Effects of muscle energy technique on pain, range of motion and function in patients with post-surgical elbow stiffness: A randomized controlled trial

Abstract

Background: Elbow is a very functional joint. Elbow stiffness is a significant cause of disability hampering the function of the upper extremity as a whole. Muscle Energy Techniques (METs) are relatively pain-free techniques used in clinical practice for restricted range of motion (ROM). Objective: To study the effects of MET on pain, ROM and function given early in the rehabilitation in post-surgical elbow stiffness. Methods: An RCT was conducted on 30 patients post elbow fracture fixation. Group 1 was given MET immediately post removal of immobilization while Group 2 received MET 1 week later along with the rehabilitation protocol. Pain (Visual Analogue Scale), ROM (goniometry) and function (Disability of Arm, Shoulder and Hand questionnaire) were assessed pre and post 3 weeks. Results: Group 1 showed greater improvement than Group 2, mean flexion and extension change between groups being [Formula: see text], 95%CI(5.9,17.4) and [Formula: see text], 95%CI(4.4,12.7), respectively. VAS and DASH scores improved better in Group 1, mean change being [Formula: see text], 95%CI(0.6,1.8) and [Formula: see text], 95%CI(13.5,22.8) for VAS and DASH scores, respectively. Conclusion: MET can be used as an adjunct to the rehabilitation protocol to treat elbow stiffness and can be given safely in the early stages of post elbow fracture rehabilitation managed surgically with open reduction and rigid internal fixation.

Efficacy of Combination Therapies on Neck Pain and Muscle Tenderness in Male Patients with Upper Trapezius Active Myofascial Trigger Points

“…e results achieved by these authors are similar to the results achieved in this study for the combination of two manual techniques (MET plus ICT) in the management of neck pain and muscle tenderness due to upper trapezius active MTrPs. e concept of relief of neck pain and decreased muscle tenderness (trigger point sensitivity) by MET can be understood through its neurophysiological effect such as inhibitory Golgi tendon reflex and descending pathway of pain modulation theories, anti-inflammatory and vascular effects [13,18,35]. MET (isometric contraction of agonist muscles) induces inhibitory Golgi tendon reflex which results in the reflex relaxation of the antagonist muscles.…”

“…MET (isometric contraction of agonist muscles) induces inhibitory Golgi tendon reflex which results in the reflex relaxation of the antagonist muscles. At the same time, the mechanoreceptors available in the joint and muscles get activated which further leads to the excitation of sympathetic system via somatic afferent and activation of the periaqueductal gray matter (PEG) which regulate the descending pain modulation [35,36]. Rhythmic muscle contraction in MET also affects the rate of lymphatic and blood flow that bring the changes in interstitial pressure and increase transcapillary blood flow.…”

“…Hence, different mechanisms would probably act at the same time to reduce pain intensity and muscle tenderness due to active MTrPs. Recently, Faqih et al (2019) conducted a study using MET in patients with postsurgical elbow stiffness and found that the application of MET immediately after postsurgical elbow brought a significant improvement in pain intensity (VAS scores), ROM, and functions (DASH scores) [35]. Kashyap et al (2018) revealed that the MPR and the MET are equally effective in improving the VAS, PPT, NDI, and range of rotation scores among the participants with nonspecific neck pain due to MTrPs [23].…”

Effectiveness of Met v/S Marhythe in Individuals With Chronic Lateral Epicondylitis: A Randomized Clinical Trial

“…Descending pain modulation could be the reason for pain reduction. Here, when the joint mechanoreceptors get activated, there is the excitation of somatic afferents leading to sympathoexcitation and localized activation of periaqueductal gray matter [14]. According to Chaitow (2006) [15], MET is an active isometric contraction method that relaxes the muscle, restores the normal blood and lymphatic circulation by altering the interstitial pressure and transcapillary blood flow that helps in washing out the nociceptive stimulants which relieve pain.…”

Immediate Effects of Ischemic Compression Therapy on Myofascial Trigger Points on Pain, Mobility and Strength in Individuals With Subacromial Impingement Syndrome: A Single-arm Study

“…On the other hand, the isometric strength assessment could act in a positive way, since post-isometric relaxation is attributed to isometric contraction (24). According to the hypothesis of Taylor et al, isometric contraction could also alter muscle viscoelastic properties and passive extensibility, thus improving ROM (15,25,26).…”