Effectiveness of Hamstring Stretching versus Muscle Energy Technique on Hamstring Flexibility in Patients with Non-specific Knee Pain; A Randomized Clinical Trial

Hamstring Stretching and METs in Knee Pain

Authors

  • Ali Raza Riphah International University, Lahore, Pakistan
  • Arshia Ijaz Health City Hospital, Lahore, Pakistan
  • Muhammad Saadan Saqib Ghurki Trust and Teaching Hospital, Lahore, Pakistan
  • Idrees Ahmed Zahoor Central Park Medical College, Lahore, Pakistan
  • Irfan Ahmed Central Park Medical College, Lahore, Pakistan
  • Nouman Abid Lifeline Healthcare and Pain Center, Lahore, Pakistan

DOI:

https://doi.org/10.55735/hjprs.v3i7.187

Keywords:

flexibility, hamstring stretching, muscle energy technique, non-specific knee pain

Abstract

Background: The muscle energy technique is one of the best methods to increase range of motion restricted due to muscle spasms and shortening. There is a large number of studies supporting the use of the muscle energy technique for pain and soft tissue mobility but very few studies exist that measure the comparison of this technique with simple stretching. Objective: To determine the effectiveness of hamstring stretching versus muscle energy technique on hamstring flexibility in patients with non-specific knee pain. Methods: This randomized trial was conducted at Bakhtawar Amin Trust Teaching Hospital, Multan, Pakistan in which patients with non-traumatic knee pain aged from 20 to 50 years were recruited in a study using a non-probability purposive sampling technique. The sample size of this study was 30 which was calculated by expecting a mean pain change of 95% power of study and 5% level of significance. Ethical approval was granted by the Office of Medical Superintendent and from the Department of Physical Therapy of Bakhtawar Amin trust teaching hospital, Multan, Pakistan. Before collecting data, a written consent form in Urdu was signed by every patient recruited. Group A was supposed to receive muscle energy technique while Group B was supposed to receive static stretching. The statistical test employed was an independent sample t-test for baseline and was employed for comparing the post-intervention scores of every variable for the two groups. The between-group difference was calculated using an independent sample t-test while the difference within the groups was calculated using repeated measure ANOVA. Results: In this study the effectiveness of METs and hamstring stretching was calculated in patients with knee pain. Out of 30 participants, 16(53.33%) were males and 14(46.66%) were females. The mean and standard deviation of age of muscle energy technique  group was 42.47±4.16 and that of hamstring stretching group was 44.48±4.37. The demographic data and scores of all the variables at the baseline of both groups were calculated. Conclusion: This study concludes that both the techniques muscle energy technique and stretching both are equally effective in reducing non-specific knee pain and improving the flexibility of hamstring muscles.

References

Callaghan MJ, Selfe J. Has the incidence or prevalence of patellofemoral pain in the general population in the United Kingdom been properly evaluated? Physical therapy in Sport 2007; 8(1): 37-43.

Clausen B, Holsgaard-Larsen A, Søndergaard J, Christensen R, Andriacchi TP, Roos EM. The effect on knee-joint load of instruction in analgesic use compared with neuromuscular exercise in patients with knee osteoarthritis: study protocol for a randomized, single-blind, controlled trial. Trials 2014; 15(1): 1-14.

Kang K-T, Koh Y-G, Nam J-H, Jung M, Kim S-J, Kim S-H. Biomechanical evaluation of the influence of posterolateral corner structures on cruciate ligaments forces during simulated gait and squatting. PLoS One 2019; 14(4): e0214496.

Terry GC, LaPrade RF. The posterolateral aspect of the knee: anatomy and surgical approach. The American Journal of Sports Medicine 1996; 24(6): 732-9.

Kraus T, Švehlík M, Singer G, Schalamon J, Zwick E, Linhart W. The epidemiology of knee injuries in children and adolescents. Archives of orthopaedic and trauma surgery 2012; 132: 773-9.

Cong Y, Lam W-K. Effects of shear reduction shoes on joint loading, ground reaction force and free moment across different cutting angles. Journal of Sports Sciences 2021; 39(12): 1386-94.

Siegele J, Horstmann T, Bunc V, Shifta P, Verle S, Niess A. Relation between pelvis malposition and functional knee pain by long distance running. Sportverletzung Sportschaden: Organ der Gesellschaft fur Orthopadisch-traumatologische Sportmedizin 2010; 24(3): 144-9.

Souza LAGd, Morimoto T, von Mühlen P, Gonçalves TC, Felippe PdS, Karolczak APB. Relation between performance in side bridge and injuries in amateur soccer. Fisioterapia em Movimento 2015; 28: 447-57.

Lemos CAG, Jorge MT, Ribeiro LA. Profile of victims and treatment of injuries by external causes according to attendance by the Municipal Rehabilitation Center of Uberlandia, MG External causes and physiotherapy. Revista Brasileira de Epidemiologia 2013; 16: 482-92.

Kim H. A Study on the Influence of Hamstring Stretching on High School Soccer Players’ Basic Motor Ability and Soccer Skill. Master's Degree Kyungsung University 2010.

Kumar GP. Comparison of cyclic loading and hold relax technique in increasing resting length of hamstring muscles. Hong Kong Physiotherapy Journal 2011; 29(1): 31-3.

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. Journal of back and musculoskeletal rehabilitation 2014; 27(1): 63-70.

Skoffer B. Low back pain in 15-to 16-year-old children in relation to school furniture and carrying of the school bag. Spine 2007; 32(24): E713-E7.

Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide: Springer; 2007.

Chan S, Hong Y, Robinson P. Flexibility and passive resistance of the hamstrings of young adults using two different static stretching protocols. Scandinavian journal of medicine & science in sports 2001; 11(2): 81-6.

Spernoga SG, Uhl TL, Arnold BL, Gansneder BM. Duration of maintained hamstring flexibility after a one-time, modified hold-relax stretching protocol. Journal of athletic training 2001; 36(1): 44.

Burton AK, McClune TD, Clarke RD, Main CJ. Long-term follow-up of patients with low back pain attending for manipulative care: outcomes and predictors. Manual therapy 2004; 9(1): 30-5.

Kumar P, Moitra M. Efficacy of muscle energy technique and pnf stretching compared to conventional physiotherapy in program of hamstring flexibility in chronic nonspecific low back pain. Indian J Physiother Occup Ther Int J 2015; 9(3): 103.

Metsavaht L, Leporace G, Riberto M, et al. Translation and cross-cultural adaptation of the lower extremity functional scale into a Brazilian Portuguese version and validation on patients with knee injuries. Journal of Orthopaedic & Sports Physical Therapy 2012; 42(11): 932-9.

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. Archives of physical medicine and rehabilitation 2010; 91(7): 1140-2.

Rossi MJ, Lubowitz JH, Guttmann D. Development and validation of the International Knee Documentation Committee Subjective Knee Form. The American Journal of Sports Medicine 2002; 30(1): 152-.

Halbertsma JP, Göeken LN, Hof AL, Groothoff JW, Eisma WH. Extensibility and stiffness of the hamstrings in patients with nonspecific low back pain. Archives of physical medicine and rehabilitation 2001; 82(2): 232-8.

de Oliveira FM, da Silva André RH. Protocolo de reabilitação cardiorrespiratória e musculoesquelética para pacientes com sequela de infecção por COVID-19–Relato de experiência: Cardiorespiratory and musculoskeletal rehabilitation protocol for patients with sequelae of COVID-19 infection-experience report. Brazilian Journal of Health Review 2022; 5(6): 22242-9.

Sharma A, Rizvi M, Kumari S, Sharma P. Comparando o efeito da liberação miofascial e técnica de energia muscular no ângulo craniovertebral e cefaleia em pacientes com cefaleia tensional. Revista Pesquisa em Fisioterapia 2022.

Pradhan SP, Shyam A, Chaitow S. MET in Post-Surgical Rehabilitation. Chaitow's Muscle Energy Techniques E-Book 2023: 291.

Nogueira HC, Navega MT. Influence of the Back School program in community agents. ConScientiae Saude 2013; 12(3).

Ferreira MS, Navega MT. Effects of a guidance program to adults with low back pain. Acta Ortopédica Brasileira 2010; 18: 127-31.

da Silva AC, de Godoy Marques CM, Marques JLB. Influence of spinal manipulation on autonomic modulation and heart rate in patients with rotator cuff tendinopathy. Journal of Chiropractic Medicine 2018; 17(2): 82-9.

Yaver J. Diagnosis and treatment of movement impairment syndromes. Physical Therapy 2002; 82(6): 626.

Siqueira DA, Baraúna MA, Dionísio VC. Functional evaluation of the knee in subjects with patellofemoral pain syndrome (PFPS): comparison between KOS and IKDC scales. Revista Brasileira de Medicina do Esporte 2012; 18: 400-3.

Shadmehr A, Hadian MR, Naiemi SS, Jalaie S. Hamstring flexibility in young women following passive stretch and muscle energy technique. Journal of back and musculoskeletal rehabilitation 2009; 22(3): 143-8.

Majeed A, Mansoor SR, Arif AB, Yasin MM, Wasim M, Naeem F. Comparison of static stretching and muscle energy techniques on hamstring tightness in asymptomatic females. Foundation University Journal of Rehabilitation Sciences 2021; 1(1): 19-23.

Ahmed AR. A comparative study of muscle energy technique and dynamic stretching on hamstring flexibility in healthy adults. Bulletin of Faculty of Physical Therapy 2011; 16(1): 1-6.

Waseem M, Nuhmani A, Ram C, et al. A comparative study of the impact of muscle energy technique and eccentric training on popliteal angle: Hamstring flexibility in Indian collegiate males. Serbian Journal of Sports Sciences 2010; 4(1): 41-6.

Waseem M, Nuhmani S, Ram C. Efficacy of Muscle Energy Technique on hamstring muscles flexibility in normal Indian collegiate males. Calicut medical journal 2009; 7(2): e4.

Ballantyne F, Fryer G, McLaughlin P. The effect of muscle energy technique on hamstring extensibility: the mechanism of altered flexibility. Journal of osteopathic medicine 2003; 6(2): 59-63.

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Published

2023-07-30

How to Cite

Raza, A., Ijaz, A., Saqib, M. S. ., Zahoor, I. A., Ahmed, I., & Abid, N. (2023). Effectiveness of Hamstring Stretching versus Muscle Energy Technique on Hamstring Flexibility in Patients with Non-specific Knee Pain; A Randomized Clinical Trial: Hamstring Stretching and METs in Knee Pain. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 3(7), 671–681. https://doi.org/10.55735/hjprs.v3i7.187

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