* Spirometric evidence of significant chronic air-flow limitation (ie, FEV1 of 50% of predicted and FEV1/FVC ratio of 70% of predicted) in whom COPD had been diagnosed (21)
* Persistent dyspnea with a self-rated intensity of ⩾6 (out of 10) on a visual analogue
* Having muscular tightness (pectoralis major and minor, upper trapezius, sternocleidomastoid)
You may not be if
• COPD with severe complications (respiratory infections, acute exacerbations, pulmonary hypertension)
* COPD with cardiovascular complications (Cor Pulmonale, atherosclerosis, risk of venous thromboembolism)
* Unstable respiratory, neurological, and cardiovascular conditions
* Congenital Cervical/spinal deformity
* Patients with frozen shoulder, shoulder, cervical radiculopathy)
