Effect of selected osteopathic lymphatic techniques on immune system in healthy subjects

Group one ( study group 1 ) : will receive group of techniques (thoracic lymphatic pump , liver pump , splenic pump techniques) will be done for 15 min , 5 min each technique. 1-thoracic lymphatic pump technique: The patient lies supine with the head turned to one side (to avoid breathing or coughing into the face of the therapist) and with the hips and knees flexed and the feet flat on the table, The therapist stands at the head of the table with one foot in front of the other ,The therapist places the thenar eminences inferior to the patient’s clavicles with the fingers spreading out over the upper rib cage . For female patients, the therapist may place the hands more midline over the sternum , The patient is instructed to take a deep breath and exhale fully,During exhalation, the therapist increases the pressure on the anterior rib cage, exaggerating the exhalation motion, At end exhalation, the therapist imparts a vibratory motion to the rib cage at two compressions per second,Should the patient need to breathe, pressure is relaxed slightly, 2-splenic pump technique: The patient is in the supine position, legs bent. The therapist stands on the patient's right side.Place the fingers of your right hand with the side of the little finger below the left costal arch. Place the left hand on top of the right hand. With both hands, oscillate in the direction of the spleen, i.e., press lightly and intermittently in a cranial-lateral direction. 3-liver pump technique :The patient breaths through her mouth. While breathing out, slight pressure is applied to the liver, which remains constant until the start of breathing in. At the end of breathing out, the pressure is suddenly released without losing contact to the skin. Group two ( study group 2) : will receive group of techniques ( sternal pump , sternal oscillation and sternal rebound techniques ) will be done for 15 min , 5 min each technique 1-sternal pump technique:The patient is in the supine position. The therapist stands at the head of the table. Place both hands on top of each other on the sternum, with the thenar eminence on the sternal angle. Ask the patient to inhale deeply. During the deep exhalation, apply pressure with both hands caudally and posteriorly. Release the pressure on the next inhalation. 2-sternal rebound technique :The patient is in the supine position. The therapist stands at the head of the table. Place both hands on top of each other on the sternum, with the thenar eminence on the sternal angle. Ask the patient to inhale deeply. During the deep exhalation, apply pressure with both hands caudally and posteriorly. Release the pressure on the next inhalation rapidly with recoil. 3-sternal oscillation technique:The patient is in the supine position. The therapist stands to the side of the patient. Place both hands on top of each other on the sternum, with the thenar eminence on the sternal angle. Both hands apply rhythmic pressure to the sternum in a caudal-posterior direction. Group three ( control group ): will receive placebo ( subjects will be handled in light touch ) , will be done for 15 min all the three study groups will be applied for 4 weeks / three times per week / delivered by qualified physiotherapist also he is osteopathic student third year.