Short-Term Effect of Muscle Energy Technique on Pain in Individuals with Non-Specific Lumbopelvic Pain: A Pilot Study

Abstract

Muscle energy technique (MET) is a common conservative treatment for pathology around the spine, particularly lumbopelvic pain (LPP). MET is considered a gentle manual therapy for restricted motion of the spine and extremities 1 and is an active technique where the patient, not the clinician, controls the corrective force 2 . This treatment requires the patient to perform voluntary muscle contractions of varying intensity, in a precise direction, while the clinician applies a counterforce not allowing movement to occur 2 . For many years, MET has been advocated to treat muscle imbalances of the lumbopelvic region such as pelvis asymmetry. The theory behind MET suggests that the technique is used to correct an asymmetry by targeting a contraction of the hamstring or the hip flexors on the painful side of the low back and moving the innominate in a corrected direction. It is worth noting however, that evidence suggests that nonsymptomatic individuals have also been shown to have pelvis asymmetries. Despite this, MET is frequently used by manual therapy clinicians.Unfortunately, few studies have examined the effectiveness of MET. Previous research has found that MET of the low back improved self report of disability when used with supervised neuromuscular reeducation and resistance exercise training 2 , but the effect of MET as an isolated treatment has not been determined. Cervical range of motion increased after 7 MET sessions, which consisted of four 5-second contractions over a 4-week period, and lumbar extension increased after 2 sessions per week for 4 weeks 4,5 . Five-second contractions have shown greatest results with application at the atlanto-axial joint 6 and the thoracic spine 1 . While MET was successful in two studies, the effect of one treatment session was not reported and only range of motion was assessed. Roberts 7 indicated the short-term effects of MET as decreased pain, increased range of motion, decreased muscle tension and spasm, and increased strength. However, these effects seemed to last only a few seconds to minutes, indicating that for continued benefit, MET would have to be applied multiple times throughout the day 7 . At present, the treatment window and lasting effect of a single MET session is undefined 1,2,4-11 . Evidence to support the use of lumbar manipulation in patients with acute lumbopelvic pain with moderate severity has been reported 12,13 , yet, because the treatment pattern of manually trained clinicians varies, we were interested to determine if MET offered similar benefits (albeit, short-term) in patients with acute LPP. Subsequently, the purpose of this ABSTRACT: Muscle energy technique (MET) is a form of manual therapy frequently used to correct lumbopelvic pain (LPP), herein the patient voluntarily contracts specific muscles against the resistance of the clinician. Studies on MET regarding magnitude and duration of effectiveness are limited. This study was a randomized controlled trial in which 20 subjects with self-reported LPP were randomized into two groups (MET ...

Thrust Manipulation Versus Muscle Energy Technique on Somatic Dysfunction in Mechanical Low Back Pain Patients

“…The study revealed that the treatment group that received HVLA thrust manipulation had significant improvements in all variables while there was no change in the control group that received placebo intervention except for spinal mobility in flexion. Selkow et al [17] also supported our results where they examined the short term effect of MET on 20 patients with non-specific lumbopelvic pain, they reported that subjects who received MET demonstrated a significant decrease in VAS worst pain 24 hours after treatment while there was an increase in worst pain in the control group which received sham treatment. However, the technique used in the later study was different from that of our study.…”

Added Effect of Muscle Energy Technique for Improving Functional Ability in Patients With Chronic Nonspecific Low Back Pain

“…Further research can be done with large sample size and follow up of the patients can be implemented in order to see the long-term effect of MET post study. [11]. Patil Prachi et al also concluded the efficacy of MET in reducing disability.…”

Effect of muscle energy technique in treating post-partum coccydynia: A randomized control trial

“…The subject was asked to "push their leg into the therapist's shoulder" and "push up with the opposite leg into therapist's hand. A total of 5 contractions were resisted by a force equal to the subject's, held for 5 seconds with 5 seconds rest between each contraction [14].…”

“…Lastly, MET is a low-force isometric contraction in a pain-free position. In conclusion, this technique is not painful or harmful to the patient [14]. The therapist provides resistive force counter to push patients' muscle contraction, aimed to help in restoring musculoskeletal functions [15].…”

“…Given the fact that MET is a commonly applied therapeutic intervention, relevant and inexpensive. Health problems for which a true gold standard is lacking, and that there is some evidence of its effectiveness, the effort of a comprehensive systematic review seems warranted [29,30].…”