Pelvic Girdle Dysfunction Interventions: Muscle Energy Technique
This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (20/01/2021)
Original Editor - User Name
Top Contributors - Wanda van Niekerk, Kim Jackson, Jess Bell and Tarina van der Stockt
Introduction[edit | edit source]
Physiotherapists have a range of available options to address pelvic girdle dysfunction. Some of these methods include[1]:
- Electrotherapy
- Massage
- Soft tissue mobilisation
- Myofascial release
- Exercises
- Bracing
- Manipulation
- Mobilisation
- Patient education
- Taping (for example kinesiotaping)
Manual therapy has been utilised and shown to be effective in the treatment of various musculoskeletal conditions.[2] Specifically, for the treatment of sacroiliac joint dysfunction, which is part of pelvic girdle dysfunction, manual therapy techniques are frequently incorporated in the treatment. Some of these techniques are manipulation, muscle energy technique (MET), McKenzie, Maitland’s mobilisation, and Mulligan’s mobilisation.[3][4] Of these techniques, MET is a popular technique used among physiotherapists and osteopaths. Muscle energy techniques are used to treat soft tissue, mobilise joint, stretch tight muscles and fascia, reduce pain and improve circulation and lymphatic drainage.[5] Muscle energy technique can be defined as “a manual treatment in which a patient produces a contraction in a precisely controlled position and direction against a counterforce applied by a manual therapist.”[5] MET works on two basic principles i.e. post isometric relaxation and reciprocal inhibition.[6]
For more information read this Physiopedia Page: Muscle Energy Technique
Evidence for Muscle Energy Technique in the Management of Pelvic Girdle Dysfunction[edit | edit source]
Muscle energy techniques have been found to be more effective than mobilization techniques in females with post-partum low back pain due to sacroiliac joint dysfunction. Sachdeva et al 2018.
In an investigation on the effect of muscle energy technique on pain and function in patients with sacroiliac joint dysfunction it was concluded that MET is an effective tool in the management of sacroiliac dysfunction.
Alkady et al investigated the efficacy of Mulligan mobilisation versus muscle energy techniques in patients with chronic sacroiliac joint dysfunction and concluded that Mulligan mobilisation was more effective than muscle energy technique.
A study on the effect of MET on pain and disability in patients with SIJ dysfunction indicated that MET and mobilisation are both effective in the treatment of chronic low back pain due to SIJ dysfunction.
In a comparative analysis of muscle energy technique (MET + corrective exercise) and conventional physiotherapy (TENS + corrective exercise) in patients with SIJ dysfunction, it was reported that along with corrective exercises, MET is moderately significant over conventional physiotherapy in improving function and decreasing pain. Dhinkaran et al
From this evidence it may be hypothesised that Muscle Energy Technique with conventional or other physiotherapy treatment may be helpful in reducing pain and improving function in patients with sacroiliac joint dysfunction, but further research is necessary, and the current quality of research is low. Kansagara et al
Pregnancy-related pelvic girdle pain
Beales et al 2015 reported that physiotherapists use MET as an alternative to exercises performed solely by the patient in the management of PPGP. Licciardone et al 2010 investigated the effect of MET as part of a multimodal treatment regime on pregnant women with lumbopelvic pain, but only reported a weak effect (0.27 for pain using a VAS).
More recently Ceprnja and Gupta (2019) investigated the immediate effectiveness of a MET in the management of pain in women with PPGP within a single session of physiotherapy. The study participants were treated with a MET and sham transcutaneous electrical nerve simulation in a randomised order.
The primary outcome measures in this study were the self-reporting of pain using a VAS and function using the Timed Up and Go. The results showed no statistically significant difference between scores for the VAS and the Timed Up and Go, following the use of MET, sham TENS or standard care which was recorded after each intervention. There was however, a statistically significant improvement in pain and function from baseline compared with each time of measurement thereafter. The authors suggest that the improvements may have been due to a placebo effect with the knowledge that care is being provided, mechanical unloading during the session or familiarisation with the test procedures.
Examples of Muscle Energy Technique in Pelvic Girdle Region[edit | edit source]
In the course on Pelvic Girdle Dysfunction by Deborah Riczo, she describes an algorithm of three exercises that she uses with great success in her patients with pelvic girdle dysfunction. You can access the course here.
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
References[edit | edit source]
- ↑ Al-Subahi M, Alayat M, Alshehri MA, Helal O, Alhasan H, Alalawi A, Takrouni A, Alfaqeh A. The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review. Journal of physical therapy science. 2017;29(9):1689-94.
- ↑ Clar C, Tsertsvadze A, Hundt GL, Clarke A, Sutcliffe P. Clinical effectiveness of manual therapy for the management of musculoskeletal and non-musculoskeletal conditions: systematic review and update of UK evidence report. Chiropractic & manual therapies. 2014 Dec 1;22(1):12.
- ↑ Bindra S. A study on the efficacy of muscle energy technique as compared to conventional therapy on lumbar spine range of motion in chronic low back pain of sacroiliac origin. Human Biol Rev. 2013;2(4):13.
- ↑ Alkady SM, Kamel RM, AbuTaleb E, Lasheen Y, Alshaarawy FA. Efficacy of mulligan mobilization versus muscle energy technique in chronic sacroiliac joint dysfunction. International Journal of Physiotherapy. 2017 Oct 1;4(5):311-8.
- ↑ 5.0 5.1 Thomas E, Cavallaro AR, Mani D, Bianco A, Palma A. The efficacy of muscle energy techniques in symptomatic and asymptomatic subjects: a systematic review. Chiropractic & Manual Therapies. 2019 Dec 1;27(1):35.
- ↑ Kansagara PR, Patel JK. Muscle Energy Technique for Sacroiliac Joint Dysfunction--An Evidence Based Practice. Indian Journal of Physiotherapy & Occupational Therapy. 2019 Apr 1;13(2).
