Effects of muscle energy techniques versus corrective exercise programme on pain, range of motion and function in patients with upper cross syndrome: a randomised clinical trial

Abstract

IntroductionUpper crossed syndrome (UCS) is a common musculoskeletal issue that includes the dysfunctional tone of the muscles in the shoulder girdle or cervicothoracic region. The objective of the current study is to compare the effects of muscle energy techniques with the National Academy of Sports Medicine-based exercise protocol on pain, range of motion, and disability in patients with UCS.MethodsIt was a single-blinded randomised clinical trial carried out in the Physiotherapy Department of the University of Lahore Teaching Hospital, Pakistan. Fifty patients with upper cross syndrome aged between 20 to 35 years were randomly allocated into two groups: group A (routine physical therapy combined with muscle energy techniques) and group B (routine physical therapy combined with the National Academy of Sports Medicine-based exercise protocol) for three sessions per week for total 8 weeks. Data were collected at baseline, 4th, 8th, and 12th week for assessing the long-term effects of the treatment protocol as well. The Visual Analogue Scale, Neck Disability Index, and an inclinometer were used to measure the pain, disability, and range of motion of the cervical region, respectively. The data was analysed using SPSS version 23.0 (IBM, New York, USA).ResultsOut of 50 participants, 30 were male and 20 were female. The mean age of all the participants in experimental group A was 29.76 ± 2.89 and that in experimental group B was 30.56 ± 2.48. At the 4th, 8th, and 12th week, pain and disability were significantly (p-value < 0.05) reduced and cervical range of motion was significantly (p-value < 0.05) improved within both groups. After 8 weeks of treatment, a significant between-group difference was seen in favour of group A in terms of cervical range of motions (flexion, extension, rotation, and side bending) with p-values of less than 0.05 and in favour of group B in terms of pain (p-value 0.03) and disability (p-value 0.04) was seen. These differences were maintained at the 12th week follow-up as well.ConclusionsThis study concluded that both NASM (National Academy of Sports Medicine-based exercise protocol) and METs (muscle energy techniques) are effective treatment options for people with upper cross syndrome. It was also concluded that METs are more effective in improving Range of motion (ROM), while the NASM-based exercise protocol is more effective in improving symptoms of pain and neck-related disability.