Effect of Muscle Energy Technique in Patients with Non-traumatic Lumbo-pelvic Pain in the Age Group of 30-40 Years

A. Suresh, Dimple Kashyap
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Abstract

Purpose: Pelvic girdle and low back pain have fallen under the diagnostic umbrella of non-specific low back pain (NSLBP). It is true that low back pain can have it’s etiology in pelvic girdle mal-alignment, and similarly low back pain with neural irritation can lead to in co-ordination of muscles causing pelvic malalignment, it is important to understand that motor in co-ordination in the pelvic girdle can be the result of peripheral and/or central mechanisms. Peripheral mechanisms include reflexogenic muscle spasms whilst central mechanisms include cortical inhibition of muscles and/or delayed central transmission due to noxious input affecting intra-cortical synergistic control between various regions of the central nervous system (CNS). Muscle energy technique (MET) is a common conservative treatment for pathology around the spine, particularly lumbopelvic pain (LPP). MET is a gentle manual therapy for restricted motion of the spine and extremities and is an active technique where the patient, not the clinician, controls the corrective force. MET of the low back has decreased pain, increased range of motion, decreased muscle tension and spasm, and increased strength when used with supervised neuromuscular re-education and resistance exercise training. At present, the treatment effect and the outcome of one or two MET session is undefined. This study is designed to determine the effectiveness of brief MET sessions on posterior innominate/ Pelvic pain when used on subjects with non-traumatic pelvic pain. Materials and method: 20 male patients of convenient random sampling based on the inclusion criteria were included in the study and were given muscle energy technique- anterior rotation of Innominate bone for single session once a day for two days and the pre and post treatment outcome were recorded using VAS score and Pelvic inclinometer (PALM) measure. Results: The pre and post treatment effects using paired t-test and the correlation on VAS, shows a decrease of mean and SD from baseline (4.7 ± 1.03) to (1.95 ± 1.14) with (t=14.457, p =.001) indicating a very high level of significance. The pre and post treatment effects using paired t-test and the correlation on PALM, shows a decrease of mean and SD from baseline (10.5 ± 1.50) to (7.1 ± 1.07) with (t=12.803, p =.004) indicating a high level of significance. Conclusion: The results showed that Muscle Energy Technique is as effective as any other manual therapy techniques in the treatment of lumbo-pelvic pain or posterior innominate considered in this study, suggests that MET was highly effective in managing pain and neutralising the pelvic rotation angles with LPP. The treatment is evidenced, and provided as much benefit as any other manual therapy techniques for LPP. Some objective outcomes showed a trend which suggested that there might have been a great interaction if the sample size was larger. Thus the conclusion from this research is that there was a high statistical significance between the pre and post treatment with brief MET sessions in acute LPP.
肌能技术在30-40岁非外伤性腰盆腔疼痛患者中的作用
目的:骨盆带和腰痛属于非特异性腰痛(NSLBP)的诊断范畴。确实,腰痛的病因可能是骨盆带错位,同样,腰痛伴有神经刺激可导致肌肉协调失调,导致骨盆带错位。了解骨盆带运动协调可能是外周和/或中枢机制的结果是很重要的。外周机制包括反射性肌肉痉挛,而中枢机制包括由于有害输入影响中枢神经系统(CNS)各区域之间皮质内协同控制而导致的肌肉皮质抑制和/或中枢传递延迟。肌肉能量技术(MET)是一种常见的保守治疗脊柱周围的病理,特别是腰盆腔疼痛(LPP)。MET是一种温和的手工疗法,用于限制脊柱和四肢的运动,是一种主动技术,患者而不是临床医生控制矫正力。在有监督的神经肌肉再教育和阻力运动训练的情况下,腰背部的MET减轻了疼痛,增加了活动范围,减少了肌肉紧张和痉挛,增加了力量。目前,一个或两个MET疗程的治疗效果和结果尚不明确。本研究旨在确定在非外伤性骨盆疼痛受试者中使用简短的MET治疗后骨盆疼痛的有效性。材料与方法:选取符合纳入标准的方便随机抽样的男性患者20例,给予肌能技术-无名骨前旋术单次治疗,每天1次,连续2天,采用VAS评分和盆腔倾角仪(PALM)测量记录治疗前后结果。结果:经配对t检验及VAS相关性分析,治疗前后的均数和标准差由基线(4.7±1.03)降至(1.95±1.14),差异有显著性(t=14.457, p =.001)。配对t检验和PALM相关性分析显示,治疗前后的平均和标准差从基线(10.5±1.50)降至(7.1±1.07),(t=12.803, p = 0.004),具有高度显著性。结论:结果表明,肌能技术在治疗腰盆腔疼痛或本研究中考虑的后侧无名指方面与任何其他手工治疗技术一样有效,表明MET在控制疼痛和中和LPP骨盆旋转角度方面非常有效。治疗是有证据的,并且提供了与任何其他手工治疗LPP技术一样多的好处。一些客观结果显示出一种趋势,即如果样本量较大,可能会有很大的相互作用。因此,本研究的结论是,急性LPP治疗前后短时间的MET治疗具有很高的统计学意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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