The Influence Of A Muscle Energy Treatment Session On Trunk Muscle Activity In Participants With Chronic Low Back Pain Brown, Lauren ¹, Banks, Heather ¹, Mahato , Niladri ², Clark, Brian ² , ³, Walkowski , Steven ² , ³ , Thomas, James ¹ , ² , ³
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The Influence Of A Muscle Energy Treatment Session On Trunk Muscle Activity In Participants With Chronic Low Back Pain
Brown, Lauren¹,Banks, Heather¹,Mahato, Niladri²,Clark, Brian²,³,Walkowski, Steven²,³ ,
1School of Rehabilitation and Communication Sciences, Division of Physical Therapy, Ohio University, 2Ohio Musculoskeletal and Neurological Institute,3Department of Biomedical Sciences College of Osteopathic Medicine, Ohio University, Athens, OH
Our healthy subjects had an average score of 0 on the MPQ-SF PPI, whereas the LBP subjects had an average score of 1.33. On the RMDQ, the healthy subjects had an average score of 0, and the LBP subjects had an average score of 5.67. There were no significant differences between the groups for age, height and weight (p>.05). Across the two target locations located in the mid-sagittal plane, the average lumbar excursion was 19.1° for the LBP subjects and 11.4° for the healthy matched controls (SD=2.59, F=4.36, p=.05) There was no significant difference found regarding only the muscle energy technique on lumbar excursion, as well as no difference during reaching requiring 30° of lumbar rotation to each side. On the contrary, there was a significant interaction of treatment (pre vs. post-muscle energy technique) and group (LBP vs. healthy subjects) (F=6.78, p=.02) (figure 3). After treatment, females with LBP demonstrated increased lumbar flexion whereas healthy female subjects exhibited a slight decrease in lumbar flexion (figure 5).
We chose to examine a commonly used clinical technique which currently does not have a sufficient level of supportive evidence for its usefulness in the treatment of low back pain. The evidence that currently exists focuses on using muscle energy to relieve the patient’s pain as opposed to its use to improve the kinematics at that area. Our research shows that there is support for the use of muscle energy to improve lumbar excursion. Specifically, female subjects with low back pain displayed increased lumbar flexion motion in a reaching task after receiving the muscle energy treatment. Healthy female subjects showed slightly less lumbar flexion following the same treatment. Females with chronic low back pain may benefit from muscle energy treatment to improve lumbar motion as well as their ability to perform tasks requiring large trunk excursions.
The results of this study were used as preliminary data for the RELIEF study, a large scale randomized controlled trial that is currently being conducted at Ohio University.
Figure 1: Target heights were calculated using the subject’s anthropometric measurements. Subjects could reach each target location with their shoulder flexed to 90° and elbow extended by flexing the hips 15° or 30°.
Figure 3: The muscle energy technique applied to the lumbar spine
Figure 2: A subject is depicted performing the reaching task.
Figure 5: Aggregate data displaying subjects’ lumbar excursion during a reaching task. Following treatment, females with LBP demonstrated increased lumbar flexion whereas healthy female subjects exhibited a slight decrease in lumbar flexion.
Figure 4: Amount of trunk excursion during the reaching task in the mid-sagital plane to the A) high target B) low target and C) average of high and low targets
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