Muscle Energy Technique Research Articles

Use of muscle energy technique amongst a nationally representative sample of Australian osteopaths

IntroductionMuscle energy technique (MET) is a therapeutic technique involving active muscle contraction by the patient. The selection of particular techniques by osteopaths is underexplored. The aim of the study was to explore the practice profile of those Australian osteopaths who use MET often in their practice compared to those who do not use the technique often. MethodsA secondary analysis of data collected from 922 participants by a practice-based research network (PBRN) for the Australian osteopathy profession was performed. Frequency of use of MET on a 4 point scale: never, rarely, sometimes, and often were binary coded as less often and often. Inferential statistics were used to explore the associations between individual practice characteristics and the frequency of MET use. Adjusted odds ratios (OR) with 95% confidence intervals (CI) and p-values were calculated from regression modelling. ResultsDichotomising participant responses resulted in less often (203, 20.5%) and often (788, 79.4%). There was a significantly greater proportion of male practitioners using MET compared to those practitioners who did not often use the technique (OR = 0.46; CI = 0.33, 0.63; p < 0.01). Australian osteopaths who often used MET were younger (36.3 vs 44.6 years old) and had fewer years in practice (9.9 vs 17.3 years) compared to osteopaths who used the technique less often. ConclusionOsteopaths who reported that they often used MET were more likely to be male, often use counterstrain and more likely to use orthopaedic testing in patient examination. The study provides an insight into how Australian osteopaths practice, particularly their use of MET. Implications for practice•When the responses of 922 Australian osteopaths who participated in a practice-based research network were dichotomized according to usage of MET, the majority reported they use MET frequently.•MET and counterstrain appear to be used in combination for musculoskeletal patient care by Australian osteopaths.•Australian osteopaths who reported often using MET were more likely to see patients for low back pain, perform orthopaedic testing, use neurological cranial nerve testing, and refer for diagnostic imaging.•The practice characteristics of osteopaths who use MET often compared to those who do not reveal insight into different practice styles within the osteopathic profession.

Effect of joint manipulation and muscle energy technique in patients with Chronic Obstructive Pulmonary Disease: A review

Effect of joint manipulation and muscle energy technique in patients with Chronic Obstructive Pulmonary Disease: A review

Manual lymphatic drainage and muscle energy techniques after third molar surgery: A randomized split‐mouth clinical trial

AbstractObjectiveThe aim was to verify if manual lymphatic drainage (MLD) and muscular energy techniques (MET) helps on pain control and amplitude of mouth opening, in patients submitted to bilateral third molars surgeries.MethodsThirty consecutive patients, aged between 18 and 45 years, 53.7% males, were randomized in two groups: physical therapy group (PG), treated with MLD and MET on one random side of the mouth, being the other side, the control (CG). Additionally, for CG, paracetamol and dexamethasone were prescribed. The control of pain and inflammation in the PG was performed using manual therapy techniques (MLD and MET) and paracetamol. Postoperative pain was evaluated through visual analogue scale (VAS) and maximum active mouth opening by using a digital caliper.ResultsOn the 8th postoperative day the VAS were 2.13 ± 1.84 in the CG and 0.33 ± 1.45 in the PG (p &lt; 0.05); the maximum active mouth opening range were 36.85 ± 6.39 mm in the CG and 53.30 ± 6.66 mm in the PG (p &lt; 0.001).ConclusionThe present study emphasized that physical therapy is a good, noninvasive, alternative for the control of pain and limitation of mouth opening in the postoperative period of third molars surgery.Impact StatementThe postoperative physical therapy (PPT) represents an efficient modality of treatment that allows a faster and better noninvasive postoperative recovery after third molar surgery. PPT can be used in public health services by integrating physiotherapists in the dental teams reducing the need for pharmacological therapies.

Effects of Muscle Energy Technique with and without Functional Task Training on Pain and Disability in Sacroiliac Joint Dysfunction

Effects of Muscle Energy Technique with and without Functional Task Training on Pain and Disability in Sacroiliac Joint Dysfunction

Comparative Study of Efficacy of Muscle Energy Technique and Positional Release Therapy in Post ACL Reconstruction in Young Adults: A Randomised Clinical Trial

The anterior cruciate ligament (ACL), it is a dense connective tissue band originating from the medial wall of the lateral femoral condyl and inserts into the middle of the intercondylar region on the tibia. It is regarded as a crucial component in the knee joint because it resists anterior tibial translation and rotational load. Young athletes who participate in sports that demand turning, decelerating, and jumping are at high risk for ACL injury. People who participate in Pivoting sports are likely to have them (e.g. football, basketball, netball, soccer, European team handball, gymnastics, downhill skiing). Environmental (e.g., high friction between shoes and the playing surface) and anatomical variables are also risk factors for ACL injury (e.g. narrow femoral intercondylar notch). Knee instability causes a reduction in activity, which can result in a decrease in knee-related quality of life. ACL injury risk factors have been classified as either internal or external to a person. Type of competition, footwear and surface, and environmental conditions are all external risk factors. Anatomical, hormonal, and neuromuscular risk factors are all internal risk factors.&#x0D; Aim and Objective: to compare the efficacy of Myofacial Release Technique versus Positional Release Therapy on range of motion post ACL reconstruction.&#x0D; Methodology: In this study total 45 patients with post ACL reconstruction will be divided into two groups, one group will receive muscle energy technique and other group will received positional release therapy. The treatment will be given for 5 sessions per week for six weeks. The assessment will be done at day one of treatment at the end of treatment at the end of first week and at the end of six week.&#x0D; Discussion: This study will find the better technique for improving Range of motion Post ACL reconstruction.&#x0D; Conclusion: Conclusion of the study will be drawn after the statistical analysis of the data gathered from the individuals enrolled in the study.

Web Axillary Pain Syndrome-Literature Evidence and Novel Rehabilitative Suggestions: A Narrative Review.

Axillary web syndrome (AWS) is defined as a visible and palpable network of cords in the skin of the axillary cavity that are tensed by shoulder abduction following surgery for breast cancer, causing significant functional limits of the ipsilateral upper limb (UL) and pain. The purpose of this narrative review is to discuss rehabilitation approaches for greater efficacy with respect to pain and novel suggestions. AWS is a frequent complication of axillary lymphadenectomy that necessitates a thorough follow-up in the medium to long term. Physiotherapy is effective in the treatment of functional limb deficits, the management of pain, and the treatment of upper limb disability. The best management approach involves the use of soft tissue techniques to slow the natural course of the syndrome, in association with therapeutic exercises for functional recovery and muscle strengthening. AWS is linked secondary lymphedema, requiring integration with manual lymphatic drainage. The physiotherapy management of AWS is currently fragmented, and insufficient information is available on the nature of the disease. Thus, randomized and controlled studies that compare rehabilitation approaches in AWS are desirable, including the possibility of using mesotherapy in the treatment of axillary and upper limb pain.

Muscle Energy Technique, Stretching and Strengthening on Hip Rotation Range and Kick Distance in Football Players with Adductor Related Groin Pain

Background: Football is a commonly played team sport, and kicking is the primary skill needed. The incidence of adductor strain is high in football players, and thus their kick distance is affected due to groin pain. This indicates the importance of stretching and strengthening exercises as a necessary therapeutic technique to treat these sportspeople.Objective: To compare the effectiveness of muscle energy techniques (MET), stretching and strengthening exercises on hip rotation, and kick distance.Design: Randomized Control Trial.Methods: Forty football players suffering from groin pain due to adductor strain were selected from five professional soccer clubs in Jazan, Saudi Arabia, and randomized into two equal groups. Affected hip joint rotation [Internal + External Rotation] range, instep kick, and sidekick distances were measured and documented as baseline values. In addition, group A received MET, stretching, and strengthening exercises, whereas group B received only stretching and strengthening exercises for six weeks. Post-test values of the outcome measures were recorded at the end of the intervention.Results: Statistical comparison of the results between the groups showed that the MET group had significant improvement than the strengthening and stretching group in the hip rotation range (p&lt;0.005), but the difference was not significant for both in-step kick and front kick distance (p&lt;0.0001).Conclusion: Thus, adding MET to the routine strengthening and stretching exercise regimen can be clinically beneficial in treating groin pain among football players.

The Immediate Effects of Muscle Energy Technique on Range of Motion and Isokinetic Muscle Strength in Volleyball Players with Glenohumeral Internal Rotation Deficit: A Randomized Controlled Trial*

The Immediate Effects of Muscle Energy Technique on Range of Motion and Isokinetic Muscle Strength in Volleyball Players with Glenohumeral Internal Rotation Deficit: A Randomized Controlled Trial*

Effect of Muscle Energy Technique versus Motor Control Exercise Adjunct to Conventional Therapy on Pain, Range of Motion and Functional Disability in Patients with Chronic Neck Pain – A Research Protocol

Background: Physical, neuropathic, or secondary causes can all contribute to neck difficulty. Any other illness might be acute 6 weeks, subacute 3 months, or chronic (lasting more than 6 weeks) (lasting up to three months). Physical consequences, life-distressing or non-life- distressing causes, large and small factors, reliable and inaccurate neck pain. Motor control is a motor retraining programme that focuses on the neck flexors, extensors, and shoulder girdle muscle's coordination and holding skills. MET is a treatment method that makes use of the patient's muscles contracting in a specific, directed manner against a therapist-applied counterforce.&#x0D; Methodology: The participants in the study will be enrolled of 50 patients who suffer from prolonged neck pain. And each group will be split into 25 people. One group will get MET for four weeks, whilst the other will get MCE and traditional treatment. Pain, ROM, and Functional Disability will be reviewed using a methodical approach.&#x0D; Conclusion: We need to see how this experiment affects people of MET versus MCT in addition to conventional therapy core on pain, ROM and functional Impairment on neck discomfort that persists. In conclusion, the focus of this research is to find out the efficacy of MET versus MCT in addition to standard therapy, as well as its impact on chronic Neck discomfort has a negative impact on one's quality of life. This study will aid in the relief of chronic neck pain.

The Effects of Instrument-Assisted Soft Tissue Mobilization, Tissue Flossing, and Kinesiology Taping on Shoulder Functional Capacities in Amateur Athletes.

Instrument-assisted soft tissue mobilization (IASTM), tissue flossing, and kinesiology taping are increasingly popular treatments among athletes for improving functional performance, despite limited evidence for their efficacy. Previous research regarding the efficacy of soft tissues and neuromuscular techniques on improving functional capacity of shoulder joints in athletes has yielded conflicting results. We examined the immediate and short-term effects of IASTM, flossing, and kinesiology taping on the functional capacities of amateur athletes' shoulders. Randomized controlled study. Clinical assessment laboratory. Eighty amateur overhead athletes (mean [SD]: age = 23.03 [1.89]; weight = 78.36 [5.32]; height = 1.77 [.11]). We randomly assigned participants to 4 research sub-groups in which they received the following treatments on their dominant shoulders: IASTM (n = 20), flossing (n = 20), both IASTM and flossing (n = 20), and kinesiology tape (n = 20). Nondominant shoulders served as controls. We evaluated participants-before, immediately after, and 45minutes after the therapeutic interventions-with the following tests: internal and external shoulder rotation range of motion, isokinetic strength and total work, the functional throwing performance index, and the one-arm seated shot put throw performance. All therapeutic interventions significantly improved the strength and functional performance of the dominant shoulder in comparison with the control (P < .005) immediately after and 45minutes after the treatment. The IASTM led to significantly greater improvement in shoulder internal rotation than kinesiology taping immediately after (P = .049) and 45minutes after the treatment (P = .049). We observed no significant differences between the other treatment interventions (P > .05). Findings from the current study support the use of novel soft tissue and neuromuscular techniques for the immediate and short-term improvement of the shoulder functional capacities in amateur overhead athletes.

The Immediate Effect of Muscle Energy Technique and Whole Body Vibration on Hamstring Muscle Flexibility and Stiffness in Healthy Young Females

The Immediate Effect of Muscle Energy Technique and Whole Body Vibration on Hamstring Muscle Flexibility and Stiffness in Healthy Young Females

A study to assess the effectiveness of muscle energy technique with sleeper stretch on posterior shoulder tightness in tennis players

The objective of this study was to assess the effectiveness of muscle energy technique with sleeper stretch on posterior shoulder tightness in tennis players. The study was conducted on 50 tennis players with posterior shoulder tightness by using GIRD (Gleno-humeral internal rotation deficit) criteria and the subjects fulfilling the inclusion and exclusion criteria were included in the study. All subjects were evaluated for the range of motion of shoulder joint using a goniometer and SPADI scale was used to measure pain and disability index of the shoulder joint. The results showed the statistically significant (p

Effectiveness of Muscle Energy Technique Versus Strain Counter Strain Technique on Trigger Points of Quadratus Lumborum among Low Back Pain Patients

Objective: To determine the effectivness of muscle energy technique versus strain counter strain techniques on trigger points of quadratus lumborum among patients with low back pain. Methodology: A quasi-experimental trial was conducted on 40 patients who had low back pain due to trigger points in Sialkot medical complex hospital, Sialkot. The participants were divided into group A (MET) and group B (SCS). Group A was treated with muscle energy techniques and moist heat therapy, while Group B was treated with strain counter strain technique and moist heat therapy for two weeks. Numeric pain rating scale and Modified Oswestry Disability Questionnaire were used. Data was analyzed on SPSS 21. Results: The mean score of the Oswestry Disability Index (ODI) was 53.10±7.35 and 56.60 ± 7.89 at the start of treatment in group A (MET) and group B (SCS), respectively. The final ODI score for group A (MET) and group B (SCS) was 22.25± 5.87 and 37.70± 7.87, respectively. The mean value of pain intensity on the Numerical Pain Rating Scale (NPRS) was 7.30±1.25 vs. 7.85±1.26 at the start of treatment in Group A (MET) and Group B (SCS), respectively. The post-treatment NPRS score was 3.20 ±1.16 vs. 4.55±1.20 for Group A (MET) and Group B (SCS), respectively. Conclusion: According to the findings of this study, both METS and SCS significantly improved pain and functional disability in patients with low back pain caused by trigger points in the quadratus lumborum. However, in terms of mean difference, METS are more effective than SCS. Keywords: Strain counter strain, METS, Trigger points, Quadratus lumborum, Low back pain

Immediate Effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Pain in Diabetic Patients with Periarthritis of Shoulder

Background: Periarthritis Shoulder, also known as adhesive capsulitis, is a condition that results in tissue degeneration, thickening of the joint capsule, and a narrowing of the glenoid cavity. Diabetes mellitus is linked to many debilitating musculoskeletal disorders of the hand and shoulder. Prevalence of adhesive capsulitis or frozen shoulder is estimated to be 11-30 percent in people with diabetes. Various interventions have already been used to prevent pain and improve quality of life. Both Muscle Energy Technique and Kalternborn Mobilization Technique are thought to have a pain-relieving effect.&#x0D; Aim &amp; Objective: The study's aim is to compare the effects of both techniques on pain in diabetic patients.&#x0D; Methods/Design: In this study experimental study, the participants will be divided into two groups: Kalternborn Mobilization Technique Group (A) and Muscle Energy Technique Group (B) based on inclusion and exclusion criteria. Both interventions include 30-45 min session which will be carried out for duration of four days. Outcome will be Pain and Quality of Life and outcome measures will be evaluated at beginning and at the end of intervention period.&#x0D; Result: Successful Completion of trial of Muscle Energy Technique and Kalternborn Mobilisation Technique will provide evidence for best strategy targeting Pain and quality of life in diabetic patients with Periarthritis of Shoulder.&#x0D; Conclusion: The study will be concluded with the significant effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Periarthritis shoulder of diabetic patients.

Effect of shoulder internal rotators strengthening versus muscle energy technique for shoulder external rotators on bowling speed among fast bowlers playing cricket: a study protocol

BACKGROUND AND PURPOSE: The literature has shown the promising effect on shoulder internal rotators strengthening on fast bowlers. However, no previous study has demonstrated the effect of muscle energy technique for shoulder external rotators on fast bowlers. This study aims to analyze the efficacy of shoulder internal rotators muscles strengthening and muscle energy technique for external rotators enhancing the bowling in speed among fast bowlers in cricket. METHODS/DESIGN: Participants will be screened based on the inclusion and exclusion criteria. Demographic data shall be collected. Participants taken shall be in the age group between 18-30 years, be randomly assigned into two groups: exercise group and MET group. Outcomes considered in the study are Universal Goniometer and Bowling speed km\h. This is a two-group, pre-test, post-test randomized clinical trial. Participants will receive 5 sessions per week within 2 months. The range of motion and speed of the ball is the primary outcome measures to the pre and post-intervention effect of the treatments. PERSPECTIVES: Results from this study can provide the basis for studying the strengthening of the shoulder internal rotator muscles and MET of shoulder external rotators in rehabilitation and clinical setups, which will provide additional help to the bowlers increase bowling speed. The procedure of the study is noninvasive, safe, and feasible. The efficacy of shoulder internal rotator strengthening and muscle energy technique for shoulder external rotators on fast bowlers in each group will be established with this study. TRIAL REGISTRATION: Clinical Trials Registry- India. (CTRI/2020/06/026046). Universal Trial Number- U1111-1257-4649.

Effect of Spencer Muscle Energy Technique Versus Maitland’s Mobilization Technique on Pain, ROM and Disability in Patients with Frozen Shoulder: A Comparative Study

Background: Adhesive capsulitis is characterized by a painful, gradual loss of both active and passive glenohumeral motion resulting from progressive fibrosis and ultimate contracture of the glenohumeral joint capsule. Patients with Adhesive capsulitis have difficulties in everyday activities and shoulder pain also disturbs sleep at night on the affected side. Muscle energy technique helps in increasing shoulder range of motion. Maitland Mobilization is commonly used in the treatment of frozen shoulder. SPENCER Muscle Energy Technique (MET) is unique in its application as the client provides the initial effort while the practitioner facilitates the process. Objective: Objectives of the study was to compare the effect of Spencer MET Vs Maitland’s mobilization on pain, Range of Motion (ROM) and Disability in the patients with frozen shoulder. Methods: In the present experimental study, total 58 patients with frozen shoulder were included. Inclusion criteria were male and female with age of 40 to 60 year with unilateral frozen shoulder (at least 3-month duration). Patients were randomly allocated in two groups with 29 patients in each group: SPENCER MET and Conventional physiotherapy and MM and conventional physiotherapy for 5days a week with total duration of 4 weeks. Pre and post intervention assessment was carried out by using VAS, SPADI and ROM. Data was analysed by using SPSS 15 version. Results: Paired t test was applied within group comparison and result showed statistically significant difference in post intervention measurement compared to pre intervention for improving pain, reducing disability and increasing all ROM in both the groups. Independent t test was applied between group comparison and result showed statistically significant difference between groups mean pre-post differences in improving pain, reducing disability and increasing all ROM except extension and internal rotation. Conclusion: This study concludes that both the techniques used in the present study i.e., Spencer Muscle Energy Technique and Maitland Mobilization are effective for improving pain, reducing disability, and increasing ROM. However, SPENCER MET is the more effective for improving pain, reducing disability, and increasing ROM compared to Maitland Mobilization in patients with frozen shoulder. KEY WORDS: Frozen shoulder, SPENCER MET, Maitland mobilization, Shoulder Pain and Disability Index, Visual Analogue Scale.

English

BACKGROUND Evidence till date indicates high incidence of neck pain, and soft tissue techniques [muscle energy technique (MET), strain counter strain (SCS)] have proven to be effective for non-specific neck pain (NSNP). However, their comparative effect is yet to be proven, hence the present study attempted to investigate the comparative effectiveness of MET with SCS techniques in individuals with NSNP. METHODS Total 10 participants diagnosed with NSNP were included in the study. They were allocated into two groups utilizing convenient sampling. Group A received MET with SCS technique and Group B received MET with conventional physiotherapy. The interventions were given for 2 weeks, 3 sessions per week for 45 minutes. The outcome measures used in the study were numeric pain rating scale (NPRS), neck disability index (NDI), range of motion (ROM) which were assessed before the intervention immediately after the first session and at 1st week and end of 2nd week. RESULTS Intragroup comparison found to be significantly reduced in terms of pain and neck disability index and improvement in cervical range of motion (P = &lt; 0.05). However intergroup comparisons showed significant difference in Group A only at the end of 2nd week of intervention (P = &lt; 0.05), but the results were not significant immediately and at the 1st week of intervention (P = &gt; 0.05). CONCLUSIONS The study concluded that MET with SCS technique is more effective in reducing pain, neck disability and improving cervical range of motion. KEY WORDS MET, SCS, NSNP

Perceptions and experiences of a manual therapy trial: a qualitative study of people with moderate to severe COPD

BackgroundChronic obstructive pulmonary disease (COPD) presents with physical, emotional and social difficulties that affect quality of life. Multimodal management includes both pharmacological and non-pharmacological strategies, and pulmonary rehabilitation (PR) plays an important role. Recent research has suggested that manual therapies may improve perceptions of dyspnea for people with COPD.MethodsFocus group interviews were conducted as part of a mixed methods study to assess the feasibility of implementing a manual therapy technique—muscle energy technique (MET)—as an adjunct to PR for people with moderate to severe COPD. Focus group interviews were conducted to examine trial participants views of the intervention and the trial design. A thematic analysis was undertaken to explore the data.ResultsTwelve participants with moderate to severe COPD participated in three focus groups. Participants were motivated to participate in the trial to be proactive about their health. They perceived MET to be a gentle, comfortable form of stretching that allowed them to ‘breathe easier’ and prepared them for PR. A small number of participants reported mild muscular discomfort during MET, but this was short-lasting and was not bothersome. Participants enjoyed the one-on-one contact with researchers and learned more about their breathing while performing spirometric testing. Most participants wanted longer and more frequent MET sessions, and some requested ‘homework’ stretching exercises.ConclusionsThe findings of this study show that a manual therapy intervention was received well by participants in a clinical trial setting. A small number of participants reported mild musculoskeletal discomfort in relation to the MET treatment. Participant preferences for additional and longer treatment sessions should be carefully considered against available resources in future clinical trials.Trial registrationANZCTR, ACTRN12618000801213. Registered 11 May 2018 - Retrospectively registered. http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374643&isReview=true

The Changes of Motor Control Strategies in Non-specific Chronic Low Back Pain During Spinal Manipulation and Muscle Energy Techniques: A Beta-band Intermuscular Pair-Wise Coherence Analysis

Background: Until now, a variety of techniques have been introduced to address the adverse effects of NS-CLBP, including spinal manipulation technique (SMT) and muscle energy technique (MET). However, most of these techniques have focused on pain assessment and disability. In other words, the intermuscular synchronization between the co-contracting muscles was not considered, and hence, the effectiveness of these techniques on the corticospinal tract function was not studied. Objectives: This study aimed to compare the effects of SMT and MET on corticospinal tract function during four phases of standing, flexion, relaxation, and extension in flexion-extension task (F-ET) in NS-CLBP using pair-wise coherence of Beta-band intermuscular coherence (Bb-IMC). Methods: Twenty volunteer healthy male subjects and twenty-four male subjects with NS-CLBP (20 - 45 years of age) participated in this work. The patients had continuous or recurrent symptoms for three months or more without any referral pain to the lower extremities. The patients were randomly assigned to two equal intervention groups (SMT and MET), and the techniques were applied as described by Greenman. Surface electromyography (sEMGs) from lumbopelvic muscles was recorded for all participants (i.e., healthy group and the patient groups), while they performed three trials of F-ET, and the pair-wise coherence for all muscles was calculated using Bb-IMC analysis. Besides, in the patient's groups, sEMGs from the muscles were recorded before and after the interventional techniques (i.e., SMT and MET), while they performed three trials of F-ET, and the pair-wise coherence was calculated. Multivariate analysis of variance test was used to compare the healthy subjects and patient groups before the interventions in A and B muscle cross at different phases of F-ET task. Furthermore, in the NS-CLBP patients, comparisons were made before and after the interventions in each group (i.e., SMT and MET groups) as well as between the two groups in A and B muscle cross at different phases of the F-ET task. Results: In the standing phase of F-ET, there were no significant differences in the SMT and MET group before and after the intervention in PWC of A muscle cross and B muscle cross (P &lt; 0.05). Considering the flexion phase, there were significant differences in the SMT group in all pair muscles as PWC (M1-M4), PWE (M1-M6), PWC (M4-M6) (P &lt; 0.05), whereas there was one significantly in PWC (M4-M6) in the MET group (P &lt; 0.05). In the relaxation phase, the SMT had significantly in PWC (M2-M5), whereas there was one significantly in PWC (M4-M6) in MET group (P &lt; 0.05). In the extension phase, although the SMT was not significant (P &lt; 0.05) in the MET intervention group, there were significant differences in the PWC (M2-M3) and PWC muscles (M2-M5). Conclusions: This study provided some pieces of evidence about the effects of one of the common manual therapy techniques on the primary motor cortex and corticospinal drive in the NS-CLBP patients. The results showed that, by increasing the pair-wise coherence in all phases of FE-T, SMT intervention was more effective than MET intervention. Therefore, the pair-wise coherence of Bb-IMC can be considered an approach for clinicians when designing the rehabilitation protocol to ensure optimal treatment.

POST-OPERATIVE REHABILITATION IN TRAUMATIC DISTAL BICEPS TENDON RUPTURE WITH ULNAR ARTERY INJURY AND ULNAR NERVE NEUROPATHY MANAGED WITH SURGICAL RECONSTRUCTION

The Biceps Brachia is an anterior arm muscle consisting of two heads that bridge the shoulder girdle to the forearm. The distal biceps tendon from both heads may converge or remain anatomically separate before attachment to the radial tuberosity. The incidence of distal biceps rupture is 1.2/100,000 per year and is mostly seen in middle-aged men. The rupture of the biceps tendon is a relatively less common lesion making this case unique. Physiotherapy rehabilitation post-surgery is found to be effective; it includes management of pain, increase range of motion exercises, strengthening exercises, muscle energy technique, cardiovascular fitness, all these together helps to improve patient outcomes. A case of the 40-year-old female is presented in this case report who underwent traumatic glass-cut injury in proximal forearm resulting in distal bicep-tendon repair with ulnar artery injury and ulnar nerve neuropathy. After surgical reconstruction patient presented with pain in the shoulder, elbow, and wrist, reduced range of motion, strength, and grip strength leading to difficulty in performing activities of daily living. Surgical history, clinical findings, outcomes, and rehabilitation are mentioned in this report. We report that there is a significant improvement in stability, range of motion, muscle strength, relief from pain, and improvement in the patient's functional level and outcomes.