The efficacy of muscle energy techniques in symptomatic and asymptomatic subjects: a systematic review
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(2019) 27:35
SYSTEMATIC REVIEW
Open Access
The efficacy of muscle energy techniques in symptomatic and asymptomatic subjects: a systematic review Ewan Thomas1,2* , Antonio Rosario Cavallaro2, Diba Mani3,4, Antonino Bianco1 and Antonio Palma1
Abstract Background: Muscle energy techniques are applied to reduce pain and increase range of motion. These are applied to a variety of pathological conditions and on asymptomatic subjects. There is however limited knowledge on their effectiveness and which protocol may be the most beneficial. Objective: The aim of this review is to determine the efficacy of muscle energy techniques (MET) in symptomatic and asymptomatic subjects. Design: Systematic Review. Methods: A literature search was performed using the following database: Cochrane Library, MEDLINE, NLM Pubmed and ScienceDirect. Studies regarding MET in asymptomatic and symptomatic patients were considered for investigation. The main outcomes took into account range of motion, chronic and acute pain and trigger points. Two trained investigators independently screened eligible studies according to the eligibility criteria, extracted data and assessed risk of bias. Randomized control trials (RCT’s) were analyzed for quality using the PEDro scale. Results: A total of 26 studies were considered eligible and included in the quantitative synthesis: 14 regarding symptomatic patients and 12 regarding asymptomatic subjects. Quality assessment of the studies through the PEDro scale observed a “moderate to high” quality of the included records. Conclusions: MET are an effective treatment for reducing chronic and acute pain of the lower back. MET are also effective in treating chronic neck pain and chronic lateral epicondylitis. MET can be applied to increase range of motion of a joint when a functional limitation is present. Other techniques seem to be more appropriate compared to MET for trigger points. Keywords: Manipulative therapies, Pain, Range of motion
Introduction Muscle energy techniques (MET) were originally developed by two osteopathic physicians, Fred Mitchell, Sr. and Fred Mitchell, Jr., to treat soft tissue, mobilize joints, stretch tight muscles and fascia, reduce pain and to improve circulation and lymphatic drainage [1, 2]. MET are defined as a manual treatment in which a patient produces a contraction in a precisely controlled position and direction against a counterforce applied by a manual * Correspondence: [email protected] 1 Sport and Exercise Sciences Research Unit, University of Palermo, Via Giovanni Pascoli 6, 90144 Palermo, Italy 2 International Academy of Osteopathic Medicine, AISeRCO, Palermo, Italy Full list of author information is available at the end of the article
therapist [3]. It could be advocated that MET are similar to proprioceptive neuromuscular facilitation stretching (PNF) [4]; however, the execution of MET is usually performed with lower forces compared to those of PNF in order to recruit tonic muscle fibers that are associated with tonic motor units which require lower action pote
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