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http://dx.doi.org/10.12674/ptk.2022.29.1.37

Comparison of the Immediate Effects of Two Types of Muscle Energy Techniques Applied to the Hamstring of Adults in Their Twenties With or Without Low Back Pain on the Pelvic Inclination and the Length of the Hamstring  

Hwang, Lee-kyeong (Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University)
Kim, Suhn-yeop (Department of Physical Therapy, College of Health and Medical Science, Daejeon University)
Publication Information
Physical Therapy Korea / v.29, no.1, 2022 , pp. 37-47 More about this Journal
Abstract
Background: Lower back pain (LBP) is a major cause of disability and a common musculoskeletal disorder encountered at some point in life. Dysfunction of the lumbar vertebrae has been associated with decreased flexibility of the hamstrings, which exhibited a strong positive correlation with LBP. Hamstring tension affects lumbar pelvic rhythm. We aimed to activate pelvic stability with compression by Active Therapeutic Movement (ATM), muscle energy technique (MET) was applied to increase the flexibility of the hamstring. Objects: In this study, we aimed to investigate the effects of MET with ATM and general MET were applied to the hamstring of adults, who were in their twenties with nor without LBP, on their pelvic inclination and the length of their hamstring. Methods: A total of 32 subjects were briefed about the purpose of this study and agreed to participate voluntarily. Before the experiment, all subjects were pre-examined, and they were divided into an LBP group and a no lower back pain group accordingly. Thereafter, all subjects participated in both in a crossover manner. After at least one week, they switched to another group and participated in the same experiment. Results: The study results revealed that both groups demonstrated significant results in the modified active knee extension test (p < 0.01) and the sit and reach test (p < 0.01) performed to assess the hamstring flexibility; an interaction (p < 0.05) was noted. Moreover, a more significant difference was observed between the MET with ATM and the general MET. Although significant results were obtained for the pelvic inclination (p < 0.01), interaction was not noted. Conclusion: Conclusively, in this study, when the MET with ATM was applied to the two groups, there was a significant difference compared to the general MET for hamstring flexibility, but it was confirmed that there was no significant difference for the pelvic inclination.
Keywords
Active Therapeutic Movement; Hamstring; Low back pain; Muscle energy technique; Pelvic inclination;
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1 Kim DY, Lee SH, Lee HY, Lee HJ, Chang SB, Chung SK, et al. Validation of the Korean version of the Oswestry Disability Index. Spine (Phila Pa 1976) 2005;30(5):E123-7.   DOI
2 Lewis CL, Laudicina NM, Khuu A, Loverro KL. The human pelvis: variation in structure and function during gait. Anat Rec (Hoboken) 2017;300(4):633-42.   DOI
3 Crowell RD, Cummings GS, Walker JR, Tillman LJ. Intratester and intertester reliability and validity of measures of innominate bone inclination. J Orthop Sports Phys Ther 1994;20(2):88-97.   DOI
4 Lewis C, Erhard R, Drysdale G. Kyphoscoliosis improvement while treating a patient for adhesive capsulitis using the active therapeutic movement version 2. J Manipulative Physiol Ther 2008;31(9):715-22.   DOI
5 Minarro PA, Andujar PS, Garcia PL, Toro EO. A comparison of the spine posture among several sit-and-reach test protocols. J Sci Med Sport 2007;10(6):456-62.   DOI
6 Kimberly PE. Formulating a prescription for osteopathic manipulative treatment. J Am Osteopath Assoc 1980;79(8):506-13.
7 Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 2001;8(12):1153-7.   DOI
8 Jeon CH, Kim DJ, Kim DJ, Lee HM, Park HJ. Cross-cultural adaptation of the Korean version of the Oswestry Disability Index (ODI). J Korean Soc Spine Surg 2005;12(2):146-52.   DOI
9 Fasuyi FO, Fabunmi AA, Adegoke BOA. Hamstring muscle length and pelvic tilt range among individuals with and without low back pain. J Bodyw Mov Ther 2017;21(2):246-50.   DOI
10 Norris CM, Matthews M. Correlation between hamstring muscle length and pelvic tilt range during forward bending in healthy individuals: an initial evaluation. J Bodyw Mov Ther 2006;10(2):122-6.   DOI
11 Kim GC, Hwang BG. Kinetic analysis on the lumbar at the trunk flexion according to the degree of hamstring flexibility of healthy adult. J Korean Soc Phys Med 2012;7(4):501-7.   DOI
12 Jandre Reis FJ, Macedo AR. Influence of hamstring tightness in pelvic, lumbar and trunk range of motion in low back pain and asymptomatic volunteers during forward bending. Asian Spine J 2015;9(4):535-40.   DOI
13 Han HI, Choi HS, Shin WS. Effects of hamstring stretch with pelvic control on pain and work ability in standing workers. J Back Musculoskelet Rehabil 2016;29(4):865-71.   DOI
14 Beneck GJ, Selkowitz DM, Janzen DS, Malecha E, Tiemeyer BR. The influence of pelvic rotation on clinical measurements of hip flexion and extension range of motion across sex and age. Phys Ther Sport 2018;30:1-7.   DOI
15 Bohannon RW, Gajdosik RL, LeVeau BF. Relationship of pelvic and thigh motions during unilateral and bilateral hip flexion. Phys Ther 1985;65(10):1501-4.   DOI
16 Pierannunzii L. Pelvic posture and kinematics in femoroacetabular impingement: a systematic review. J Orthop Traumatol 2017;18(3):187-96.   DOI
17 Laird RA, Keating JL, Kent P. Subgroups of lumbo-pelvic flexion kinematics are present in people with and without persistent low back pain. BMC Musculoskelet Disord 2018;19(1):309.   DOI
18 Gajdosik R, Lusin G. Hamstring muscle tightness. Reliability of an active-knee-extension test. Phys Ther 1983;63(7):1085-90.   DOI
19 Smith M, Fryer G. A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group. J Bodyw Mov Ther 2008;12(4):312-7.   DOI
20 Ballantyne F, Fryer G, McLaughlin P. The effect of muscle energy technique on hamstring extensibility: the mechanism of altered flexibility. J Osteopath Med 2003;6(2):59-63.   DOI
21 Laird RA, Gilbert J, Kent P, Keating JL. Comparing lumbopelvic kinematics in people with and without back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord 2014;15:229.   DOI
22 Gajdosik RL, Hatcher CK, Whitsell S. Influence of short hamstring muscles on the pelvis and lumbar spine in standing and during the toe-touch test. Clin Biomech (Bristol, Avon) 1992;7(1):38-42.   DOI
23 Congdon R, Bohannon R, Tiberio D. Intrinsic and imposed hamstring length influence posterior pelvic rotation during hip flexion. Clin Biomech (Bristol, Avon) 2005;20(9):947-51.   DOI
24 Salt E, Wiggins AT, Rayens MK, Hooker Q, Shojaei I, Bazrgari B. The relationship between indicators of lumbo-pelvic coordination and pain, disability, pain catastrophizing and depression in patients presenting with non-chronic low back pain. Ergonomics 2020;63(6):724-34.   DOI
25 Last AR, Hulbert K. Chronic low back pain: evaluation and management. S Afr Fam Pract 2010;52(3):184-92.   DOI
26 Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, et al. Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment. Curr Pain Headache Rep 2019;23(3):23.   DOI
27 Handel M, Horstmann T, Dickhuth HH, Gulch RW. Effects of contract-relax stretching training on muscle performance in athletes. Eur J Appl Physiol Occup Physiol 1997;76(5):400-8.   DOI
28 Levine D, Whittle MW. The effects of pelvic movement on lumbar lordosis in the standing position. J Orthop Sports Phys Ther 1996;24(3):130-5.   DOI
29 Reiman MP, Weisbach PC, Glynn PE. The hips influence on low back pain: a distal link to a proximal problem. J Sport Rehabil 2009;18(1):24-32.   DOI
30 Roussouly P, Pinheiro-Franco JL. Biomechanical analysis of the spino-pelvic organization and adaptation in pathology. Eur Spine J 2011;20 (Suppl 5):609-18.   DOI
31 Ha TH, Saber-Sheikh K, Moore AP, Jones MP. Measurement of lumbar spine range of movement and coupled motion using inertial sensors - a protocol validity study. Man Ther 2013;18(1):87-91.   DOI
32 Norris CM, Matthews M. Inter-tester reliability of a self-monitored active knee extension test. J Bodyw Mov Ther 2005;9(4):256-9.   DOI
33 Hooten WM, Cohen SP. Evaluation and treatment of low back pain: a clinically focused review for primary care specialists. Mayo Clin Proc 2015;90(12):1699-718.   DOI
34 Ebrahimi S, Kamali F, Razeghi M, Haghpanah SA. Comparison of the trunk-pelvis and lower extremities sagittal plane intersegmental coordination and variability during walking in persons with and without chronic low back pain. Hum Mov Sci 2017;52:55-66.   DOI
35 Bagheri R, Takamjani IE, Dadgoo M, Sarrafzadeh J, Ahmadi A, Pourahmadi MR, et al. A protocol for clinical trial study of the effect of core stabilization exercises on spine kinematics during gait with and without load in patients with non-specific chronic low back pain. Chiropr Man Therap 2017;25:31.   DOI
36 Ahmed AR. A comparative study of muscle energy technique and dynamic stretching on hamstring flexibility in healthy adults. Bull Fac Ph Th Cairo Univ 2011;16(1):1-6.
37 Lewis C, Diaz R, Lopez G, Marki N, Olivio B. A preliminary study to evaluate postural improvement in subjects with scoliosis: active therapeutic movement version 2 device and home exercises using the Mulligan's mobilization-with-movement concept. J Manipulative Physiol Ther 2014;37(7):502-9.   DOI
38 Chaitow L. Muscle energy techniques. 3rd ed. Korean Academy of Orthopedic Manual Therapy, translator. Seoul: Koonja; 2008;155-8.
39 Herrington L. Assessment of the degree of pelvic tilt within a normal asymptomatic population. Man Ther 2011;16(6):646-8.   DOI
40 Connor SO, McCaffrey N, Whyte E, Moran K. Reliability of a modified active knee extension test for assessment of hamstring flexibility. Int J Athl Ther Train 2015;20(4):32-6.   DOI
41 Lederman E. Fundamentals of manual therapy: physiology, neurology, and psychology. London: Churchill Livingstone; 1997.
42 DeLoach LJ, Higgins MS, Caplan AB, Stiff JL. The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg 1998;86(1):102-6.   DOI
43 Yoo WG. Effect of the individual strengthening exercises for posterior pelvic tilt muscles on back pain, pelvic angle, and lumbar ROM of a LBP patient with excessive lordosis: a case study. J Phys Ther Sci 2014;26(2):319-20.   DOI
44 Lopez-Minarro PA, Muyor JM, Belmonte F, Alacid F. Acute effects of hamstring stretching on sagittal spinal curvatures and pelvic tilt. J Hum Kinet 2012;31(2012):69-78.   DOI