62 |
F |
Housewife |
2 |
1.7 |
1.3 |
3 |
2.5 |
2.1 |
|
11 |
Karthyaniamma |
75 |
F |
Housewife |
3 |
2.6 |
2 |
4 |
3.4 |
2.8 |
|
12 |
Fathima |
74 |
F |
Housewife |
2 |
1.9 |
1.6 |
3.1 |
2.4 |
2.2 |
|
13 |
Meenakshiamma |
71 |
F |
Housewife |
2.5 |
2 |
1.6 |
3.4 |
2.8 |
2.4 |
|
14 |
Gracy |
72 |
F |
Housewife |
3 |
2.7 |
2.4 |
4.3 |
3.5 |
3 |
|
15 |
Thomas |
74 |
M |
Retired |
2.6 |
2.1 |
1.5 |
3.8 |
3 |
2.4 |
ANNEXURE -3
Outcome Measure
Chest expansion is assessed using a standard measuring tape
(inch tape).It is simple , valid ,and
reliable method for evaluating chest expansion.it is simple and inexpensive tool.
The procedure is performed with the participant in upright position and tape is
placed around the chest at predetermined anatomical levels commonly at the level of axilla ,third or
fourth intercostal Chest expansion is assessed using a standard measuring
tape(inch tape).it is a space ,and xiphoid process to record the difference
between maximum inspiration and maximum expiration. The vaues are noted in
centimeters /inches.previous studies establish that measuring tape has good
intra-rater reliability ,especially when measurements are taken at consistent
anatomical landmark and under standardized conditions
ANNEXURE -4
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CONSENT FORM
Name of study : Effectiveness of thoracic extension exercises
on chest expansion in elderly Individuals
Purpose of study: To find the effectiveness of thoracic
extension exercises on chest expansion in elderly individuals
I………………………………. Voluntarily agree to participate in this
research study.I have understood all the harm and benefit about this study .I
fully consent to participate in the above mentioned study.
Yes/No
Participant Name:
Signature :
