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http://dx.doi.org/10.12674/ptk.2022.29.1.54

Comparison of the Effect of Muscle Energy Techniques and Stretching Exercises on Pain and Psychosocial Dysfunction Levels in Individuals With Low Back Pain  

Cha, Byung-ha (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. 54-63 More about this Journal
Abstract
Background: Low back and neck pain are two of the most common medical problems in the adult population. It is estimated that between 70% and 80% adults experience an episode of low back pain at least once during their lifetime. Objects: This study aimed to compare the effects of various stretching exercises and muscle energy techniques used for treatment of iliopsoas, quadratus lumborum, and hamstrings of patients with low back pain. Methods: A total of 52 subjects were randomly assigned to the control group (n = 17), the muscle energy technology group (METG, n = 19), and the stretching exercise group (SEG, n = 16). Interventions were performed twice a week for 4 weeks. Outcomes were measured before and after 4 weeks of treatment in the three groups, using the Korean version of the Oswestry Disability Index, the Visual Analogue Scale (VAS), the Fear Avoidance Belief Questionnaire (FABQ), the Finger to Floor test (FTF), the Modified-Modified Schober Test (MMS), and the Trunk Flexion Range of Motion test. Results: This study showed significant reduction in the pre-test and post-test KODI, VAS, and FABQ scores in all the three groups (p < 0.05). The KODI, VAS, FABQ and FTF assessed in this study showed interactions between the groups and the measurement time point (p < 0.01). After intervention, the KODI, VAS, FABQ and FTF in the SEG and METG were significantly higher (p < 0.05), and there was no difference between the METG and SEG. MMS and HFROM test showed no difference between the three groups (p > 0.05). Conclusion: KODI, VAS, FABQ and FTF showed significant improvement after basic physical therapy, muscle energy technique, and stretching exercise intervention. And there was no significant difference in the intervention effect between the muscle energy group and the stretching exercise group.
Keywords
Disability; Low back pain; Muscle energy techniques; Pain; Psychosocial; Stretching;
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1 Harrison DD, Cailliet R, Janik TJ, Troyanovich SJ, Harrison DE, Holland B. Elliptical modeling of the sagittal lumbar lordosis and segmental rotation angles as a method to discriminate between normal and low back pain subjects. J Spinal Disord 1998;11(5):430-9.
2 Johnson EN, Thomas JS. Effect of hamstring flexibility on hip and lumbar spine joint excursions during forward-reaching tasks in participants with and without low back pain. Arch Phys Med Rehabil 2010;91(7):1140-2.   DOI
3 Fahmy E, Shaker H, Ragab W, Helmy H, Gaber M. Efficacy of spinal extension exercise program versus muscle energy technique in treatment of chronic mechanical low back pain. Egypt J Neurol Psychiatry Neurosurg 2019;55:77.   DOI
4 Battie MC, Videman T, Gibbons LE, Manninen H, Gill K, Pope M, et al. Occupational driving and lumbar disc degeneration: a case-control study. Lancet 2002;360(9343):1369-74.   DOI
5 Fogleman M, Lewis RJ. Factors associated with self-reported musculoskeletal discomfort in video display terminal (VDT) users. Int J Ind Ergon 2002;29(6):311-8.   DOI
6 Makhsous M, Patel JC, Lin F, Hendrix, RW, Zhang LQ. Sitting pressure in a wheelchair with adjustable ischial and back supports. Paper presented at: RESNA 26th International Annual Confence - Technology & Disability: Research, Design, Practice & Policy; 2003 Jun 19-23; Atlanta, GA, USA. Washington, D.C.: RESNA, 2003.
7 Mayer TG, Vanharanta H, Gatchel RJ, Mooney V, Barnes D, Judge L, et al. Comparison of CT scan muscle measurements and isokinetic trunk strength in postoperative patients. Spine (Phila Pa 1976) 1989;14(1):33-6.   DOI
8 Arab AM, Nourbakhsh MR. Hamstring muscle length and lumbar lordosis in subjects with different lifestyle and work setting: comparison between individuals with and without chronic low back pain. J Back Musculoskelet Rehabil 2014;27(1):63-70.   DOI
9 Bachrach RM, Micelotta J, Winuk C. The relationship of low back pain to PSOAS insufficiency. J Orthop Med 2007;29(3):98-104.   DOI
10 Rabia K, Nasir RH, Hassan D. Immediate effect of muscle energy technique in comparison with passive stretching on hamstring flexibility of healthy individuals: a randomized clinical trial. Isra Med J 2019;11(4 Pt B):310-3.
11 Ellythy MA. Efficacy of muscle energy technique versus myofascial release on function outcome measures in patients with chronic low back pain. Bull Fac Ph Th Cairo Univ 2012;17(1):51-7.
12 Skoffer B. Low back pain in 15- to 16-year-old children in relation to school furniture and carrying of the school bag. Spine (Phila Pa 1976) 2007;32(24):E713-7.   DOI
13 Jorgensson A. The iliopsoas muscle and the lumbar spine. Aust J Physiother 1993;39(2):125-32.   DOI
14 Poitras S, Blais R, Swaine B, Rossignol M. Management of work-related low back pain: a population-based survey of physical therapists. Phys Ther 2005;85(11):1168-81.   DOI
15 Fasen JM, O'Connor AM, Schwartz SL, Watson JO, Plastaras CT, Garvan CW, et al. A randomized controlled trial of hamstring stretching: comparison of four techniques. J Strength Cond Res 2009;23(2):660-7.   DOI
16 Chaabene H, Behm DG, Negra Y, Granacher U. Acute effects of static stretching on muscle strength and power: an attempt to clarify previous caveats. Front Physiol 2019;10:1468.   DOI
17 Pandey E, Kumar N, Das S. Effect of stretching on shortened quadratus lumborum muscle in non specific low back pain. Physiother Occup Ther J 2018;11(2):80-6.
18 Rubin DI. Epidemiology and risk factors for spine pain. Neurol Clin 2007;25(2):353-71.   DOI
19 Balague F, Dutoit G, Waldburger M. Low back pain in schoolchildren. An epidemiological study. Scand J Rehabil Med 1988;20(4):175-9.
20 Chaitow L. Muscle energy techniques. Korean Academy of Orthopedic Manual Therapy, Translator. 3rd ed. Seoul: Koonja; 2008;154, 157, 169.
21 Kisner C, Colby LA. Therapeutic exercise: foundations and techniques. Jang JH, Kang SH, Koo HS, Kim MJ, Kim MH, Kim JH, et al., Translator. 6th ed. Seoul: Yeongmunsa; 2016;216.
22 Worrell TW, Perrin DH, Gansneder BM, Gieck JH. Comparison of isokinetic strength and flexibility measures between hamstring injured and noninjured athletes. J Orthop Sports Phys Ther 1991;13(3):118-25.   DOI
23 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
24 Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986;27(1):117-26.   DOI
25 Halbertsma JP, Goeken LN, Hof AL, Groothoff JW, Eisma WH. Extensibility and stiffness of the hamstrings in patients with nonspecific low back pain. Arch Phys Med Rehabil 2001;82(2):232-8.   DOI
26 Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab 2016;41(1):1-11.   DOI
27 Joo MK, Kim TY, Kim JT, Kim SY. Reliability and validity of the Korean version of the fear-avoidance beliefs questionnaire. Phys Ther Korea 2009;16(2):24-30.
28 Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol 2010;24(6):769-81.   DOI
29 Stutchfield BM, Coleman S. The relationships between hamstring flexibility, lumbar flexion, and low back pain in rowers. Eur J Sport Sci 2006;6(4):255-60.   DOI
30 Hossain MD, Choudhury MRA, Mojumder MMA. A comparative study of treatment of chronic backache between conventional method and trigger point injections (TPI). J Armed Forces Med Coll 2009;5(1):37-40.
31 Fryer G. Muscle energy technique: an evidence-informed approach. Int J Osteopath Med 2011;14(1):3-9.   DOI
32 Perret C, Poiraudeau S, Fermanian J, Colau MM, Benhamou MA, Revel M. Validity, reliability, and responsiveness of the fingertip-to-floor test. Arch Phys Med Rehabil 2001;82(11):1566-70.   DOI
33 Tousignant M, Poulin L, Marchand S, Viau A, Place C. The modified-modified Schober test for range of motion assessment of lumbar flexion in patients with low back pain: a study of criterion validity, intra- and inter-rater reliability and minimum metrically detectable change. Disabil Rehabil 2005;27(10):553-9.   DOI
34 Lee W. Effects of exercise using a stick on muscle activity of gluteus maximus and erector spinae during backward return from forward bending. J Musculoskelet Sci Technol 2019;3(2):38-43.   DOI
35 Oh YT. Effects of a muscle energy technique on pain and functionality in patients with chronic low back pain. PNF Mov 2016;14(2):139-47.
36 Lee J, Sim H, Choi Y. The effect of muscle energy technique and instrument assisted soft tissue mobilization in adults with shortened hamstring on the range of motion, muscle strength and muscle thickness. J Korean Orthop Man Phys Ther 2021;27(1):21-30.
37 An CS. The effects of hamstring stretching exercise on angle of lumbar flexion and pain reduction with chronic low back patients. J Korean Phys Ther 2005;17(4):559-67.
38 Jung SH, Park DS. Effects of active and passive hamstring stretching on pelvic mobility in low back pain patients. J Korean Soc Phys Med 2021;16(1):49-61.   DOI
39 Franke H, Fryer G, Ostelo RWJG, Kamper SJ. Muscle energy technique for non-specific low-back pain. A Cochrane systematic review. Int J Osteopath Med 2016;20:41-52.   DOI