Muscle Energy Technique Research Articles

The Efficacy of Manual Therapy in Patients with Knee Osteoarthritis: A Systematic Review.

Background and objectives: Osteoarthritis (OA) is among the most common degenerative diseases that induce pain, stiffness and reduced functionality. Various physiotherapy techniques and methods have been used for the treatment of OA, including soft tissue techniques, therapeutic exercises, and manual techniques. The primary aim of this systemic review was to evaluate the short-and long-term efficacy of manual therapy (MT) in patients with knee OA in terms of decreasing pain and improving knee range of motion (ROM) and functionality. Materials and Methods: A computerised search on the PubMed, PEDro and CENTRAL databases was performed to identify controlled randomised clinical trials (RCTs) that focused on MT applications in patients with knee OA. The keywords used were ‘knee OA’, ‘knee arthritis’, ‘MT’, ‘mobilisation’, ‘ROM’ and ‘WOMAC’. Results: Six RCTs and randomised crossover studies met the inclusion criteria and were included in the final analysis. The available studies indicated that MT can induce a short-term reduction in pain and an increase in knee ROM and functionality in patients with knee OA. Conclusions: MT techniques can contribute positively to the treatment of patients with knee OA by reducing pain and increasing functionality. Further research is needed to strengthen these findings by comparing the efficacy of MT with those of other therapeutic techniques and methods, both in the short and long terms.

Muscle energy technique versus active release technique on motor functions in patients with carpal tunnel syndrome

Introduction Carpal tunnel syndrome is the most common median nerve neuropathy, accounting for 90% of all neuropathies, with prevalence in the general UK adult population ranging from 7–16% and bilateral symptoms reported in more than 50% of all cases. The pathophysiological mechanisms involved in the median nerve compression and traction are thought to be complex. This study compared the effectiveness of muscle energy technique and active release technique in patients with carpal tunnel syndrome. Methods This study involved a total of 30 male and female patients with carpal tunnel syndrome, aged between 30 and 50 years. The patients were randomly assigned to two equal groups, group A and group B. Group A received muscle energy technique, and group B received active release technique. Results Independent one-tailed t-tests revealed that the intragroup comparisons showed statistically significant increases in pinch grip strength and motor nerve conduction velocity of the median nerve post-treatment in group A (P=0.001 and 0.0001 respectively), while in group B, there were statistically significant increases in pinch grip strength and motor nerve conduction velocity post-treatment (P=0.037 and 0.043 respectively). The intergroup comparisons showed statistically significant differences in favour of group A. Conclusions Because there was little significant difference between the two groups, this study concluded that both treatment techniques were effective in increasing median motor nerve conduction and hand grip strength. However, muscle energy technique increased motor nerve conduction velocity and pinch grip muscle strength more than active release technique.

Effect of Manual Therapy (MET) Versus Conventional Therapy for Improving Tendo-Achilles Flexibility and Foot Posture in children with Autism Spectrum Disorder

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects individuals across social, ethnic, and geographic groups. Autistic children have difficulty with gross motor and fine motor functioning difficulties including a wide range of signs and symptoms. Toe walking due to tendo-achilles (TA) tightness is commonly observed gait in autistic children altering foot posture in them. The knowledge about the abnormalities may be useful for the assessment and treatment planning of ASD children. Material and Methods: We evaluated TA tightness, ROM of the ankle joint, and compare the effect of Manual Therapy (MET) and conventional therapy for improving TA flexibility and foot posture. Procedure: A comparative study included twenty diagnosed autistic children as per inclusion criteria which were divided into two groups, Group A was given conventional therapy in the form of passive stretching, whereas Group B was given manual therapy in the form of muscle energy technique. The participants were clinically examined and evaluate TA tightness in the form of elastography, range of motion, and foot posture. Data were taken at baseline pre and after postintervention. Results: There was a significant improvement in elastography readings, range of motion, and foot posture index in both groups postintervention but significant improvement was observed in Group B as compared to Group A, i.e., P > 0.05. Conclusion: It was concluded that there is a significant effect of manual therapy in the form of muscle energy technique for improving TA flexibility and foot posture as compared to conventional therapy.

Effect of Muscle Energy Technique Versus Aerobic Exercise on Chronic Cyclic Pelvic Pain

Effect of Muscle Energy Technique Versus Aerobic Exercise on Chronic Cyclic Pelvic Pain

Effect of Muscle Energy Technique in Patients with Non-traumatic Lumbo-pelvic Pain in the Age Group of 30-40 Years

Purpose: Pelvic girdle and low back pain have fallen under the diagnostic umbrella of non-specific low back pain (NSLBP). It is true that low back pain can have it’s etiology in pelvic girdle mal-alignment, and similarly low back pain with neural irritation can lead to in co-ordination of muscles causing pelvic malalignment, it is important to understand that motor in co-ordination in the pelvic girdle can be the result of peripheral and/or central mechanisms. Peripheral mechanisms include reflexogenic muscle spasms whilst central mechanisms include cortical inhibition of muscles and/or delayed central transmission due to noxious input affecting intra-cortical synergistic control between various regions of the central nervous system (CNS). Muscle energy technique (MET) is a common conservative treatment for pathology around the spine, particularly lumbopelvic pain (LPP). MET is a gentle manual therapy for restricted motion of the spine and extremities and is an active technique where the patient, not the clinician, controls the corrective force. MET of the low back has decreased pain, increased range of motion, decreased muscle tension and spasm, and increased strength when used with supervised neuromuscular re-education and resistance exercise training. At present, the treatment effect and the outcome of one or two MET session is undefined. This study is designed to determine the effectiveness of brief MET sessions on posterior innominate/ Pelvic pain when used on subjects with non-traumatic pelvic pain. Materials and method: 20 male patients of convenient random sampling based on the inclusion criteria were included in the study and were given muscle energy technique- anterior rotation of Innominate bone for single session once a day for two days and the pre and post treatment outcome were recorded using VAS score and Pelvic inclinometer (PALM) measure. Results: The pre and post treatment effects using paired t-test and the correlation on VAS, shows a decrease of mean and SD from baseline (4.7 ± 1.03) to (1.95 ± 1.14) with (t=14.457, p =.001) indicating a very high level of significance. The pre and post treatment effects using paired t-test and the correlation on PALM, shows a decrease of mean and SD from baseline (10.5 ± 1.50) to (7.1 ± 1.07) with (t=12.803, p =.004) indicating a high level of significance. Conclusion: The results showed that Muscle Energy Technique is as effective as any other manual therapy techniques in the treatment of lumbo-pelvic pain or posterior innominate considered in this study, suggests that MET was highly effective in managing pain and neutralising the pelvic rotation angles with LPP. The treatment is evidenced, and provided as much benefit as any other manual therapy techniques for LPP. Some objective outcomes showed a trend which suggested that there might have been a great interaction if the sample size was larger. Thus the conclusion from this research is that there was a high statistical significance between the pre and post treatment with brief MET sessions in acute LPP.

Effectiveness of Suboccipital Muscle Inhibition Technique versus Muscle Energy Technique on Hamstring Muscle Flexibility in College Going Students

Background: Hamstring is one of the commonest muscle which often gets tight. Suboccipital muscle inhibition technique is a method of relaxing tension in four muscles located between occiput and axis which regulates the upper cervical vertebra. When the tone of suboccipital muscles falls, it has been reported that the tone of knee flexors such as hamstrings also decreases due to relaxation of myofascia. This is because hamstrings and suboccipital muscles are connected by one neural system, which passes through the duramater called the superficial back line. Muscle energy technique is a procedure that involves voluntary contraction of a patient’s muscle in a precisely controlled direction, at varying levels of intensity and has been utilized in lengthening of tight muscles. Method: The study was done after obtaining approval from ethical committee. Subjects having hamstring tightness who fulfilled inclusion criteria were selected from the population. 52 subjects were included and divided into two groups. The study was carried out for 5 days. Subjects in the experimental group were treated with SMIT and Subjects in control group were treated with MET. Outcome measures used were Active Knee extension test and Back Saver Sit and Reach Test. Data was analysed post treatment (Immediate effects) and at the end of 5th session using non- parametric tests at 5% level of significance. Result: Within group analysis at post treatment and at the end of 5th session showed significant improvement in both the outcome measures in experimental and control group. Between group analysis showed no significant effect post treatment whereas after 5 days significant difference was found where more improvement was found in the control group i.e. Muscle energy technique group. Conclusion: Suboccipital Muscle Inhibition Technique and Muscle Energy Technique both were effective in improving hamstring flexibility but Muscle energy technique was found to be more effective. Keywords: Suboccipital Muscle Inhibition Technique, Muscle Energy Technique (MET), Flexibility, Active Knee Extension (AKE), Back Saver Sit and Reach Test (BSRT).

Immediate Effect of Strain Counterstrain Technique versus Muscle Energy Technique on Upper Trapezius Tenderness in Non-Specific Neck Pain

Background: The most common form of neck pain is non-specific which is deep, dull aching & poorly localized. Non-specific pain is associated with upper trapezius tenderness. For people who work at desks and computers, or who spend many hours driving, have poor ergonomics which causes the upper trapezius to become sore and painful. The soreness can lead to the development of tender points which can be the major reason for developing neck pain and muscle spasm. Physiotherapy techniques like muscle energy technique and Strain counterstrain has been proposed to treat tenderness in trapezius. Objective: To compare the immediate effect of Strain Counterstrain Technique & Muscle Energy Technique on pain, pain pressure sensitivity & mobility on non-specific neck pain with upper trapezius tenderness using Visual analogue scale, Pressure Algometer & Universal Goniometer respectively. Method: 60 subjects were selected as per inclusion and exclusion criteria& were randomly assigned to Group A (n=30) & Group B (n=30); Strain Counterstrain and Muscle Energy Technique respectively. Visual Analogue Scale, Pain Pressure Sensitivity & Cervical Rotation & Lateral Flexion Motion bilaterally was noted before & after application of both techniques and the data was statistically analysed. Result: Both groups showed statistical significance (p< 0.05) differences in all outcome measures between pre test and post test values of Group A and Group B but there is no statistical significant (p> 0.05) difference in the outcome measures between groups. Conclusion: The study concludes that both techniques are equally effective in treating pain, increasing lateral flexion and rotation range of motion, and improving pain pressure sensitivity. Keywords: Strain Counterstrain, muscle energy technique, upper trapezius tenderness,visual analog scale, non-specific neck pain,pain pressures sensitivity.

Muscle Energy Technique in the Rehabilitative Treatment for Acute and Chronic Non-Specific Neck Pain: A Systematic Review.

Background: Non-specific neck pain (NNP) affects 30–50% of the general population, and it often leads to severe disability. Several manual therapy techniques are available to reduce pain and disability and to improve cervical range of motion and functional activities. Muscle Energy Technique (MET) showed more evidence for treating such a disorder. The aim of this current scientific literature analysis was to compare the clinical effects of MET with the other manual or rehabilitative treatments for non-specific acute and chronic neck pain. Methods: The literature search was conducted using the following databases: PubMed, Medline, PEDro, Cochrane Database, and Google Scholar from 2010 to January 2020. Clinical trials about MET were included. The quality of the trials was assessed according to the PEDro scale. Results: Twenty-one papers according to inclusion and exclusion criteria were selected: 15 studies about non-specific acute neck pain and 6 studies about non-specific chronic neck pain. Conclusions: This analysis suggests that the MET approach has a good clinical effect on reducing neck pain in patients with acute neck pain and improves cervical range of motion in patients with chronic neck pain, and is better if combined with a traditional rehabilitative approach. This review’s findings should be considered with caution for physiotherapy practice because of the studies’ methodologic limitations. On the basis of the current available and limited evidence, clinicians could combine MET with traditional physiotherapy and other manual techniques when treating people with non-specific neck pain.

Effectiveness of Muscle Energy Technique on Improving Hamstring Muscle Flexibility in High School Level Kabaddi Players

Introduction: Kabaddi is one of the most popular games, which makes it our national pride. Kabaddi requires a lot of power, strength, flexibility, agility, speed, breath control and wariness. The game comes under contact sports and hence injuries are common. Muscle Energy Technique (MET) is a form of manual therapy used to relax the muscles via autogenic or reciprocal inhibition and lengthen the muscle, which uses muscle’s own energy in the form of gentle isometric contraction. The purpose of this study is to find out the effectiveness of MET on improving hamstring muscle flexibility, active knee extension (AKE) range, and agility in high school level kabaddi players. Subjects: 30 female amateur kabaddi players Methodology: 30 high school level Kabaddi players were assessed and selected based on the inclusion and exclusion criteria, and assigned into two groups. Group A (experimental n=15) received MET along with conventional exercises and Group B received Conventional flexibility exercises alone for 5 consecutive days. Pre-post and a follow-up measurement of hamstring flexibility, AKE and agility was taken using flexometer, 90-90 test and agility T-test. Results: Statistical analysis was done using paired and unpaired t-test. In paired t-test, the hamstring muscle flexibility improved significantly on day 5, on follow-up day 8 measurement it showed reduction in flexibility but not significant for both groups. The AKE of right and left knee joint has significantly improved on day 5 and there was significant reduction on day 8. Whereas the agility for both groups has significantly improved on day 5 and 8. On unpaired t-test, there is significant difference between both groups for all 3 outcomes. Conclusion: The Muscle energy Technique is effective on improving hamstring muscle flexibility, Active knee extension range and agility in 5 day MET programme. Therefore, concluded that Muscle Energy Technique is effective and can be administered on-field prior to sports events, and thereby improve player’s performance. Keywords: MET, Kabaddi, Hamstring injuries, Flexometer test, active knee extension test, agility T-test.

MUSCLE ENERGY TECHNIQUE VS YOGASANA ON ILIOPSOAS TIGHTNESS TO IMPROVE FLEXIBILITY AND LUMBAR RANGE OF MOTION IN YOUNG ADULTS: A COMPARATIVE STUDY

Purpose of study:Iliopsoas is a muscle of lower extremity prone to tightness with prevalence of 83.8% in young and middle-aged adults leading to lower back pain. Objective: To compare the effect of Muscle Energy Technique versus Yogasana on Iliopsoas tightness to improve exibility and lumbar range of motion in Young adults. Methodology: 30 subjects with Iliopsoas tightness within age group 18-35 fullling the selection criteria were selected and assigned into Group A (n=15) that received Muscle Energy Technique and Group B (n=15) received Yoga technique “Anjanyesana”, both the groups underwent the intervention for 2 weeks, 3 sessions per week. Pre and Post treatment Modied Thomas Test, Lumbar range of motion for exion, Lumbar side exion and Lumbar side rotation were used as outcome measures. Results: Group A showed a statistical signicant difference with mean of 6.3±2.7, while Group B showed difference with mean of 10.0±4.64 on Modied Thomas test with p=0.021 post 2 weeks of intervention. There was statistically signicant improvement in lumbar side exion with p=0.02,with mean and SD of 3.3±1.952 for group A and 1.3±0.457 for group B. However, based on the mean values, other outcome measures showed better improvement in Group A as compared to group B. Conclusion: Both MET and Yogasana were effective in improving exibility of Iliopsoas and lumbar range of motion. While MET proved to show immediate effects in decreasing hip exion tightness, Yogasana was more effective following 2 week intervention.

Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome.

Studies have indicated that the muscle energy technique (MET) and the positional release technique (PRT) are effective in the management of piriformis syndrome (PS); however, evidence is scarce regarding the combination of these techniques in the form of an integrated neuromuscular inhibition technique (INIT) in the management of individuals with PS. Although a previous trial investigated the effect of INIT for PS, that study did not integrate Ruddy's reciprocal antagonist facilitation (RRAF) method into the INIT protocol, nor did the authors diagnose PS according to established criteria. To examine the effects of INIT with integrated RRAF compared with PRT in the management of patients diagnosed with PS. This study was designed as a single blind randomized clinical trial in which participants diagnosed with PS were randomly allocated into INIT and PRT groups. Each group attended two treatment sessions per week for 8weeks. Patients in the INIT group received a protocol in which the patient's tender point or trigger point was palpated in the belly of the piriformis approximately halfway between the inferior lateral angle of the sacrum and the greater trochanter, at which point the therapist applied an intermittent or sustained pressure and maintained the pressure for 20-60seconds (depending on the participant's response to pain reduction). For INIT patients, that protocol was also followed by RRAF, a method in which a patient introduces a series of tiny/miniature contractions or efforts (20 times per 10seconds) against a therapist's resistance. Patients in the PRT group were treated by palpating the same trigger point described in the INIT group, followed by application of light pressure at the location of the trigger point, which was maintained the pressure for 2minutes or until the pain subsided (determined by asking the participant to report a pain score using a visual analog scale at 30second intervals). For both groups, three repetitions of the INIT or PRT treatment were performed over 10minutes at each clinical visit. Additionally, each group also received stretching exercises immediately after the INIT or PRT treatment session. Each participant was assessed at baseline, immediately posttreatment, and at 4months posttreatment for pain, sciatica, functional mobility, quality of life, hip abduction, and internal rotation. A repeated measures analysis of variance (ANOVA) of within-between group interactions was used to analyze the treatment effect. Forty eight participants (age range, 25-47 years; mean age±standard deviation, 32.81±3.27 years) were randomized into the INIT and PRT groups, with 24 participants in each group. No significant between-group differences (p>0.05) were observed in the baseline demographic and clinical variables of the participants. A repeated-measures ANOVA indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (p<0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the INIT group improved significantly compared with the PRT group in all outcomes (p<0.05) immediately posttreatment and at the 4months follow up period. INIT was more effective than PRT in the management of individuals with PS. It should be noted the significant improvement achieved in both the groups may have also been contributed to by the stretching exercises that were used as adjunct therapies by both groups.

Collagen Matrix vs. Autogenous Connective Tissue Graft for Soft Tissue Augmentation: A Systematic Review and Meta-Analysis.

Soft tissues have been shown to be critical for the maintenance of both teeth and implants. Currently, regenerative soft tissue techniques propose the use of collagen matrices, which can avoid the drawbacks derived from the obtainment of autogenous tissue graft. A systematic review and meta-analysis were conducted to ascertain the efficacy of collagen matrices (CM) compared to autogenous connective tissue graft (CTG) to improve soft tissue dimensions. An electronic and manual literature searches were performed to identify randomized clinical trials (RCT) or controlled clinical trials (CCT) that compared CTG and CM. Pooled data of width of keratinized tissue (KT) and mucosal thickness (MT) were collected and weighted means were calculated. Heterogeneity was determined using Higgins (I2). If I2 > 50% a random-effects model was applied. Nineteen studies were included based on the eligibility criteria. When using CTG a higher MT gain (0.32 mm, ranging from 0.49 to 0.16 mm) was obtained than when employing CM. Similar result was obtained for the width of KT gain, that was 0.46 mm higher (ranging from 0.89 to 0.02 mm) when employing CTG. However, it can be stated that, although autogenous CTG achieves higher values, CM are an effective alternative in terms of total width of KT and MT gain.

THE EFFECTIVENESS OF PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION IN MECHANICAL NECK PAIN: A SYSTEMATIC REVIEW

Introduction: Neck pain is a health condition that has a high incidence rate and causes an inability to do daily activities and requires cost in handling it. People with neck pain could be associated with an alteration and deficit of the proprioception of the muscle and neck joint that play a significant role in joint position, postural stability, and motor control of the head and neck. Objective: The purpose of this systematic review is to find out the effectiveness of proprioceptive neuromuscular facilitation in mechanical neck pain. Method: The systematic review access to journal databases such as: PubMed Central (PMC) NCBI, Physiotherapy Evidence Database (PEDro), ProQuest, Google Scholar, MEDLINE, and the Cochrane Controlled Trials Register in the Cochrane Library. Results: The initial search in 6 databases found a total of 30 articles. Based on inclusion and exclusion criteria 4 articles were used in this systematic review. The application of the muscle energy techniques was applied ranging from 1 time to 8 weeks of intervention. From the 4 reviewed studies concluded that proprioceptive neuromuscular facilitation was effective in improving neck range of motion and function in mechanical neck pain. Conclusion: Based on the results of this systematic review it can be concluded that proprioceptive neuromuscular facilitation is effective in improving pain, pain threshold, range of motion, and functional performance in individual with neck pain. The appropriate articles are still limited to 4 studies, but have good to strong qualities. In addition, the application of intervention does not have the same standard.

Can the sleep quality of patients with chronic neck pain be improved by muscle energy techniques combined with Swedish massage?

Background and purposeMuscle energy techniques (METs) are used to reduce tension in neck muscles and therefore, can be used together with Swedish massage to enhance its effect. The aim of this study was to assess if using METs combined with massage could improve sleep quality. Materials and methodsIn this prospective, randomised controlled trial forty patients with chronic cervical spine pain were divided into two equal groups. Both groups attended 10 sessions of Swedish massage, and the study group additionally attended MET-sessions. Sleep disturbances were assessed with the Pittsburgh Sleep Quality Index (PSQI). ResultsA significant improvement in terms of sleep disturbances was seen in both groups. The MET group demonstrated improvement in all PSQI components. In the control group, the improvement included only 4 components of the index. ConclusionMassage therapy combined with relaxing METs may be more effective than massage therapy alone in this group of patients.

Effect of Mulligan’s Mobilization with Movement and Post Isometric Relaxation Technique on Pain, Range of Motion and Functional Outcome in Subjects with Adhesive Capsulitis

Mobilization techniques and soft tissue techniques are widely used in managing Adhesive Capsulitis. Among various researches on different mobilization, the study results showed that the clinical concepts of Mulligan’s Mobilization with movement is good. The results of various studies on different soft tissue techniques concluded that post isometric relaxation technique of Muscle energy technique is better. The aim of the study was to compare the effect of Mulligan’s Mobilization with movement and post isometric relaxation technique on pain, range of motion and functional outcome in subjects with Adhesive Capsulitis. 30 subjects were selected and divided into 2 groups of 15 subjects in each group by purposive sampling method. Subjects in Group A received Mulligan’s Mobilization with movement and conventional management, subjects in Group B received post isometric relaxation technique and conventional management for 4 weeks. Numerical Pain Rating Scale, Universal goniometer and Shoulder pain and disability index were used to measure pain, range of motion and functional outcome. There was a significant difference between the within group and between group in all parameters following intervention. However, Mulligan’s group has shown significant improvement in all parameters ( using unpaired ‘t’ test, the calculated ‘t’ value for pain is 10.27, p&lt;0.05 and the ‘t’ value for ROM is 22.45 for external rotation, 14.95 for abduction, p&lt;0.05 and the ‘t’ value for functional outcome is 6.71, p&lt;0.05). This study concludes that the Mulligan’s mobilization with movement is more effective in reducing pain, improving range of motion and functional outcome in subjects with Adhesive Capsulitis.

Effectiveness of Laser Therapy and Ultrasound Therapy along with Muscle Energy Technique in subjects with Trapezitis

Aim: To find the effectiveness of laser therapy and ultrasound therapy along with muscle energy technique in treatment of Trapezitis. Materials and Methods: Non-equivalent quasi experimental study design was used in this study. Total of 30 subjects with trapezitis were selected using non probability convenient sampling technique.30 Subjects was divided into two groups by lot system. Group A received laser therapy and Group B received ultrasound therapy and for both the group muscle energy technique was given. The outcome measures are Neck Disability Index (NDI) for measuring Functional Disability. Data collected and tabulated was statistically analyzed. Result: Statistical analysis of post-test, Neck Disability Index (NDI) revealed that there is statistically significant difference seen between Group A and Group B. Conclusion: From the result, it has been concluded that Laser therapy with muscle energy technique (Group A) was more effective than Ultrasound therapy with muscle energy technique (Group B) on improving functional ability in subjects with Trapezitis.

A comparative study of Thai massage and muscle energy technique for chronic neck pain: A single-blinded randomized clinical trial

BackgroundMyofascial pain syndrome (MPS) is the most common form of muscle disorders. Traditional Thai massage (TM) and muscle energy (ME) technique have been used to treat patients with MPS for long time but head-to-head comparisons of these interventions have not been established. AimThe aim of the current study was to compare the effects of TM and the ME technique on pain intensity (PI), pressure pain threshold (PPT), neck disability (ND), and neck flexion range of motion (NFROM) in patients with chronic neck pain associated with myofascial trigger points (MTrPs). DesignA randomized, single-blinded clinical trial. SettingDepartment of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University. PopulationForty-five patients with chronic neck pain associated with MTrPs were recruited. MethodsThe patients were randomly allocated to the TM, ME, or control groups, with each having eight treatment sessions over a period of two weeks. PI, PPT, ND, and NFROM were assessed before, immediately after the first treatment session, and one day after the last treatment session. ResultsBased on the results, both TM and the ME technique resulted in a significant improvement in all parameters (p < 0.05) compared to the control group. Additionally, no significant difference was observed between TM and the ME technique in all parameters. ConclusionsThe application of TM or the ME technique can be a practical alternative approach for the treatment of chronic neck pain associated with MTrPs.

The profile of older adults seeking chiropractic care: a secondary analysis

BackgroundMusculoskeletal conditions are the primary reason older adults seek general medical care, resulting in older adults as the highest consumers of health care services. While there is high use of chiropractic care by older adults, there is no recent, specific data on why older adults seek chiropractic care and how chiropractors manage conditions. Therefore, the purpose of this study was to describe the demographic characteristics of older adults seeking chiropractic care, and to report problems diagnosed by chiropractors and the treatment provided to older adults who seek chiropractic care.MethodsA secondary data analysis from two, large cross-sectional observational studies conducted in Australia (COAST) and Canada (O-COAST). Patient encounter and diagnoses were classified using the International Classification of Primary Care, 2nd edition (ICPC-2), using the Australian ICPC-2 PLUS general practice terminology and the ICPC-2 PLUS Chiro terminology. Descriptive statistics were used to summarize chiropractor, patient and encounter characteristics. Encounter and patient characteristics were compared between younger (< 65 years old) and older (≥65 years old) adults using χ2 tests or t-tests, accounting for the clustering of patients and encounters within chiropractors.ResultsA total of 6781 chiropractor–adult patient encounters were recorded. Of these, 1067 encounters were for persons aged > 65 years (16%), from 897 unique older patients. The most common diagnosis within older adult encounters was a back problem (56%), followed by neck problems (10%). Soft tissue techniques were most frequently used for older patients (85 in every 100 encounters) and in 29 of every 100 encounters, chiropractors recommended exercise to older patients as a part of their treatment.ConclusionsFrom 6781 chiropractor–adult patient encounters across two countries, one in seven adult chiropractic patients were > 65 years. Of these, nearly 60% presented with a back problem, with neck pain and lower limb problems the next most common presentation to chiropractors. Musculoskeletal conditions have a significant burden in terms of disability in older adults and are the most commonly treated conditions in chiropractic practice. Future research should explore the clinical course of back pain in older patients seeking chiropractic care and compare the provision of care to older adults across healthcare professions.

A Closer Look into the Association between the Sacroiliac Joint and Low Back Pain.

INTRODUCTIONLow back pain is the most common type of global disability and annually costs the United States over two billion dollars. Opioids have been used to reduce low back pain, although current evidence concerning efficacy is lacking. Sacroiliac joint dysfunction (SIJD) is estimated to be a primary pain source of low back pain in between 10 and 25% of affected patients. The primary objective of this study was to evaluate the rate of SIJD identified through osteopathic techniques in a convenience sample of patients seeking low back pain treatment. The secondary objective was to assess prevalence of low back pain and SIJD among different age groups, and genders.METHODSRetrospective chart reviews were completed the adult patients who had received osteopathic manipulative treatment for low back pain at Family Health and Wellness Center in Essexville, MI from January 2018 through June 2019. The prevalence of patients with SIJD was identified during reviews of osteopathic procedural documentation for patients seeking low back pain treatment. Data regarding patients’ age, sex, and treatment modalities were also extracted. Descriptive statistics consisting of frequencies and percentages were calculated.RESULTSA total of 84 patient records were reviewed. A total of 51 (60.7%) patients seeking low back pain treatment were diagnosed with SIJD identified by osteopathic providers. This included patients with both lumbar and sacral diagnoses simultaneously. SIJD alone accounted for 26 (31%) of patients seeking treatment. Female patients were more likely to have SIJD involvement than males. Forty one (48.8%) treated patients were between 45-64 years old. Muscle Energy Technique was documented to be the most used for 68 (81%) patients. In addition, techniques tended to move from direct to indirect for older patients.DISCUSSIONOur study demonstrated that SIJD appeared to contribute to low back pain in 51 (60.7%) of low back pain cases identified using osteopathic techniques. This is much greater than the previously reported percentages of 10 to 25%. One possible confounding influence included varied resident screening and reporting of sacral dysfunction. Since multiple areas of the body can be treated at one time, our current procedure notes did not allow for distinguishing between which types of modalities were used on each region or capture residents’ preferred treatments.CONCLUSIONSAlthough further studies are needed, our results suggest that knowledge of SIJD’s impact on low back pain could lead to improved patient outcomes such as decreased medical costs and opioid use.

Comparison of two manual therapy approaches combined with exercise on pain, strength and electromyographic muscle activity in athletes with subacute mechanical low back pain

Subacute mechanical low back pain (MLBP) has been found to increase significantly in athletes in the past decade. Manual therapy combined with exercises seems to be promising option; however, its potential effect in athletes is not fully known yet. The study aimed to compare between the effects of mulligan sustained natural apophyseal glides (SNAG) combined with exercise, muscle energy technique (MET) combined with exercise therapy and exercise therapy alone on pain, strength and muscle activity in athletes with subacute mechanical low back pain (MLBP). The athletes were screened for inclusion into the study using physical examination and Oswestry Disability Index (ODI). The study was a randomized 3 arm repeated measure design and a total of thirty athletes completed the study (n = 30). Athletes in group 1 received mulligan sustained natural apophyseal glides (SNAG) combined with exercise, group 2 received muscle energy technique (MET) combined with exercise while those in group 3 were submitted to exercise only. Athletes in all groups received treatment 3 times a week for 4 weeks. The outcome measures were visual analog scale (VAS) scores, back extensor strength and electromyographic (s EMG) muscle activity of longissimus lumborum (LL) and transversus abdominis (Tr A). The VAS score were decreased in all three groups (p < 0.05); however, group 2 and group 1 were more effective than group 3 (p < 0.05). The back extensor strength increased in two groups (p < 0.05): group 2 showed a significant increase compared to group 1. The s EMG muscle activity of LL and Tr A increased in two groups (p < 0.05): group 2 showed a significant increase compared to group 1. There were significant time, group and interaction effects for the three outcome measures (p < 0.05). The addition of MET combined with exercise therapy reduces pain level, improves back extensor strength and muscle activity of LL and TrA in athletes suffering with subacute MLBP more than mulligan SNAG combined with exercise therapy and exercise therapy alone.