Effects of muscle energy technique in patients with chronic low back pain of zygapophyseal joint origin

Abstract

This study aimed to investigate the immediate effect of muscle energy technique (MET) for individuals with chronic low back pain (LBP) from zygapophyseal joint origin. Twenty-one subjects who met the criteria were recruited. The participants were randomly assigned to receive one session of treatments either MET as experimental group or lumbar stabilization exercises (LSE) as control group. The primary outcome was lumbar spine movements, and secondary outcomes were pain threshold, pain intensity, and disability level. Lumbar active range of motion (AROM) for flexion, extension, right lateral flexion, left lateral flexion, right rotation, and left rotation, and pressure pain threshold (PPT) were evaluated at baseline and immediately after treatment. Visual analogue scale (VAS) was evaluated at baseline, immediately after treatment, and two days after treatment. In addition, Thai version of the modified Oswestry LBP Disability Questionnaire (ODQ) was utilized at baseline and two days after treatment. Independent sample t-test, and two-way repeated measure ANOVA were used for statistical analysis. The results showed significant main effect of time for right lateral flexion, VAS and ODQ scores (p<.001). The time effect of lateral flexion movement might be the result of reflex muscle relaxation after both interventions. Also, the pain and function were improved after both types of physical therapy treatments. The analysis of changed score showed no significant differences for all outcomes. In conclusion, this study revealed the immediate effect of MET and LSE which were effective to increase AROM, decrease pain intensity and disability level. Therefore, the choice or combination of MET and LSE as tailor-made intervention might be more beneficial for individuals with chronic LBP due to zygapophyseal joint problems.