1. The patient crosses arms in front, grasps each elbow, and sits in a flexed trunk posture 2. The therapist places the patient's forearms onto the upper chest. The therapist places the both hands around the patient at the posterior rib angles to facilitate upward rotation 3. While the patient lifts into trunk extension, the therapist places a sweeping force (accessory glide) at the rib angles to facilitate upward rotation of the rib cage 4. As the patient lifts further into trunk extension, the therapist adds an anterior gliding of the thoracic spine 5. This is repeated until a greater amount of trunk extension is obtained