An
investigation into the changes in muscle strength following the application
of muscle energy technique, or soft tissue mobilisation
Karl Healy Supervisor: Phyllis Woodfine
ABSTRACT
Background
and Objectives: Soft Tissue
Mobilisation (STM) and Concentric Isotonic Muscle Energy Technique (MET) are
common treatment techniques used by manual therapists in the rehabilitation
of many musculoskeletal disorders. The
aim of this controlled study was to examine
the immediate physiological changes in the quadriceps muscle after the
application of either STM or MET, by measuring changes in muscle strength.
Methods: Asymptomatic subjects (N = 27) were randomly allocated to one
of three groups, receiving either STM for three minutes, three sets of
concentric isotonic MET, or control (three minutes relaxing supine).
Two consecutive strength measurements were taken from the left
quadriceps muscle, directly before and after the allocated treatment, using
a bespoke measuring apparatus with a force gauge.
This process was repeated for the right quadriceps muscle to give two
measurements per subject.
Analysis:
Compared to pre-treatment strength measurements, post-treatment measurements
were significantly greater for the STM treatment group (p = 0.017), however
there were no significant changes for both the MET (p = 0.84) and the
control groups (p = 0.22). These
were analysed using within group paired t-tests.
A one-way analysis of variance with Student-Newman-Keuls
multiple comparisons test, compared the differences of the pre and post
strength measurements between each group and found no significant
differences (P = 0.14).
Conclusion:
The study showed that there was a significant increase in quadriceps muscle
strength after the application of STM, indicating it may be a beneficial
technique in patient rehabilitation. Although
MET showed no significant effect on muscle strength, its therapeutic effects
in rehabilitation cannot be dismissed, as the large number of variables in
this study, discussed in the limitations, may have influenced the accuracy
of the study and may need further refinement.
Alternatively, concentric
isotonic MET may indeed have no immediate effect on muscle strength, which
challenges the current beliefs and models regarding the physiological
effects of this type of MET. However,
further study of MET would be required, which considered both immediate and
long-term effects, in order to add
clarity to the results.
MET and STM techniques are widely accepted within the
manual therapies, however their effectiveness is poorly supported by robust
clinical evidence, therefore further research is needed to endorse their use
in patient rehabilitation.