Muscle Energy Technique Research Articles

Clinical Leadership Perspectives: Advancements in Manual Physical Therapy Practice with the Pakistani Context

Physical therapy is a healthcare discipline that is dedicated to help individuals and patients in maintaining their health while optimizing their strength, function, and movements. Pakistan being a developing country, experiences a slower pace in the establishment of advancements in the medical professions. Whereas physical therapy is significantly improving day by day in Pakistan; additionally, this study aims to discuss the advances, in manual therapy concerning the physical therapy profession in Pakistan. This study aimed to evaluate the perception of clinical leadership and its recent advancements concerning the manual physical therapy practice in Pakistan for the preceding year. For this purpose, semi-structured interviews were conducted with 10 physical therapists from 5 different cities in Pakistan. Physical therapists with at least 10 years of clinical practice were included in the data collection. The interviews were audio/video recorded, data verbatim transcribed, and analyzed manually by open coding and in-vivo coding. Furthermore, thematic analysis was done to identify different elements of recent advancements concerning manual physical therapy by finding the appropriate patterns in the gathered data. The results showed that advancements occurred in the last decade, such as international certifications, workshops, hands-on practice and master programs. There is lack of awareness, gender barriers, and financial constraints in adopting new advancements. The focus was shifted more toward muscle energy technique and myofascial release. Modalities were preferred in the past for pain relief; however, in the recent decade, they have been replaced by manual therapy techniques. Pain management and prognosis are better with manual therapy. These advancements will be cost-effective for the patient. This study concluded that manual therapy in Pakistan has undergone a significant transformation during the last preceding years. There is still great potential for more advancement in manual therapy techniques in Pakistan.

Osteopathic management of non-specific neck pain: Preliminary findings from a cross sectional study of Australian osteopaths

ObjectiveNeck pain is a highly prevalent condition that leads to considerable pain and disability. There is an economic cost to neck pain at both a personal and broader health system level. Neck pain may be classified as ‘non-specific’ neck pain (NSNP) when there is an absence of identifiable underlying disease or abnormal anatomical structure. Osteopaths play a role in the management of NSNP, but it is unclear how osteopaths specifically manage this condition. This study explores what osteopaths do for patients with NSNP. MethodsCross sectional design. Via an online survey. ResultsAll participants in this study reported applying soft tissue techniques, using exercise prescription, discussing physical activity levels, physical fitness, stress management, pain education and posture and ergonomics for patients with NSNP. Less than half of the osteopaths in this study reported using PROMs in clinical practice for the management of non-specific neck pain and only a small number completed continuing professional development (CPD) related to the clinical management of NSNP. ConclusionThis study demonstrates Australian osteopaths use a range of manual therapy techniques and education strategies in clinical practice for the management of NSNP in line with clinical practice guidelines. Implications for clinical practice•All osteopaths in this study reported applying soft tissue techniques, using exercise prescription, discussing physical activity levels, physical fitness, stress management, pain education and posture and ergonomics for patients with NSNP.•Less than half of the osteopaths in this study reported using PROMs in clinical practice for the management of non-specific neck pain.•Only a small number of Australian osteopaths completed continuing professional development (CPD) related to the clinical management of NSNP.

Integrating Manual Therapy and Exercise: Evaluating the Efficacy of Muscle Energy Technique Combined with Free Exercises in Alleviating Symptoms of Chronic Rheumatoid Arthritis

Introduction: Autoimmune chronic disease Joint pain, inflammation, and irregularities are RA symptoms. Everyone's physical and emotional health is affected by this awful sickness. RA treatments are being investigated to improve life. Even while medications treat RA, physical therapy is growing. Patients can receive MET for musculoskeletal issues. The effects of MET on chronic rheumatoid arthritis quality of life are unknown. Free MET's impact on chronic rheumatoid arthritis sufferers will be studied. We seek to improve treatment options and empower patients through active rehabilitation by studying this unknown territory. Few have studied advanced manual therapy like MET for RA, making this study intriguing. A comprehensive MET and free exercise study may improve long-term RA patients' clinical processes and quality of life. This study addresses a knowledge gap, recommends future research, and promotes awareness of how advanced manual therapy may improve quality of life for chronic rheumatoid arthritis patients.
 Objectives:To determine the impact that the muscular energy technique has on the quality of life of people who suffer from chronic rheumatoid arthritis. To investigate the impact that free workouts have on the quality of life of people who suffer from chronic rheumatoid arthritis.
 Conclusion:This study found that free exercises and MET enhanced RA patients' quality of life. Therapeutic interventions targeting systemic inflammation and polyarthritis were guided by HAQ and NRS testing to reduce discomfort, strengthen, and enhance function. Hot moist packs reduced stiffness and NRS values declined quickly during MET and free exercises, relieving discomfort. 30–60-year-olds maintained muscle tone and power with medication and targeted exercises. After isometric relaxation, manual treatment harmonized inputs, reduced discomfort, and improved pain, disability, and joint range. High HAQ ratings suggested better quality of life, suggesting rigorous manual treatment and exercise may assist chronic RA. These findings advise treating rheumatoid arthritis using tailored methods and more investigation.

Muscle Energy Technique Versus Dry Needling of Active Trigger Points in Quadratus Lumborum: A Comparative Study on Functional Disability in Low Back Pain

Background: Lower back pain (LBP) is a prevalent condition that significantly impacts the quality of life and mobility of individuals. Active trigger points in the quadratus lumborum muscle are a common source of LBP, often requiring effective physiotherapeutic interventions. Dry needling (DN) and Muscle Energy Techniques (METs) are two commonly used treatments, though their comparative efficacy has not been extensively studied. Objective: The study aimed to compare the effects of DN and METs on the functional disability of patients with active quadratus lumborum trigger points contributing to lower back pain. Methods: In this randomized controlled trial, 24 patients were equally divided into two groups to receive either DN or METs over a three-week period, with sessions conducted twice weekly. The Modified Oswestry Disability Index (MODI) was employed to measure functional disability at baseline, after the first, third, and sixth sessions. Repeated measures ANOVA was utilized for intra-group and inter-group comparisons. Results: Both interventions showed a decrease in MODI scores, indicating an improvement in functional disability. However, DN was significantly more effective than METs in reducing disability scores (p < 0.05). Notably, no significant difference was found between the post-treatment NPRS and PPT scores within or between the groups. Conclusion: DN appears to be a more effective intervention than METs for reducing functional disability associated with active trigger points in the quadratus lumborum among LBP patients. Despite the efficacy of both treatments, DN may be prioritized as a preferred modality in clinical settings.

Global Postural Exercise Program Versus Muscle Energy Technique on Management of Temporomandibular Joint Disorders

Objective: To compare between the effects of global postural exercise program against muscle energy technique on maximum pressure pain threshold, maximal mouth opening range of motion as well as quality of life on patients with temporomandibular joint disorders. Methods: 63 patients having temporomandibular disorders were randomized into three groups; Group (A) were given global postural exercise program in addition to conventional therapy (in the form of LASER and hot packs), Group (B) were given muscle energy technique as well as traditional therapy and the Group (C) control were given traditional therapy only. All patients were examined by the pressure algometer, paquimeter and Arabic version of Oral health impact profile 14 questionnaire as well as the duration of treatment were 6 weeks. Results: there were no significant statistical differences revealed pretreatment for all variables, Mmaximal mouth opening range of motion, quality of life scale, as well as pain) as in mouth opening (P=0.130), OHIP-14 (P=0.642), right temporalis muscles (P=0.384), left temporalis muscles (P=0.930), right masseter muscles (P=0.790), left masseter muscles (P=0.064), right trapezius muscle (P=0.403), and left trapezius muscle (P=0.058) among groups where (P>0.05). While after-treatment and follow up , there were significant statistical differences were P value was (P<0.05), in mouth opening (P=0.0001 and P=0.0001, respectively), OHIP-14 (P=0.0001 and P=0.0001, respectively), right temporalis muscles (P=0.035 and P=0.020, respectively), left temporalis muscles (P=0.0001 and P=0.0001, respectively), right masseter muscles (P=0.001 and P=0.0001, respectively), left masseter muscles (P=0.004 and P=0.035, respectively), right trapezius muscle (P=0.0001 and P=0.0001, respectively), and left trapezius muscle (P=0.031 and P=0.001, respectively) between groups. Conclusion: Both Muscle energy technique and global postural exercise program improved mouth opening, pressure pain threshold, as well as quality of life in temporomandibular joint disorders patients, with the superiority of muscle energy technique over global postural exercise program.

COMPARATIVE EFFECTS OF MUSCLE ENERGY TECHNIQUE AND COUNTERSTRAIN TECHNIQUE ON PAIN, FUNCTION STATUS AND SATISFACTION LEVEL IN PLANTER FASCIITIS PATIENTS

Objective: To compare the effects of muscle energy technique and counterstrain technique on pain, functional status and satisfaction level in patients with planter fasciitis.
 Methods: This randomized clinical trial was conducted from May to November 2022. Total 66 patients were recruited using purposive sampling technique. Clinically diagnosed patients of plantar fasciitis of age 20-60 years, both gender and history of pain?4 weeks were randomly allocated into two groups. Muscle energy technique was applied to group A and Counterstrain technique was given to Group B with routine physiotherapy. Outcomes measure were Visual Analog Scales for pain, Foot and Ankle Ability Measure for functional level and Patient Satisfaction Questionnaire-18 for satisfaction level. Assessment was conducted at baseline, 1st and 2ndweek. Independent t-test and RM-ANOVA was used for between and within-group differences with p?0.05 was significant.
 Results: The results showed no significant difference between Group A and Group B in pain (p=0.245), functional status (ADL: p=0.862, Sport: p=0.092) and satisfaction level (p=0.108). However, significant within-group difference was observed with pain (p=0.000), functional status (p=0.000) and general satisfaction level (p=0.000).
 Conclusion: Muscle Energy and Counterstrain Technique are equally beneficial in decreasing pain, enhancing functional status and patient satisfaction level in plantar fasciitis patients.
 Keywords: Counterstrain Technique; Functional Status; Foot and ankle ability measure; Muscle energy technique; Pain; Planter fasciitis; Satisfaction Level; Visual analog scale

Physical Therapist Interventions to Reduce Headache Intensity, Frequency, and Duration in Patients With Cervicogenic Headache: A Systematic Review and Network Meta-Analysis.

The aim of this study was to assess the efficacy of physical therapist interventions on the intensity, frequency, and duration of headaches, as well as on the quality of life of patients with cervicogenic headache. The following databases were searched up to October 2022: Physiotherapy Evidence Database, Web of Science, Pubmed, and Cochrane Library. Randomized controlled trials assessing the effect of physical therapist interventions on adults with cervicogenic headache were included. Quality appraisal was conducted using the Cochrane risk of bias 2.0 tool and the Confidence in Network Meta-analysis web app. Synthesis methods were conducted in accordance with the Cochrane Handbook. Of the 28 identified reports, 23 were included in the quantitative synthesis. Manipulation plus dry needling was the highest-ranked intervention to reduce the short-term headache intensity (mean difference [MD] = -4.87; 95% CI = -8.51 to -1.24) and frequency (MD = -3.09; 95% CI = -4.93 to -1.25) when compared to a control intervention. Other high-ranked and clinically effective interventions (when compared to a control intervention) were muscle-energy technique plus exercise (MD = 4.37; 95% CI = -8.01 to -0.74), as well as soft tissue techniques plus exercise (MD = -3.01; 95% CI = -5.1 to -0.92) to reduce short-term headache intensity, and dry needling plus exercise (MD = -2.92; 95% CI = -4.73 to -1.11) to reduce short-term headache frequency. These results were based on a low certainty of evidence. The 4 most highly ranked interventions can be considered in clinical practice. However, no conclusive recommendation can be made due to the low certainty of evidence. Combined interventions such as spinal joint manipulation plus dry needling and muscle-energy technique or soft tissue techniques or dry needling plus exercises seem to be the best interventions to reduce short-term cervicogenic headache intensity and/or frequency.

Muscle energy technique to reduce pain and disability in cases of non-specific neck pain: A systematic review and meta-analysis of randomized controlled trials

BackgroundTo investigate the effectiveness of muscle energy technique (MET) for treatment of non-specific neck pain (NSNP). MethodsA literature search was performed using electronic databases from their inception until October 2023 for randomized controlled trials (RCTs) that investigated the effects of MET on NSNP. A change in pain intensity and reduced disability were the primary and secondary outcomes, respectively, standardized using Hedges’ g. A random effects model was used for data pooling. ResultsThis study included 26 RCTs comprising 1170 participants. The results showed that MET significantly reduced pain intensity (Hedges' g = −0.967 95 % CI = −1.417 to −0.517, p < 0.001). However, subgroup analysis revealed that this significant benefit was observed only when MET was combined with other treatments and not with MET monotherapy. MET also reduced disability (Hedges’ g = −0.545, 95 % CI = −1.015 to − 0.076, p = 0.023). Meta-regression analysis showed that an increase in treatment duration/session per week contributed to greater pain reduction. No adverse events were reported following the MET. ConclusionsIn conclusion, our meta-analysis suggests MET's potential effectiveness within a combined treatment for NSNP. However, the evidence's low certainty is likely influenced by bias and study variations. To strengthen these findings, future research should focus on higher-quality clinical trials, longer follow-up periods, and prediction interval presentations.

Muscle Energy Technique Effects On Pain, Cervical Range of Motion, and Functional Disability

An unfavorable sensory or emotional encounter connected to actual or potential tissue injury is referred to as neck pain, and it affects the region of the neck between the superior nuchal line and the first thoracic spinous process. Mechanical neck pain often commences insidiously and is of multifactorial etiology, causing disability and clinical symptoms. It is a comparative study where 30 male and female subjects were assessed and identified with Mechanical Neck Pain, recruited for the study, and randomly divided into two groups with 15 subjects in each group. Outcome measures were the Visual Analogue Scale (VAS), goniometer, and neck disability index (NDI). Pre-Test and Post-Test were carried out for both groups and analyzed using paired 't-tests and independent 't-tests in an IBM SPSS statistics 26 software. This study aimed to compare the effectiveness of muscle energy technique with conventional therapy vs. kinesio taping with conventional therapy in chronic mechanical neck pain, cervical range of motion, and functional disability of the neck. KT provides sensory feedback, tension, and afferent stimulation to reduce pain and improve ROM. It also helps in lymphatic and vascular flow and corrects misaligned structures. Muscle energy technique and Kinesio taping showed significant improvement in VAS, Goniometer, and NDI in mechanical neck pain patients, making them suitable for inclusion in mechanical neck pain treatment.

Physical Therapy Management of Pelvic Pain in Men: Two Case Reports

BACKGROUND: The purpose of this case report is to describe 2 cases where individualized pelvic floor physical therapy (PFPT) was used to care for 2 individuals with general pelvic pain. CASE PRESENTATION: Two male patients with pelvic pain and urinary dysfunction were referred to PFPT. Assessment of breathing pattern, the pelvic floor, and the pelvic girdle were performed. Goals were set with a therapist to address their chief complaints and reduce pelvic pain through use of muscle energy techniques, manual therapy, therapeutic exercise, and behavioral modifications. FOLLOW-UP: Both patients improved after only 4 physical therapy treatment sessions and reported clinically significant improvements in National Institutes of Health Chronic Prostatitis Symptom Index scores. DISCUSSION: The successful and rapid resolution of symptoms in these cases demonstrates the potential benefits of PFPT, patient compliance, and timely referrals to PFPT to expedite outcomes. JOSPT Cases 2023;3(4):227-232. Epub 11 September 2023. doi:10.2519/josptcases.2023.11495

Dry needling versus muscle energy technique on shoulder adhesive capsulitis post mastectomy

Objectives. To compare the effect of dry needling and muscle energy technique on adhesive capsulitis post mastectomy. Design. A single-blinded randomized clinical study. Setting. Outpatient setting. Subjects. Fifty female patients diagnosed with shoulder adhesive capsulitis post mastectomy, ranging in age from 30 to 60 years, were randomly assigned to two groups. Participants in Group A were administered dry needling treatment, plus a traditional physical therapy program in the form of shoulder joint mobilization, shoulder muscle stretching, and ROM exercise; Group B received muscle energy technique, plus a traditional physical therapy program in the form of shoulder joint mobilization, shoulder muscle stretching, and ROM exercise. Intervention. Two sessions per week over five weeks. Outcome measures. Shoulder range of motion, pressure pain threshold, and shoulder dysfunction were measured pre-treatment and post-treatment. Results. There was no statistically significant difference observed in the age distribution between the groups (p &gt; 0.05). Following the treatment, there was a notable rise in the pressure pain threshold and a considerable decline in shoulder dysfunction when compared to the pre-treatment condition (p &lt; 0.001). There was a notable rise in the ranges of shoulder flexion, abduction, and external rotation after the treatment when compared to before the treatment in both group A and B (p &gt; 0.001). The percentage of change in flexion, abduction, and external rotation in group A was 125.03%, 76.43%, and 58.72%, respectively. In contrast, group B exhibited percentage changes of 137.48%, 97.51%, and 68.78% in flexion, abduction, and external rotation, respectively. There was no statistically significant difference seen between the groups prior to treatment, as shown by a p-value greater than 0.05. The analysis of the data after treatment demonstrated a statistically significant rise in the pressure pain threshold for group A in comparison to group B (p &lt; 0.001). However, there was no significant disparity observed in shoulder dysfunction between the two groups (p &gt; 0.05). Following the treatment, there was a notable rise in the range of motion (ROM) for flexion, extension, and abduction in group B when compared to group A (p &lt; 0.001). Conclusion. Application of either dry needling or muscle energy technique results in a notable enhancement in the severity of symptoms in adhesive capsulitis post mastectomy, with superiority for dry needling.

Efficacy of Muscle Energy Technique alone and in combination with Interferential Therapy for the Treatment of Non-specific Low Back Pain

Non-specific back pain is one of the prevalent musculoskeletal disorders in general population worldwide and also a major contributor of days lost from the work. It is considered one of the major causes of financial burden on the healthcare. Objective: To compare the effectiveness of muscle energy technique alone and in combination with interferential therapy in the management of non-specific back pain. Methods: After getting the review ethical committee approval from The Neurocounsel Clinics, current RCT was initiated from 21 May, 2023 to 20 September 2023 and registered at ClinicalTrails.gov under NCT06098053. Sample size was calculated by Epitool which came 30. Simple random sampling technique was used to randomize participants into two equal groups. Group A was given muscle energy technique and group B was given muscle energy technique plus interferential therapy. 2 sessions/week for 4 &amp; half weeks. Evaluation was done at pain numeric scale &amp; EQ-5D-5L (QoL). Pre and post-test analysis was done by use of SPSS version 21 and level of significance was kept p&lt;0.05. Results: The mean age in group A was 31.40±10.91 whereas in group B it was 26.93±11.69. Mann Whitney U test showed significant difference (p&lt;0.05) between groups on the basis of PNS and insignificant difference (p&gt;0.05) between groups on the basis of QoL. Conclusions: It was concluded from the results of this study that MET and IFT are more effective in alleviating patient’s pain but are equally effective in improving quality of life in patients suffering from non-specific back pain.

Comparative Effectiveness of Proprioceptive Neuromuscular Facilitation Stretch Vs Spencer Muscle Energy Technique on Pain and Disability in Patients with Adhesive Capsulitis

Purpose: Adhesive capsulitis is a condition in which the tissues of the shoulder joint become tight and impede movement. It is characterized by gradual loss of both active and passive glenohumeral joint motion, resulting in fibrosis, scarring and contractures of the joint capsule. Patient with adhesive capsulitis usually have difficulty in performing overhead activities, as well as routine duties such as combing their hair, dressing themselves, and throwing a ball. The objective of this study was to determine the effectiveness of proprioceptive neuromuscular facilitation (PNF) stretch vs muscle energy technique (MET) on pain and disability in patients with adhesive capsulitis.&#x0D; Methodology: Study Design: This research employed a rigorous single-blinded randomized controlled trial design to investigate the comparative effectiveness of two manual therapy techniques in the management of adhesive capsulitis. The study was conducted in accordance with established ethical guidelines and principles. Participant Selection: A total of 30 participants, aged between 30 and 60 years, were recruited for this study. The selection process adhered to specific inclusion and exclusion criteria to ensure the homogeneity of the participant group. Inclusion criteria encompassed individuals in the 2nd and 3rd stages of adhesive capsulitis, both males and females, those with comorbid conditions such as diabetes and hypertension, and individuals experiencing painful restrictions in active and passive glenohumeral or periscapular motion. It was essential that participants had the ability to understand Punjabi or Urdu and were willing to participate. Exclusion criteria included individuals with a history of post-traumatic immobilization, cognitive impairment, previous surgery or arthroscopy, cervical pathology, neoplasm/tumor, or reflex sympathetic dystrophy. Informed Consent: Before the commencement of the study, informed consent was obtained from all participants. The participants were fully informed of the study's objectives, procedures, and potential risks and benefits. The rights of voluntary participation and the option to withdraw from the study at any time were emphasized. Participant data were anonymized and kept confidential throughout the research process to safeguard privacy. Randomization: To minimize bias, participants were randomly assigned to two distinct treatment groups, Group A and Group B. The randomization process was conducted using a computer-generated method, ensuring that each participant had an equal chance of being assigned to either group. Interventions: The study employed two distinct manual therapy techniques for the treatment of adhesive capsulitis. Group A received proprioceptive neuromuscular facilitation (PNF) stretching, while Group B underwent the Spencer muscle energy technique (MET). Both interventions were administered over a duration of one month. Baseline Treatment: In addition to the primary interventions, all participants received a hot pack as a baseline treatment. This standard treatment approach aimed to create a consistent baseline condition for all participants and to alleviate any discomfort. Data Collection: The collection of data was a crucial aspect of this study. Data were gathered through the utilization of structured data collection forms, designed to capture demographic information and adhere to the inclusion and exclusion criteria. Additionally, standardized assessment tools were used to quantify outcomes. The Shoulder Pain Assessment Disability Index (SPADI) was employed to evaluate both pain and functional disability, while the Numeric Rating Scale (NRS) was utilized to measure pain intensity.&#x0D; Findings: Statistical analysis was done by using statistical package for the social sciences (SPSS) version 28. The collected data was analyzed and presented using appropriate statistical techniques. The data were initially checked for normality using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Non-parametric tests were employed due to the non-normal distribution of the data. Qualitative data were analyzed for frequency and percentage. Intra-group differences were examined using the Wilcoxon signed-rank t-test, while inter-group differences were assessed with the Mann Whitney U-test. Spencer mean Mets treatment group has lower mean ranks in total SPADI pain as compared to PNF study group.&#x0D; Conclusion: the study concluded that Spencer Mets has been more effective in reducing the pain of the patients as compared to PNF treatment. Healthcare professionals involved in the treatment of patients with adhesive capsulitis should consider the incorporation of Spencer MET as a viable option for pain management. The superior pain reduction observed in this study suggests that this technique may yield favorable results in real-world clinical settings. While this study offers valuable insights, further research is warranted to explore the long-term effects and potential differences in functional outcomes between Spencer MET and PNF treatment. Comparative studies with larger sample sizes and extended follow-up periods can provide a more comprehensive understanding of the benefits of these techniques.

EFFICACY OF MUSCLE ENERGY TECHNIQUE ON SHOULDER ADHESIVE CAPSULITIS POST MASTECTOMY

Background: Shoulder pain, disability and impaired movements are frequently reported complication in post- mastectomy patients. Most individuals who have had a mastectomy suffer from adhesive capsulitis, which causes shoulder pain and impairment. Aim: The current study was conducted to investigate the effectiveness of Muscle energy technique (MET) on shoulder adhesive capsulitis post mastectomy. Patients and methods: The present work was carried-out on sixty patients with adhesive capsulitis after mastectomy who participated in this study, they were aged from 40 to 60 years. The individuals were recruited from National Cancer Institute, Cairo University. They were randomized into 2 groups; every group included 30 patients. Group (A) (study group): were givenMET5 days per week for eight weeks as well as their traditional physiotherapy program (Mobilization exercises, stretching of the Posterior capsule, as well as Range of motion (ROM) exercises). Group (B) (control group):received only the conventional physical therapy program, 5 days per week for eight weeks. Visual analogue scale (VAS) was utilized to measure the shoulder pain. Goniometer was utilized to evaluate shoulder ROM. Shoulder pain and disability index (SPADI) was utilized to evaluate shoulder function. All assessments were conducted pretreatment as well as post treatment. Results: In both Groups A and B, post-treatment VAS as well as SPADI scores were significantly lower than pre-treatment scores (p &lt; 0.001). the percentage of change of VAS as well as SPADI in Group A was 68.28% and 71.88% respectively, while it was, 45.76% and 54.4% in group B respectively. In both groups, post-treatment shoulder flexion, abduction, as well as lateral rotation were all significantly higher than pre-treatment values. Shoulder flexion, abduction, as well as external rotation all increased by 128.25, 75.76, and 99.95% in group A, whereas they increased by 97.58, 59.9, and 89.38% in group B, respectively. Pretreatment comparisons showed no statistically significant differences among the groups. Post-treatment comparisons between the two groups showed that VAS and SPADI scores were significantly lower in Group A compared to Group B (p &lt; 0.001). Shoulder flexion, abduction, as well as external rotation were significantly improved in group A than in group B after treatment (p &lt; 0.001). Conclusion: adding MET in rehabilitation program can improve the shoulder pain, ROM as well as function in adhesive capsulitis management Postmastectomy.

Effects of Muscle Energy Technique on Pain and Range of Motion in Chronic Low Back Pain Subjects with Lateral Flexion Restriction

Effects of Muscle Energy Technique on Pain and Range of Motion in Chronic Low Back Pain Subjects with Lateral Flexion Restriction

Effectiveness of muscle energy techniques and friction massage in hamstring tightness amongst young athletes of Pakistan

Background: compromised hamstring flexibility is a risk factor to sports-related injuries, as muscular tightness is believed to reduce athletic performance. Different muscle energy techniques and friction massage are commonly practiced by manual therapists to improve hamstring flexibility. Objectives: To compare the effectiveness of muscle energy technique and friction massage in hamstring tightness among young athletes in Pakistan Methodology: A randomized controlled trial was conducted at Helping Hand Institute of Rehabilitation Sciences (HHIRS), Mansehra, and Neurological Orthopaedic and Sports Injury Services Mansehra (NOSIS). A total of n=60 young athletes between 18-25 years with hamstring tightness and limited straight leg raise range of motion (&lt;110⁰) were included in the study. The non-probability purposive sampling was used for data collection then the participants were randomly divided into Group A (n=20) received Post facilitation stretch (PFS), group B (n=20) received post-isometric relaxation (PIR), and Group C (n=20) which received deep friction massage through electronic massager. The athletic performance of the participants was assessed using the YMCA sit and reach test (S&amp;RT) for flexibility, agility run test (ART) for agility, vertical jump test (VJT) for explosive power, and 100-meter run test (RT) for speed and explosive power at baseline, 10th day, and 20th day of the intervention. Results: The participants had a mean age of 21.55±2.05 years. The result showed that participants who received PFS showed significant (p&lt;0.05) results as compared to PIR and FM after the 10th day, regarding VJT (p=0.006), ART (p=0.015), S&amp;RT (p&lt;0.001) and 100m RT (p&lt;0.001). After the 20th day, PFA showed better results than PIR and FM after the 10th day. The participant who received FM showed less improvement than the remaining two groups but statistically significant p&lt;0.05. Conclusion Muscle energy techniques, particularly PFS and PIR, proved effective in enhancing athletic performance parameters, including vertical jump, agility, and flexibility, among young athletes with hamstring tightness. These findings support their use in sports rehabilitation and injury prevention. Keywords: friction massage; hamstring tightness; manual mobilization technique; muscle energy technique; soft tissue mobilization post isometric relaxation; post facilitation stretch. Clinical Trail Number: NCT03680300

Can Talocural Mobilization and Muscle Energy Technique Improve Balance and Joint Position Sense in Healthy Adults?

Can Talocural Mobilization and Muscle Energy Technique Improve Balance and Joint Position Sense in Healthy Adults?

Isolated meniscus allograft transplantation with soft-tissue technique effectively reduces knee laxity in the presence of previous meniscectomy: In-vivo navigation of 18 consecutive cases

ObjectivesAlthough meniscal allograft transplantation (MAT) is a well-established procedure with satisfactory clinical results, limited in vivo kinematic information exists on the effect of medial and lateral MAT performed in the clinical setting. The purpose of the present study was to evaluate the biomechanical effect of arthroscopic isolated medial and lateral MAT with a soft-tissue fixation on pre- and post-operative knee laxity using a surgical navigation system. Methods18 consecutive patients undergoing MAT (8 medial, 10 lateral) were enrolled. A surgical navigation system was used to quantify the anterior-posterior displacement at 30 and 90 degrees of knee flexion (AP30 and AP90), the varus-valgus rotation at 0 and 30 degrees of knee flexion (VV0 and VV30) and the dynamic laxity on the pivot-shift test (PS), which was determined through the anterior displacement of the lateral tibial compartment (APlat) and posterior acceleration of the lateral tibial compartment during tibial reduction (ACC). Data from laxity before and after MAT were compared through paired t-test (p ​< ​0.05). ResultsAfter medial MAT, there was a significant decrease in tibial translation of 3.1 ​mm (31%; p ​= ​0.001) for AP30 and 2.3 ​mm (27%; p ​= ​0.020) for AP90, a significant difference of 2.5° (50%; p ​= ​0.002) for VV0 and 1.7° (27%; p ​= ​0.012) for VV30. However, medial MAT did not determine any reduction in the PS kinematic data. Lateral MAT determined a significant decrease in the tibial translation of 2.5 ​mm (38%; p ​< ​0.001) for AP30 and 1.9 ​mm (34%; p ​= ​0.004) for AP90 as well as a significant difference of 3.4° (59%; p ​< ​0.001) for VV0 and of 1.7° (23%; p ​= ​0.011) for VV30. There was also a significant reduction of the PS of 4.4 ​mm (22%; p ​= ​0.028) for APlat and 384.8 ​mm/s2 (51%; p ​= ​0.005) for ACC. ConclusionMAT with soft-tissue fixation results in a significant laxity reduction in an in-vivo setting. Medial MAT improved knee kinematics by determining a significant reduction with particular emphasis on AP translation and VV manoeuvre. Conversely, Lateral MAT determined a massive reduction of the PS and a mild decrease of the AP translation and VV manoeuvre. Study designControlled laboratory study.

How Schroth Therapists Vary the Implementation of Schroth Worldwide for Adolescents with Idiopathic Scoliosis: A Mixed Methods Study.

(1) Background: Schroth is a type of physiotherapeutic scoliosis specific exercise (PSSE) prescribed to adolescents with idiopathic scoliosis (AIS). Studies have investigated the effectiveness of Schroth but are yet to elucidate how Schroth is applied clinically and the factors that influence their prescription. (2) Methods: A mixed methods design was used comprising an anonymous survey and semi-structured interviews of Schroth therapists who treated AIS and who were publicly listed on the Barcelona Scoliosis Physical Therapy School or the International Schroth 3-dimensional Scoliosis Therapy School websites. The survey included 64 questions covering demographics, session and treatment characteristics, and whether therapists included other treatment modalities in their clinical practice. A convenience sample of survey participants were invited to participate in a semi-structured interview to further explore the factors that influenced their prescription of Schroth for AIS. Results from the survey were analyzed descriptively (n, %), whereas inductive thematic analysis was used for the interviews. (3) Results: of the 173 survey respondents (18% response rate), most were from Europe and North America (64.0%), female (78.6%), physiotherapists (96.0%), and worked in private settings (72.3%). Fifty-two per cent of participants used other types of PSSE as an adjunct to Schroth, the Scientific Exercise Approach to Scoliosis (SEAS) being the most frequently used (37.9%). Non-PSSE methods were used 'at some point' as an adjunct by 98.8% of participants, including massage and other soft tissue techniques (80.9%), Pilates (46.6%), and Yoga (31.5%). The Schroth techniques used by all survey respondents included breathing and pelvic corrections. Seven participants were interviewed, but data saturation was achieved after only four interviews. Thematic analysis revealed four, inter-related broad themes describing the factors that influenced Schroth prescription for AIS: (1) the adolescent as a whole, including physical, emotional and mental characteristics, and patient goals, (2) family, including parent relationship with the adolescent and the motivation of parents in regard to Schroth, (3) the systems within which the treatment was being offered, such as vicinity to the clinic and the presence of financial insurance support, and (4) therapist characteristics, such as their training and experience. (4) Conclusions: Schroth therapists worldwide use a variety of adjunctive methods to treat AIS. Therapists prescribing Schroth exercises to AIS consider the complex interplay of intra-, inter- and extra-personal factors in clinical practice. These considerations move beyond the three components of evidence-based practice of research, patient preferences, and clinical expertise, towards a systems-based reflection on exercise prescription.

Effectiveness Of Kaltenborn Mobilization Versus Muscle Energy Technique On Shoulder Range Of Motion In Adhesive Capsulitis

Objective: To compare the effectiveness of muscle energy techniques (post isometrics relaxation) and Kaltenborn mobilizations on shoulder range of motion (ROM) in adhesive capsulitis. Methodology: A randomized Control Trial (CRT) was conducted on patients with adhesive capsulitis for 6 months September 2021 to February 2022. Data was collected through a convenient sampling technique. 30 patients were taken from the physiotherapy department of the holy family hospital, Rawalpindi. The sample size was calculated using the Open Epi Tool. Data was collected by using Universal Goniometer at baseline, after 2 weeks and after 4 weeks of treatment. Patients who met the inclusion criteria and gave consent were included in the study. Patients were randomly allocated into two groups: Group A &amp; Group B. Group A received muscle energy technique and Group B received grade II &amp; III Kaltenborn mobilizations. Results: Data was analysed using SPSS software version 22. Both groups showed improvements in shoulder range of motion but Group A showed a statistically significant difference (p&lt;0.05) in flexion and abduction ROM from Group B. Conclusion: The muscle energy technique is much more effective in improving flexion and abduction ROM except rotation than Kaltenborn mobilizations in adhesive capsulitis.