Abstract

Background: Within the human body, mechanical low back pain is among the most prevalent ailment, next only to the common cold. Back discomfort contributes to tardiness, reduced efficiency, healthcare costs, lost wages, and a host of psychological issues. Muscle energy approach combines the exactitude of passive mobilization with manual therapy to treat movement dysfunction. A passive manual treatment method called positional release is utilized to enhance function and lessen discomfort Aim : The aim of the study is to compare the effectiveness of MET versus PRT on pain and disability index in individual with mechanical low back ache. Objective: The objective of the study is to compare the effectiveness of MET and Positional release technique on pain and lumbar ROM in mechanical low back pain Methodology: This comparative experimental research investigation (pre- and post-intervention) was conducted in the outpatient department of ACS Hospital, Chennai. This research investigation intended to assess and contrast the efficacy of Manual Therapy (MET) and Progressive Resistance Training (PRT) in alleviating pain and impairment in patients with mechanical low back pain. A cohort of 30 individuals was selected based on predefined inclusion and exclusion criteria. Employing a basic random sample technique, thirty participants were randomly allocated into two groups of fifteen throughout a duration of six weeks, with three sessions each week. Pain and disability were assessed by the Visual Analogue Scale (VAS) and the Modified Oswestry Low Back Pain Disability Questionnaire. Comparisons of pre-test and post-test mean values yielded a statistically significant difference (p < 0.001), demonstrating that the Muscle Energy Technique is superior than the Positional Release Approach for lower lower back pain of mechanical origin. Result: Upon analysing the Pre-test and Post-test data from Group A and Group B, as measured by the Visual Analogue Scale (VAS) and the Modified Oswestry Low Back Pain Disability Questionnaire, a statistically significant difference in mean scores is seen, with a p-value of < 0.001. Conclusion: This study demonstrates the finding that the Muscle Energy Technique is substantially more efficacious as opposed to the Positional Release Technique for individuals suffering from mechanical low back pain.

• 1.   Rodrigo Dalke meucci et al., Prevalence of Chronic Low Back Pain, Revista de saude publica, 2015 49, 73. https://doi.org/10.1590/ S0034-8910.2015049005874
• 2.   Marico Antonio Dos Santos; low back pain & risk factors during the third infancy, Fisioterapia em Movimento, 2019, 32. 10.1590/1980-5918.032.AO10
• 3.   Joshua Scottwill et al, Mechanical low back pain, American family physician., 2018, 98(7), 421 – 428.https://pubmed.ncbi.nlm.nih. gov/30252425/
• 4.   Balague Federico et al., Non specific low back pain, The lancent 2012 482 – 491. https://doi. org/10.1016/S0140-6736(11)60610-7
• 5.   Joo Soo Yoon et al., The effects of Swissball and stabilisation exercise on pain & bone mineral density of patient with chronic low back pain., J Physio Ther Sci, 2013 aug 25 (8) : 953 – 956. https://doi.org/10.9734/jpri/2021/ v33i36A31934
• 6.   John Peloza., lower back pain symptoms, diagnosis and treatment 2017.javascript:void(0)
• 7.   Wu A., March L. et al., Global low back pain prevalence & years lived with disability from 1990 to 2017 : Ann Trans Med 2020; 8 (6), 299 – 313. https://doi.org/10.21037%2Fatm.2020.02.175
• 8.   Everett C. hills, Mechanical low back pain, Physical medicine & Rehabilitation feb 2022. https://emedicine.medscape.com/ article/310353-overview.
• 9.   Heba Embaby et al., Effects of MET in treating post partum coccydina., physical therapy & Rehabilitation., 2017, 2055 – 2386. 10.7243/2055- 2386-4-5
• 10.   P. Naik Prashanth., Comparison of MET and PRT in acute low back pain, Indian journal of physiotherapy and occupational therapy june 2010. https://www.researchgate.net/profile/ DeepakAnap/publication/223202765_1_ Effect_of_Acetic_acid_iontophoresis_ o n _ c a l c i f i c _ T e n d i n i t i s _ o f _ G l u t e u s _ medius_and_minimus_-_A_case_study/ links/0912f4fdc0d54edc63000000/1-Effectof-Acetic-acid-iontophoresis-on-calcificTendinitis-of-Gluteus-medius-and-minimusA-case-study.pdf#page=36
• 11.   E. Fahmy et al., Efficacy of spinal extension exercise program versus MET in treatment of chronic mechanical low back pain, The Egyptian journal of neurology, psychiatry and neurosurgery, 2019., 55(1), 1-6. https://doi. org/10.1186/s41983-019-0124-5
• 12.   Jagatheesan Alagesan; Unnati. S. Shah., Effect of positional release therapy & taping on unilateral upper trapezius tender points – RCT, international journal of health & pharmaceutical sciences ISSN22780564. https:// scholar.google.com/citations?view_op=view_ citation&hl=en&user=TCF0E2MAAAAJ&citation_for_view=TCF0E2MAAAAJ:PVjk1bu6vJQC
• 13.   K.Kirupa et. al., A comparative study between positional release technique and stretching with isometric exercises for acute trapezitis patient,, NOVYI MRI research journal, ISSN NO: 0130 – 7673. https://dx.doi.org/10.16965/ ijpr.2022.122
• 14.   Manivannan M Kaandeepan et al., Comparing the effectiveness of PRT technique & passive stretching on hamstring muscle through sit to reach test in normal female subjects, physiotherapy and occupational therapy, 2011, 5 (3), 58. https://www. researchgate.net/profile/Lata-Parmar-3/ publication/261098235_Ashish_V_Gupta_ Lata_Parmar_To_Assess_the_Relation_ Between_Walking_Capacity_and_Cardiorespiratory_Function_in_Post_Polio_ Residual_Paralysis_-_Indian_Journal_ of_Physiotherapy_and_Occupational_ Therapy_J/links/54b3b69e0cf26833efcea27c/ Ashish-V-Gupta-Lata-Parmar-To-Assessthe-Relation-Between-Walking-Capacityand-Cardio-respiratory-Function-in-PostPolio-Residual-Paralysis-Indian-Journal-ofPhysiotherapy-and-Occupational-Therapy. pdf#page=62
• 15.   Timothy speicher et al., Top 10 positional release therapy techniques to break the chain of pain, Athletic therapy today 2006 11(6): 69 – 71. https://digitalcommons.sacredheart.edu/ pthms_fac/14/
• 16.   Emad Eldin Mohamed, Conventional therapy versus positional release therapy in the treatment low back dysfunction., international journal of physical therapy & research, 2017 vol 5 (5). https://dx.doi.org/10.16965/ ijpr.2017.201
• 17.   Anne F Mannion et al., pain measurement in patients with low back pain, Nature clinical practice Rheumatology, 2007 3 (11), 610 – 618. https://www.nature. com/articles/ncprheum0646#citeas:~:text=610%E2%80%93618%20(2007).-,https%3A// doi.org/10.1038/ncprheum0646,-Download%20citation
• 18.   Anne M Boonstra et al., Reliability & validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain, International journal of rehabilitation research 2008, 31(2), 165 to 169. https://journals.lww. com/intjrehabilres/abstract/2008/06000/ reliability_and_validity_of_the_visual_ a n a l o g u e . 8 . a s p x # : ~ : t e x t = 1 0 . 1 0 9 7 / MRR.0b013e3282fc0f93
• 19.   Jeremy CT Fairbank, the oswestry disability index, spine 2010, 25(22) 2940 – 2953. https:// doi.org/10.3171/2013.7.SPINE13288
• 20.   Julie M fritz, James J Irrang., A comparison of modified oswestry low back pain disability questionnaire & the Quebec back pain disability scale, physical therapy 2001 81(2), 776 – 778. https://doi.org/10.1093/ptj/81.2.776
• 21.   Franke H, Fryer G, Ostelo RW, Kamper SJ. Muscle energy technique for non-specific lowback pain. Cochrane Database Syst Rev. 2015 Feb 27;2015(2):CD009852.doi:PMC10945353. https://doi.org/10.1002/14651858.CD009852. pub2.
• 22.   Memon Fa, Memon sh. assessing the impact of positional release technique and muscle energy technique on low back pain-a randomized controlled trial. Pakistan Journal of Rehabilitation. 2023; 12(2): 45–54. https:// doi.org/10.36283/pjr.zu.12.2/007
• 23.   Woby S.R., et al. Adjustment to chronic low back pain – the relative influence for fear avoidance beliefs, catastrophizing and appraisals of control, Behaviour Research and Therapy 42.7 2004 761–774 https://doi.org/10.1016/S0005- 7967(03)00195-5
• 24.   Essential of orthopaedics & applied physiotherapy, Jayant joshi 431 2002
• 25.   Mellin G. Decreased joint and spinal mobility associated with low back pain in young adults, J Spinal Disord 1990; 3: 238 – 243. https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Mellin+G.+- Decreased+joint+and+spinal+mobility+associated+with+low+back+pain+in+young- + a d u l t s % 2 C + J + S p i n a l + D i s o r - d + 1 9 9 0 & b t n G = # : ~ : t e x t = i n c l u d e % 2 0 citations-,Decreased%20joint%20and%20 s p i n a l % 2 0 m o b i l i t y % 2 0 a s s o c i a t e d % 2 0 with%20low%20back%20pain%20in,G%20 Mellin,-Clinical%20Spine%20Surgery
• 26.   bhojan kannabiran, et al. A comparative study on effectiveness of two manual therapy techniques on pain and lumbar range of motion in individuals with mechanical low back ache, ECorthopaedics2.12015:36–42. https:// scholar.google.com/scholar?hl=en&as_ sdt=0%2C5&q=bhojan+kannabiran%2C+et al.++A+comparative+study+on+effectiveness+of+two+manual+therapy+techniques+on+pain+and+lumbar+range+of+mot i o n + i n + i n d i v i d u a l s + w i t h + m e c h a n i - cal+low+back+ache&btnG=#:~:text=A%20 Comparative%20Study%20of,Orthopae dics%2C%202015%20%2D%20ecronicon.net
• 27.   Eric Wilson, Otto payton et al., muscle enegy technique in patients with acute low back pain: a pilot control trial, 2003: 502 – 512, 33(9) https://www.jospt.org/doi/10.2519/ jospt.2003.33.9.502
• 28.   Marzouk A Ellythy., Efficacy of muscle energy technique versus myofascial release on function outcome measures in patients with chronic low back pain, 2012 https:// scholar.google.com/scholar?hl=en&as_ sdt=0%2C5&q=Marzouk+A+Ellythy.%2C+Efficacy+of+muscle+energy+technique+versus+myofascial+release+on+function+outcome+measures+in+patients+with+chronic+low+back+pain%2C+2012&btnG=#:~:text=%5BPDF%5D,Efficacy%20of%20muscle%20 energy%20technique%20versus%20myofascial%20release%20on%20function%20outcome,MA%20Ellythy,-Bull%20Fac%20Ph
• 29.   Taimoor Ameen et al., Comparison of effectiveness of muscle energy technique with strain counter strain technique on the patients of Non specific Neck Pain, 2022. https://doi. org/10.54393/tt.v3i1.36
• 30.   Richa Mahajan, Chitra Kataria, Kshitija Bansal, Comparative Effectiveness of muscle energy technique and Static stretching for treatment of subacute mechanical neck pain. . Comparative effectiveness of muscle energy technique and static stretching for treatment of subacute mechanical neck pain
• 31.   Deepali Sharma, Siddhartha Sen., Effects of MET on Pain and Disability in subjects with SI Joint dysfunction, 2014. Effects of muscle energy technique on pain and disability in subjects with SI joint dysfunction
• 32.   Prachi N Patil., et al., Effectiveness of muscle energy technique on quadratus in acute low back pain- RCT Indian journal of physiotherapy, 2010. Effectiveness of muscle energy technique on quadratus lumborum in acute low back pain-randomized controlled trial
• 33.   Mitushi Kishor Deshmukh, Pratik Arun, et al., Effect of Muscle energy Technique on Piriformis tightness in Chronic Low back Pain with radiation, Journal of Evolution of Medical and Dental Sciences 9(44),2020. 10.14260/ jemds/2020/722
• 34.   Shah Atika Suri, Misra Anand, Comparative study on the effectiveness of Maitland mobilization technique versus Muscle energy technique in treatment of Adhesive Capsulitis, 2013. Comparative study on the effectiveness of Maitland mobilization technique versus muscle energy technique in treatment of shoulder adhesive capsulitis

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