Comparison of Diaphragmatic Stretch Technique and Proprioceptive Neuromuscular Facilitation in Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Hasini Ramesh, Dr. Deepak Jain N, Dr. Rajendra Kachhwaha

Abstract: Background of the study: COPD is a chronic respiratory condition characterized by persistent airflow limitation and progressive breathing difficulty. COPD causes airflow limitation, dyspnea, and reduced functional capacity. Manual physiotherapy interventions may improve respiratory mechanics. Air trapping and hyperinflation further impair respiratory mechanics, reducing functional capacity and quality of life. Pulmonary rehabilitation is essential in COPD management. Along with pharmacological treatment, physiotherapy interventions improve ventilation, strengthen respiratory muscles, and reduce symptoms. Manual therapy techniques enhance chest wall mobility and thoracic expansion, improving breathing efficiency. Among these, Proprioceptive Neuromuscular Facilitation (PNF) and diaphragmatic stretching are used to optimize respiratory function. Aim: To determine whether diaphragmatic stretch technique or PNF technique produces better outcomes in mild to moderate COPD patients. Objectives: 1) To compare diaphragmatic stretch technique and proprioceptive neuromuscular facilitation in mild to moderate COPD. 2) To examine the effect of Diaphragmatic Stretch Technique on patients with mild to moderate COPD with respect to PEFR, Breathlessness, Cough and sputum. 3) To examine the effect of Proprioceptive Neuromuscular Facilitation Technique on patients with mild to moderate COPD with respect to PEFR, Breathlessness, Cough and sputum. Methodology: A randomized controlled trial was conducted in 70 patients with mild to moderate COPD from the pulmonology OPD were randomly divided into two groups of 35 each. Group 1 received diaphragmatic stretch technique, and Group 2 received chest Proprioceptive Neuromuscular Facilitation Technique, three sessions weekly for four weeks. Outcomes included Peak Expiratory Flow Rate (PEFR), Borg?s RPE scale for breathlessness, and CASA-Q, assessed pre- and post-intervention. Appropriate nonparametric statistical tests were applied to determine significance. Results: Both groups showed significant improvement in all measured outcomes. Greater improvement was observed in the PNF group for PEFR, dyspnea, and CASA-Q scores. Conclusion: Both interventions were beneficial, with chest PNF demonstrating superior short-term outcomes in this sample.

Keywords: COPD, pulmonary rehabilitation, diaphragmatic stretch, proprioceptive neuromuscular facilitation, dyspnea, peak expiratory flow rate, manual therapy

How to Cite?: Hasini Ramesh, Dr. Deepak Jain N, Dr. Rajendra Kachhwaha, "Comparison of Diaphragmatic Stretch Technique and Proprioceptive Neuromuscular Facilitation in Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial", Volume 15 Issue 5, May 2026, International Journal of Science and Research (IJSR), Pages: 740-746, https://www.ijsr.net/getabstract.php?paperid=SR26505104735, DOI: https://dx.dx.doi.org/10.21275/SR26505104735

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