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Table 3 Summary of evidence of studies with Symptomatic patients

From: The efficacy of muscle energy techniques in symptomatic and asymptomatic subjects: a systematic review

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.
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