Effect of first rib mobilization with stretching versus stretching alone in people with Thoracic Outlet Syndrome

INTERVENTION: Intervention1: Group A first rib mobilization alone: Participants will receive first rib mobilization they will be made to do diaphragmatic breathing exercise thoracic extension and rotation exercise cervical range of motion exercises scapular stabilization exercises and nerve gliding exercises Treatment will be provided 4 sessions per week for 4 weeks Control Intervention1: First rib mobilization combined with stretching of scalene and pectoralis minor muscle: Participants will receive first rib mobilization stretching of scalene and pectoralis minor muscle they will be made to do diaphragmatic breathing exercise thoracic extension and rotation exercise cervical range of motion exercises scapular stabilization exercises and nerve gliding exercises. Treatment will be provided 4 sessions per week for 4 weeks CONDITION: Health Condition 1: M628‐ Other specified disorders of muscle PRIMARY OUTCOME: Pain intensity measured using Visual Analog ScaleTimepoint: Baseline pre and post assessment at 4th week SECONDARY OUTCOME: Functional disability measured using Disabilities of the Arm Shoulder and Hand DASH questionnaireTimepoint: Baseline pre and post assessment at 4th week INCLUSION CRITERIA: Individuals clinically diagnosed with thoracic outlet syndrome Individuals experiencing pain and functional limitations related to thoracic outlet syndrome Participants willing to participate and provide informed consent