Abstract
Objective: To determine the efficacy of rib cage mobilization on lung function in COPD patients
Study Design: A randomized control trial
Place and Duration of Study: Department of Physical Therapy and Rehabilitation Fauji Foundation Hospital Rawalpindi and Pakistan Railway General Hospital Rawalpindi, from sep. 2010 to sep. 2011
Methodology: Sixty two patients were randomly placed into two groups, 35 in group A and 27 in group B. The inclusion criteria was at least one year history of COPD, altered Dyspnea index, and decrease FEV1/FVC ratio and the exclusive criteria was less than one year history of COPD, normal Dyspnea index and no change in FEV1/FVC ratio. All the patients were treated for three weeks and rib cage mobilization was applied in group A and deep breathing exercise in group B. The rib cage mobilization was applied in sitting and side lying position for 10th to 2nd ribs and in supine position for 1st rib. The Dyspnea index and FEV1/FVC ratio were used as assessment tools, and were calculated before and after the physical therapy intervention program in all patients. The data was statistically analyzed by SPSS-20 and paired t- test was applied to calculate the probability at 95% level of significance.
Results: the result shows that the rib cage mobilization increase FEV1/FVC ratio and Dyspnea index more significantly (P value = 0.004, P value = 0.006) in group A, as compared to the deep breathing exercise in group B (P value = 0.073, and P value = 0.083).
Conclusion: we conclude that rib cage mobilization has very effective role to increase ribcage mobility and improve lung function in COPD patients.

Key words: COPD, rib cage mobilization, FEV1/FVC ratio