The effect of isolytic contraction and passive manual stretching on pain and knee range of motion after hip surgery: A prospective, double-blinded, randomized study

Abstract

Stretching has its impact on both contractile and noncontractile tissues and is the most important rehabilitation technique utilised used to prevent and treat joint stiffness. Passive manual stretch (PMS) and muscle energy technique (MET) are two of the most commonly used techniques. Our study evaluates the effectiveness of isolytic form of MET in gaining knee range of motion (ROM) and decreasing pain in acute knee involvement and comparing it with standard PMS. We used the clinical scenario of knee joint mobilization in patients operated for hip fractures. Fifty-two subjects were alternatively randomized to two groups, isolytic contraction (ILC) group (n Z 26) and PMS group (n Z 26). In both the PMS and ILC groups, significant improvements in pain score (measured by the visual analog scale) and knee ROM were reported after the treatment period (p < 0.001). The ILC had significantly better improvement in pain score than the PMS group (p Z 0.003). The improvement in knee ROM, however, demonstrated no significant between-group difference (p > 0.05). Thus, isolytic form of MET may be a viable method to decrease pain and improve knee ROM in patients who had undergone surgery after a hip fracture.

Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial

“…The study concluded that MET was more effective than stretching in improving hamstring flexibility [19]. A study by Parmar et al [20] concluded that isolytic contraction was better in improving range and reducing pain.…”

“…MET is an advanced stretching techniques [7]. Studies using these two techniques individually in symptomatic as well as in asymptomatic population have shown improvement [8–12], but very few studies have compared these techniques in a symptomatic population, where conflicting results are seen [13–20]. A study done by Mahajan et al [17] compared these two treatment technique in patients with mechanical neck pain.…”

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

“…The study concluded that MET was more effective in improving knee ROM in patients who had restricted knee ROM in the acute duration in post-operative hip fractures. 3 No adverse reactions were documented with application of MET in the immediate post-operative period in this study. Hence, it is safe to use MET in the early stages of fracture rehabilitation.…”

“…This plays a role in the descending modulation of pain. 3 On application of MET, there maybe a reduction in proinflammatory cytokines and it may also desensitize the peripheral nociceptors. Blood and lymphatic flow rates may also be affected due to rhythmic muscle contraction and there could be changes in the interstitial pressure and increase in the transcapillary blood flow.…”

“…All these may lead to reduced joint function and may hamper the patient’s ability to perform functional tasks, thereby affecting his activities of daily living. 3,4 There is controlled trauma to the tissues around the elbow post elbow surgeries. This could also cause stiffness post operatively.…”