Diaphragmatic Release vs Inspiratory Muscle Training in Pulmonary Fibrosis

Pulmonary fibrosis is characterized by progressive lung parenchyma destruction, resultingin restricted pulmonary function, severe dyspnea, impaired exercise tolerance, andreduced quality of life. While standard pharmacotherapy remains essential,non‐pharmacological interventions such as physical therapy techniques are vital tooptimize physiological function and functional independence in these patients. Thisrandomized controlled trial aims to compare the therapeutic effects of two distinctphysical therapy interventions‐Diaphragmatic Release Technique (DRT) and TargetedInspiratory Muscle Training (IMT)‐administered over a 12‐week period in patients withstable pulmonary fibrosis. Study Procedures & Interventions:A total of 40 eligible participants with stable pulmonary fibrosis will be randomlyallocated into one of two parallel treatment arms (20 participants per group): Group A(Diaphragmatic Release Technique ‐ DRT): Participants will receive a manual therapyintervention in addition to their standard medical treatment. The therapist appliesgentle cranial and lateral traction to the rib cage while the patient is in a supineposition to provide a sustained stretch to the diaphragm. Sessions last 10‐15 minutes andare conducted 3 times per week for 12 weeks. Group B (Targeted Inspiratory MuscleTraining ‐ IMT): Participants will perform targeted inspiratory muscle training using athreshold inspiratory muscle trainer device in addition to their standard medicaltreatment. Performed in an upright seated position, patients execute deep, forcefulinspirations starting at 30‐40% of their perceived effort. Each session consists of 5‐7sets of 6‐10 breaths ( 15 minutes total), 3 times per week for 12 weeks, with weeklyprogressive intensity adjustments