{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T23:30:17Z","timestamp":1778196617948,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2019,7,23]],"date-time":"2019-07-23T00:00:00Z","timestamp":1563840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Manual noninvasive respiratory techniques have traditionally been used to treat respiratory pathologies. The aim of this study was to analyze the effects of the diaphragmatic release technique and the thoracic lymphatic pump technique versus conventional respiratory retraining in children with asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Using a quasi-experimental design, 60 children with asthma were allocated to undergo the diaphragmatic release technique (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 20), thoracic lymphatic pump technique (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 20), or conventional respiratory retraining (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 20) in this study. Serum immunoglobulin E levels, diaphragmatic mobility, pulmonary function, and P\n                      <jats:sub>\n                        (A-a)O\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      were assessed before and after 12 treatment sessions that were conducted over nonconsecutive days in a 4-week program.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      After 12 treatments, the changes in the serum immunoglobulin E level for each group was not significantly different from the other groups. Compared with conventional respiratory retraining, the diaphragmatic release technique was associated with a significant improvement in FVC (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001) and FEV\n                      <jats:sub>1<\/jats:sub>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002); the thoracic lymphatic pump technique showed no differences. With regard to diaphragmatic mobility, both the diaphragmatic release technique and the thoracic lymphatic pump technique yielded significantly favorable effects when compared with conventional respiratory retraining (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .01, respectively). Further, no significant between-group differences were detected in terms of the P\n                      <jats:sub>\n                        (A-a)O\n                        <jats:sub>2<\/jats:sub>\n                      <\/jats:sub>\n                      (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .07).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The thoracic lymphatic pump technique and conventional respiratory retraining approaches were helpful interventions that could be used to alleviate the symptoms of childhood asthma. Nevertheless, the diaphragmatic release technique was a potentially more effective intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.06716","type":"journal-article","created":{"date-parts":[[2019,7,23]],"date-time":"2019-07-23T15:15:18Z","timestamp":1563894918000},"page":"1422-1432","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Prospective Effects of Manual Diaphragmatic Release and Thoracic Lymphatic Pumping in Childhood Asthma"],"prefix":"10.1177","volume":"64","author":[{"given":"Ragab K","family":"Elnaggar","sequence":"first","affiliation":[{"name":"Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt, and with the Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed A","family":"Shendy","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy for Cardiovascular, Respiratory Disorders and Geriatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa Z","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Department of Radiology and Medical Imaging, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,7,23]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2014.14036"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI8205"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.4.1254"},{"key":"e_1_3_2_5_2","first-page":"PA1026","article-title":"Alveolar-arterial oxygen gradient in asthma","volume":"48","author":"Shaw D","year":"2016","unstructured":"Shaw D, , Adejumo I, , Green R, , Pavord I. 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