Table 3 Summary of evidence of studies with Symptomatic patients
| Authors | Sample size (n) | Sessions (n) | Patients symptom | Anatomical administration of MET | Procedure | Outcome | Additional information | Comparison with other technique |
|---|---|---|---|---|---|---|---|---|
| Bindra [10] | 30 | 6 | Chronic LBP | Sacroiliac Joint | Contraction for 8–10s at 25% max force – 2-3 s relaxation – 4-6 contractions – at the barrier of restriction | VAS and ROM improved at the end of treatment | MET and conventional therapy are both effective in managing lumbar back pain | Conventional therapy (ultrasound 5 mins, intensity of 1 W/cm2 and TENS for 10 mins 50–100 Hz) |
| Cassidy et al. [14] | 100 | 1 | Mechanical neck pain | Upper trapezius | 5 s contraction – 4 contractions – at the restricted joint movement | Pain decreased and ROM increased | HVLA technique has larger benefits than MET after a single application | Comparison with HVLA |
| Kamali et al. [35] | 46 | 15 | Thoracic Kyphosis | Thoracic spine | 5–7 s contraction at 25% of max force – 5 contractions – at the barrier of movement | Reduced Kyphosis increased ROM | Manual therapy is as effective as exercise therapy in reducing thoracic kyphosis | Exercise Therapy |
| Küçükşen et al. [17] | 82 | 8 | Chronic lateral epicondylitis | Elbow | 5 s contraction at 75% max force – 5 s relaxation – 5 contractions – at the resistance point | Decreased VAS, Decreased DASH score (Disabilities of the Arm, Shoulder and Hand), increased PFGS (pain-free grip strength) |
MET and CSI improved the strength, pain, and functional status of patients. CSI is a better option as a short term option. MET is superior as a long term option. |
Corticosteroid Injections (CSI) |
| Nagrale et al. [38] | 60 | 12 | Non specific neck pain | Upper trapezius | 7–10s contraction at 20% max force – Relaxation phase – 30s stretch after contraction to a new resistance point – 3-5 contractions. | VAS, Neck disability index (NDI) and ROM. |
Significantly greater improvements in pain and neck disability and lateral cervical flexion ROM were detected in favor of the INIT group | Integrated neuromuscular inhibition technique (INIT) |
| Oliveira-Campelo et al. [39] | 117 | 1 | Unilateral latent trigger points | Upper trapezius | 5 s contraction at 25% max force – 5 s relaxation – new end point – 3-5 contractions | ROM, and pain thresholds improved after a single session. | Ischemic compression resulted with a more stable improvement | Passive stretch, ischemic compression, placebo, control. |
| Phadke et al. [13] | 60 | 6 | Neck pain | Upper trapezius and levator scapulae | 7–10s contraction at 20% max force − 20 s stretch beyond the resistance barrier − 5 contractions | Reduced pain (VAS) and reduced NDI | MET and stretching are both effective in relieving pain and reducing disability. | Static stretching |
| Sadria et al. [12] | 64 | 1 | Latent trigger points | Upper trapezius | 7–10s contraction at 20% max force – relaxation phase – 30s stretch at the restriction barrier - | VAS reduction | Both techniques are equivalent for treating latent trigger points | Active release |
| Sakshi et al. [40] | 30 | 8 | Chronic neck pain | Suboccipitalis, Upper Trapezius and Pectoralis Major. | 7–10s contraction with mild effort – new barrier – 3 contractions. | Reduction of neck disability index, Reduced forward head posture and pain | MET was superior to exercise intervention. | Exercise intervention |
| Selkow et al. [7] | 20 | 1 | Acute LBP | Lumbar region | 5 s contraction – 5 s relaxation – 4 contractions | VAS decreased | n/a | Control group |
| Tanwar et al. [42] | 30 | 18 | Plantar fasciitis | Gastrocnemius | 7–10s contraction at 20% max force – new restriction barrier – 30s stretch – 3 contractions | Increased ROM, improved foot functional index (FFI) and reduced pain | n/a | Static Stretch |
| Ulger et al. [9] | 113 | 18 | Chronic LBP | Low back | 8 s contraction at 30% of max force – new stretch position - repeated until necessary | Pain severity reduction, Decreased Oswestry disability index (ODI), Improved quality of live levels | MET and spinal mobilization are equally effective on pain, function and quality of life. MET is more effective for pain during activity and functional parameters. | Spinal mobilization |
| Wilson et al. [8] | 8 | 8 | Acute LBP | Low back | 5 s contraction – new barrier of motion – 4 contractions | Reduction in ODI score | MET elicited superior changes compared to control group. | Control |
| Yeganeh Lari et al. [11] | 60 | 4 | Latent trigger points | Upper Trapezius | 7–10s contraction at 20% max force – relaxation phase – new barrier of motion – 30s stretch – 3-5 contractions | Reduced VAS, Increased neck ROM and increased pressure pain thresholds | MET+Dry needling was more effective in increasing rom and reducing pain than the 2 techniques alone. | Dry needling and MET+dry needling |
| Total: 954 | Mean: 7.6 |