Hamstring flexibility in young women following passive stretch and muscle energy technique. Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro). The immediate effects of muscle energy technique on posterior shoulder tightness: a randomized controlled trial. Short- and medium-term effects of manual therapy on cervical active range of motion and pressure pain sensitivity in latent myofascial pain of the upper trapezius muscle: a randomized controlled trial. Comparison of the Short-Term Outcomes after Postisometric Muscle Relaxation or Kinesio Taping Application for Normalization of the Upper Trapezius Muscle Tone and the Pain Relief: A Preliminary Study Short-Term Effect of Muscle Energy Technique on Pain in Individuals with Non-Specific Lumbopelvic Pain: A Pilot Study The effect of duration of stretching of the hamstring muscle group for increasing range of motion in people aged 65 years or older. Muscle energy technique versus corticosteroid injection for management of chronic lateral epicondylitis: randomized controlled trial with 1-year follow-up. Comparison of manual therapy and exercise therapy for postural hyperkyphosis: A randomized clinical trial The Measurement of Lumbar Proprioception in Individuals With and Without Low Back Pain The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: a randomized controlled trial Mechanical and physical responses to stretching with and without preisometric contraction in human skeletal muscle. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females. A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group. Muscle energy technique in patients with acute low back pain: a pilot clinical trial. The immediate effect of manipulation versus mobilization on pain and range of motion in the cervical spine: a randomized controlled trial. The effect of manual therapy and exercise in patients with chronic low back pain: Double blind randomized controlled trial. Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial☆
BACKGROUND Research is limited and controversial on the effectiveness of various stretching methods on muscle lengthening . OBJECTIVE Study ing the effectiveness of static stretch and muscle energy technique on the flexibility of hamstring muscles . METHODS Thirty young females ( 20 - 25 yrs old ) participated voluntarily in this study . Subjects were r and omly assigned to two groups : static stretch group ( controls ; n=15 ) and muscle energy technique ( MET ) group ( experimental ; n=15 ) . The control group underwent ten sessions of static stretches of hamstring muscle , and the experimental group was assigned to ten sessions of MET at 50 % voluntary isometric contraction . Hamstring flexibility was evaluated by passive knee extension test at baseline and again following interventions . RESULTS Both treatment methods were capable of significantly improving the shortness of hamstring muscles ( P < 0.01 ) ; and no considerable difference was observed between the methods . CONCLUSION Ten sessions of hamstring stretches in normal young women using either static stretch or MET had similar effect on restoring flexibility to hamstrings Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials STUDY DESIGN R and omized controlled trial . OBJECTIVES To compare a muscle energy technique ( MET ) for the glenohumeral joint ( GHJ ) horizontal abductors and an MET for the GHJ external rotators to improve GHJ range of motion ( ROM ) in baseball players . BACKGROUND Overhead athletes often exhibit loss of GHJ ROM in internal rotation , which has been associated with shoulder pathology . Current stretching protocol s aim ed at improving flexibility of the posterior shoulder have result ed in inconsistent outcomes . Although utilization of MET has been hypothesized to lengthen tissue , there are limited empirical data describing the effectiveness of such stretches for treating posterior shoulder tightness . METHODS Sixty-one Division I baseball players were r and omly assigned to 1 of 3 groups : MET for the GHJ horizontal abductors ( n = 19 ) , MET for the GHJ external rotators ( n = 22 ) , and control ( n = 20 ) . We measured preintervention and postintervention GHJ horizontal adduction and internal rotation ROM , and conducted analyses of covariance , followed by Tukey honestly significant difference post hoc analysis for significant group-by-time interactions ( P<.05 ) . RESULTS The group treated with the MET for the horizontal abductors had a significantly greater increase in GHJ horizontal adduction ROM postintervention ( mean ± SD , 6.8 ° ± 10.5 ° ) compared to the control group ( -1.1 ° ± 6.8 ° ) ( P = .011 ) and a greater increase in internal rotation ROM postintervention ( 4.2 ° ± 5.3 ° ) compared to the group treated with the MET for the external rotators ( 0.2 ° ± 6.3 ° ) ( P = .020 ) and the control group ( -0.2 ° ± 4.0 ° ) ( P = .029 ) . No significant differences among groups were found for any other variables ( P>.05 ) . CONCLUSION A single application of an MET for the GHJ horizontal abductors provides immediate improvements in both GHJ horizontal adduction and internal rotation ROM in asymptomatic collegiate baseball players . Application of MET for the horizontal abductors may be useful to gain ROM in overhead athletes . LEVEL OF EVIDENCE Therapy , level 2b- OBJECTIVE The purpose of this study was to investigate effects of different manual techniques on cervical ranges of motion and pressure pain sensitivity in subjects with latent trigger point of the upper trapezius muscle . METHODS One hundred seventeen volunteers , with a unilateral latent trigger point on upper trapezius due to computer work , were r and omly divided into 5 groups : ischemic compression ( IC ) group ( n=24 ) ; passive stretching group ( n=23 ) ; muscle energy technique group ( n=23 ) ; and 2 control groups , wait- and -see group ( n=25 ) and placebo group ( n=22 ) . Cervical spine range of movement was measured using a cervical range of motion  instrument as well as pressure  pain sensitivity by means of an algometer and a visual analog scale . Outcomes were assessed pretreatment , immediately , and 24 hours after the intervention and 1 week later by a blind research er . A 4 × 5 mixed repeated- measures analysis of variance was used to examine the effects of the intervention and Cohen d coefficient was used . RESULTS A group-by-time interaction was detected in all variables ( P<.01 ) , except contralateral rotation . The immediate effect sizes of the contralateral flexion , ipsilateral rotation , and pressure pain threshold were large for 3 experimental groups . Nevertheless , after 24 hours and 1 week , only IC group maintained the effect size . CONCLUSIONS Manual techniques on upper trapezius with latent trigger point seemed to improve the cervical range of motion and the pressure pain sensitivity . These effects persist after 1 week in the IC group The main purpose of the study was to evaluate the resting bioelectrical activity of the upper trapezius muscle ( the UT muscle ) before and after one of the two interventions : postisometric muscle relaxation ( PIR ) and Kinesio Taping ( KT ) . Moreover a comparison between group results was conducted . From the initial 61 volunteers , 52 were selected after exclusion criteria and were allocated r and omly to 2 groups : PIR group and KT group . Outcome measures were assessed at baseline and completion of the intervention . The primary outcome measure was change in bioelectrical activity of UT muscle evaluated by surface electromyography ( sEMG ) . Secondary outcomes included subjective assessment of pain using visual analogue scale ( VAS ) . Significant differences were found only in KT group : the average resting bioelectrical activity decreased by 0.8 μV ( p = 0.0237 ) and the average VAS result reduced by 2.0 points ( p = 0.0001 ) . Greater decrease of VAS results was recorded in KT group compared to PIR group ( p = 0.0010 ) . Both PIR and KT intervention did not influence significantly the resting bioelectrical activity of UT muscle . KT application was better for pain relief in the studied sample compared with PIR intervention Abstract Muscle energy technique ( MET ) is a form of manual therapy frequently used to correct lumbopelvic pain ( LPP ) , herein the patient voluntarily contracts specific muscles against the resistance of the clinician . Studies on MET regarding magnitude and duration of effectiveness are limited . This study was a r and omized controlled trial in which 20 subjects with self-reported LPP were r and omized into two groups ( MET or control ) after magnitude of pain was determined . MET of the hamstrings and iliopsoas consisted of four 5-second hold/relax periods , while the control group received a sham treatment .  Tests for current and worst pain , and pain with provocation were administered at baseline , immediately following intervention and 24 hours after intervention . Separate 2x3 ANOVAs were used to assess results as change scores . Visual analog score ( VAS ) for worst pain reported in the past 24 hours decreased for the MET group ( 4.3mm±19.9 , p=.03 ) and increased for the sham ( control ) group ( 17.1mm±21.2 , p=.03 ) . Subjects receiving MET demonstrated a decrease in VAS worst pain over the past 24 hours , thereby suggesting that MET may be useful to decrease LPP over 24 hours BACKGROUND AND PURPOSE Stretching protocol s for elderly people ( > or = 65 years of age ) have not been studied to determine the effectiveness of increasing range of motion ( ROM ) . The purpose of this study was to determine which of 3 duration s of stretches would produce and maintain the greatest gains in knee extension ROM with the femur held at 90 degrees of hip flexion in a group of elderly individuals . SUBJECTS Sixty-two subjects ( mean age = 84.7 years , SD = 5.6 , range = 65 - 97 ) with tight hamstring muscles ( defined as the inability to extend the knee to less than 20 degrees of knee flexion ) participated . Subjects were recruited from a retirement housing complex and were independent in activities of daily living . METHODS Subjects were r and omly assigned to 1 of 4 groups and completed a physical activity question naire . The subjects in group 1 ( n = 13 , mean age = 85.1 years , SD = 6.4 , range = 70 - 97 ) , a control group , performed no stretching . The r and omly selected right or left limb of subjects in group 2 ( n = 17 , mean age = 85.5 years , SD = 4.5 , range = 80 - 93 ) , group 3 ( n = 15 , mean age = 85.2 years , SD = 6.5 , range = 65 - 92 ) , and group 4 ( n = 17 , mean age = 83.2 years , SD = 4.6 , range = 68 - 90 ) was stretched 5 times per week for 6 weeks for 15 , 30 , and 60 seconds , respectively . Range of motion was measured once a week for 10 weeks to determine the treatment and residual effects . Data were analyzed using a growth curve model . RESULTS A 60-second stretch produced a greater rate of gains in ROM ( 60-second stretch = 2.4 degrees per week , 30-second stretch = 1.3 degrees per week , 15-second stretch = 0.6 degrees per week ) , which persisted longer than the gains in any other group ( group 4 still had 5.4 degrees more ROM 4 weeks after treatment than at pretest as compared with 0.7 degrees and 0.8 degrees for groups 2 and 3 , respectively ) . DISCUSSION AND CONCLUSION Longer hold times during stretching of the hamstring muscles result ed in a greater rate of gains in ROM and a more sustained increase in ROM in elderly subjects . These results may differ from those of studies performed with younger population s because of age-related physiologic changes OBJECTIVE To determine the short- and long-term effectiveness of the muscle energy technique ( MET ) compared with corticosteroid injections ( CSIs ) for chronic lateral epicondylitis ( LE ) . DESIGN R and omized controlled trial with 1 year of follow-up . SETTING Outpatient clinic of a university 's department of physical medicine and rehabilitation . PARTICIPANTS Patients with chronic LE ( N=82 ; 45 women , 37 men ) . INTERVENTIONS Eight sessions of MET , or a single CSI was applied . MAIN OUTCOME MEASURES Grip strength , pain intensity , and functional status were assessed using the pain-free grip strength ( PFGS ) , a visual analog scale ( VAS ) , and the Disabilities of the Arm , Shoulder and H and ( DASH ) question naire , respectively . Measurements were performed before beginning treatment and at 6 , 26 , and 52 weeks afterward . RESULTS When the baseline PFGS , VAS , and DASH scores were compared with the scores at the 52-week follow-up , statistically significant improvements were observed in both groups over time . The patients who received a CSI showed significantly better effects at 6 weeks according to the PFGS and VAS scores , but declined thereafter . At the 26- and 52-week follow-ups , the patients who received the MET were statistically significantly better in terms of grip strength and pain scores . At 52 weeks , the mean PFGS score in the MET group was significantly higher ( 75.08±26.19 vs 62.24±21.83 ; P=.007 ) and the mean VAS score was significantly lower ( 3.28±2.86 vs 4.95±2.36 ; P=.001 ) than those of the CSI group . Although improvements in the DASH scores were more pronounced in the MET group , the differences in DASH scores between the groups were not statistically significant . CONCLUSIONS This study showed that while both MET and CSI improved measures of strength , pain , and function compared with baseline , subjects receiving MET had better scores at 52 weeks for PFGS and the VAS for pain . We conclude that MET appears to be an effective intervention in the treatment of LE ABSTRACT Objective : To compare the efficacy of a manual therapy and an exercise therapy program in improving  postural hyperkyphosis among young adults . Methods : Forty-six women between the ages of 18 to 30 years with thoracic kyphosis diagnosed by flexicurve ruler were r and omly assigned to either an exercise therapy or a manual therapy group . The exercise therapy program focused on stretching and strengthening exercises in 15 sessions over 5 weeks . The manual therapy group received 15 sessions of manual techniques including massage , mobilization , muscle energy and myofascial release .  Kyphosis angle and back extensor muscle strength were measured with a motion analysis system and a dynamometer at the baseline and after treatment . The data were analyzed with paired and independent t-tests . Results : After treatment , the angle of thoracic kyphosis was smaller and back extensor muscle strength was significantly greater in both the exercise and manual therapy groups ( p < 0.001 ) . We found no significant differences between groups in the changes in kyphosis angle or muscle strength after treatment ( p > 0.05 ) . Conclusion : Manual therapy was as effective as exercise therapy in reducing kyphosis angle and increasing back extensor muscle strength in young women with postural hyperkyphosis Study Design . A clinical trial comparing a  back pain group with a pain‐free group .  Objectives . To investigate whether proprioceptive deficits existed in a group of individuals reporting low back pain . Summary of Background Data . Little work has so far been conducted on the measurement of proprioception in the spine . Those studies that have been carried out , however , have failed to identify proprioceptive deficits in individuals with back pain . Previous work on peripheral joints has revealed that proprioception is affected with muscular or joint injury or degeneration . Methods . Forty individuals took part in the study , 20 with back pain and 20 with no pain . Participants were required to reproduce a predetermined target position , in st and ing and four‐point kneeling , 10 times in 30 seconds . A computer screen was used to provide visual feedback on position . A mean deviation from the target position was obtained for each individual . A measurement of left elbow position sense was conducted in five individuals from each group to establish differences in short‐term motor memory between the groups . Results . There were no differences between the subject groups in terms of short‐term motor memory ( P > 0.05 ) . A two‐way analysis of variance between subject groups and position to identify differences in accuracy ( deviation from the target ) found that there were differences between subject groups in either position ( P < 0.05 ) . There was no significant difference in accuracy between the positions used ( P > 0.05 ) . Conclusions . Differences in proprioception do exist between individuals with back pain and those free from back pain . Further research needs to be undertaken on proprioceptive exercise programs and their effect on back pain Abstract Currently , large levels of practice variability exist regarding the clinical deactivation of trigger points . Manual physical therapy has been identified as a potential means of resolving active trigger points ; however , to date the ideal treatment approach has yet to be eluci date d. The purpose of this clinical trial was to compare the effects of two manual treatment regimens on individuals with upper trapezius trigger points . Sixty patients , 19–38 years of age with non-specific neck pain and upper trapezius trigger points , were r and omized into one of two , 4 week physical therapy programs . One group received muscle energy techniques while the second group received an integrated neuromuscular inhibition technique ( INIT ) consisting of muscle energy techniques , ischemic compression , and strain – counterstrain ( SCS ) . Outcomes including a visual analog pain scale ( VAS ) , the neck disability index ( NDI ) , and lateral cervical flexion range of motion ( ROM ) were collected at baseline , 2 and 4 weeks after the initiation of therapy . Results revealed large pre – post-effect sizes within the INIT group ( Cohen 's d = 0.97 , 0.94 and 0.97 ) . Additionally , significantly greater improvements in pain and neck disability and lateral cervical flexion ROM were detected in favor of the INIT group ( 0.29–0.57 , 0.57–1.12 and 0.29–0.57 ) at a 95 % CI respectively . The findings of this study indicate the potential benefit of an integrated approach in deactivating upper trapezius trigger points . Further research should be performed to investigate the long-term benefits of the current treatment approach OBJECTIVE To examine electromyography ( EMG ) activity , passive torque , and stretch perception during static stretch and contract-relax stretch . DESIGN Two separate r and omized crossover protocol s : ( 1 ) a constant angle protocol on the right side , and ( 2 ) a variable angle protocol on the left side . SUBJECTS 10 male volunteers . INTERVENTION Stretch-induced mechanical response in the hamstring muscles during passive knee extension was measured as knee flexion torque ( Nm ) while hamstring surface EMG was measured . Final position was determined by extending the knee to an angle that provoked a sensation similar to a stretch maneuver . Constant angle stretch : The knee was extended to 10 degree below final position , held 10sec , then extended to the final position and held for 80 sec. Variable angle stretch : The knee was extended from the starting position to 10 degrees below the final position , held 10sec , then extended to the onset of pain . Subjects produced a 6-sec isometric contraction with the hamstring muscles 10 degrees below the final position in the contract-relax stretch , but not in the static stretch . MAIN OUTCOME MEASURES Passive torque , joint range of motion , velocity , and hamstring EMG were continuously recorded . RESULTS Constant angle contract-relax and static stretch did not differ in passive torque or EMG response . In the final position , passive torque declined 18 % to 21 % in both contract-relax and static stretch ( p<.001 ) , while EMG activity was unchanged . In the variable angle protocol , maximal joint angle and corresponding passive torque were significantly greater in contract-relax compared with static stretch(p<.01 ) , while EMG did not differ . CONCLUSION At a constant angle the viscoelastic and EMG response was unaffected by the isometric contraction . The variable angle protocol demonstrated that PNF stretching altered stretch perception AIM The purpose of this clinical trial experiment was to compare the effects of the combination of dry needling ( DN ) and the muscle energy technique ( MET ) on the upper trapezius latent myofascial trigger point . METHOD Sixty female patients , aged 18 - 30 with latent myofascial trigger points in the upper trapezius muscle were r and omly divided into three groups : group 1 ( n = 20 ) received DN and MET , group 2 ( n = 20 ) received only MET , and group 3 ( n = 20 ) received only DN . The visual analogue scale ( VAS ) , pressure pain threshold ( PPT ) , and range of active contra lateral flexion ( CLF ) were measured before each treatment . The patients were treated for three sessions in a one-week period with at least a two-day break between each session , and in session four , an assessment of primary outcomes was conducted without any treatment . RESULTS All three treatment groups showed decreases in pain ( p = 0.001 ) and increases in PPT levels ( p = 0.001 ) as well as increases in CLF ( p = 0.001 ) . But the group receiving trigger point DN together with MET showed more significant improvement than the other two groups in VAS , PPT and ROM . No significant differences were found between the MET-only group and the DN-only group . CONCLUSION Our results indicate that all three treatments used in this study were effective for treating MTP . According to this study , DN and MET is suggested as a new method for the treatment of MTP Variations in the application of muscle energy technique ( MET ) for increasing the extensibility of muscles have been advocated , but little evidence exists to support the relative merit of a particular approach . This study investigated two types of muscle energy techniques that have been advocated in the osteopathic literature that differ primarily in the duration of the post-contraction stretch phase . Forty asymptomatic participants ( mean age=22.1+/-3.5 , male female=1:4 ) were r and omly allocated to one of two groups ( Group 1 : MET with 30-s post-isometric stretch phase ; Group 2 : MET with 3-s post-isometric stretch phase ) . Hamstring length was measured using active knee extension ( AKE ) . Participants received an initial application of the allocated intervention , and then a second application 1 week later . Analysis with a split-plot ANOVA revealed a significant effect of time ( F(3,36)=42.30;p<0.01 ) , but no significant time*group interaction ( F(3,36)=0.12 ; p=0.95 ) . Post-hoc analysis revealed that the significant differences over time occurred between pre- and post- measurements at both weeks , and between post-Week 1 and pre-Week 2 measurements . Both techniques appeared to be equally effective in increasing hamstring extensibility , and there appeared to be sustained improvement 1 week following the initial treatment . The findings suggest that altering the duration of the passive stretch component does not have a significant impact on the efficacy of MET for short-term increases in muscle extensibility STUDY DESIGN A prospect i ve , pilot clinical trial . OBJECTIVE Examining the outcomes of Muscle Energy Technique ( MET ) in patients with acute low back pain . BACKGROUND MET is commonly used to treat patients with acute low back pain . No r and omized controlled trials examining the outcomes of this treatment in symptomatic population s has been reported in the literature . METHODS AND MEASURES Ten men and 9 women diagnosed with acute low back pain were r and omly assigned with stratification to 1 of 2 treatment groups . Patients were matched according to age , gender , and initial Oswestry score . The control group received supervised neuromuscular re-education and resistance training while the experimental group received the same exercises coupled with MET . Both groups received the selected treatment 8 times over a 4-week period ( 2 times per week ) . Patients completed an Oswestry Disability Index on their first and eighth visits and change scores were calculated . RESULTS A 2-tailed t test ( P < .05 ) demonstrated a statistically significant difference with the experimental group showing greater improvement in the Oswestry Disability Index score than the control group . CONCLUSION MET combined with supervised motor control and resistance exercises may be superior to neuromuscular re-education and resistance training for decreasing disability and improving function in patients with acute low back pain OBJECTIVE The main objective of this study is to compare the immediate results of manipulation to mobilization in neck pain patients . DESIGN The patients were compared in a r and omized controlled trial without long-term follow-up . SETTING The study was conducted at an outpatient teaching clinic on primary and referred patients . PATIENTS One hundred consecutive out patients suffering from unilateral neck pain with referral into the trapezius muscle were studied . Fifty-two subjects were manipulated  and 48 subjects were mobilized .  The mean ( SD ) age was 34.5 ( 13.0 ) yr for the manipulated group and 37.7 ( 12.5 ) yr for the mobilized group . Sixteen subjects had neck pain for less than 1 wk , 34 subjects had pain for between 1 wk and 6 mo and 50 subjects had pain for more than 6 mo . Seventy-eight subjects had a past history of neck pain . Thirty-one subjects had been involved in an injurious motor vehicle accident and 28 subjects had other types of minor trauma to the neck . There were no significant differences between the two treatment groups with respect to history of neck pain or level of disability as measured by the Pain Disability Index . INTERVENTION The patients received either a single rotational manipulation ( high-velocity , low-amplitude thrust ) or mobilization in the form of muscle energy technique . MAIN OUTCOME MEASURES Prior to and immediately after the treatments , cervical spine range of motion was recorded in three planes , and pain intensity was rated on the 101-point numerical rating scale ( NRS-101 ) . Both pre- and post-test measurements were conducted in a blinded fashion . RESULTS The results show that both treatments increase range of motion , but manipulation has a significantly greater effect on pain intensity . Eighty-five percent of the manipulated patients and 69 % of the mobilized patients reported pain improvement immediately after treatment . However , the decrease in pain intensity was more than 1.5 times greater in the manipulated group ( p = .05 ) . CONCLUSION This study demonstrates that a single manipulation is more effective than mobilization in decreasing pain in patients with mechanical neck pain . Both treatments increase range of motion in the neck to a similar degree . Further studies are required to determine any long-term benefits of manipulation for mechanical neck pain BACKGROUND AND OBJECTIVES To determine the effects of spinal stabilization exercises ( SSE ) and manual therapy methods on pain , function and quality of life ( QoL ) levels in individuals with chronic low back pain ( CLBP ) . METHODS A total of one-hundred thirteen patients diagnosed as CLBP were enrolled to the study . The patients allocated into Spinal Stabilization group ( SG ) and manual therapy group ( MG ) , r and omly . While SSE performed in SG , soft tissue mobilizations , muscle-energy techniques , joint mobilizations and manipulations were performed in MG . While the severity of pain was assessed with Visual Analog Scale ( VAS ) , Oswestry Disability Index ( ODI ) and Short Form 36 ( SF-36 ) assessment s were performed to evaluate the functional status and QoL , respectively . All assessment s were repeated before and after the treatment . RESULTS Intragroup analyses both treatments were effective in terms of sub parameters of pain , function and life quality ( p < 0.05 ) . Inter group analyses , there was more reduction in pain and improvement in functional status in favor of MG ( p < 0.05 ) . CONCLUSIONS This study showed that SSE and manual therapy methods have the same effects on QoL , while the manual treatment is more effective on the pain and functional parameters in particular Background : Mechanical neck pain is one of the common musculoskeletal disorders . Muscle energy technique ( MET ) may be a useful intervention for treating such disorder . Objective : The aim of this study was to compare the effect of MET with passive stretching on pain and functional disability in people with mechanical neck pain . Methods : A r and omized controlled trial was undertaken . Sixty patients with mechanical neck pain were r and omly allocated to either the MET group or control group . The former group received MET , and the latter group received static stretching . Both groups received conventional therapy . Treatment was given once a day for 6 days . A visual analogue scale ( VAS ) was used to measure the intensity of pain , and functional disability was assessed using the neck disability index ( NDI ) was immediately before treatment and again on the 6th day . Results : VAS and NDI scores showed a significant improvement in both MET and stretching groups on the 6th day postintervention ( p < 0.05 ) . However , both VAS and NDI scores showed better improvement in the MET group as compared to the stretching group ( p < 0.025 ) . Conclusion : Muscle energy technique was better than stretching technique in improving pain and functional disability in people with mechanical neck pain
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 .
The aim of this review is to determine the efficacy of  muscle energy techniques ( MET )  in symptomatic and asymptomatic subjects .
Systematic Review .