The Effect of Muscle Energy Technique and Instrument Assisted Soft Tissue Mobilization in Adults with Shortened Hamstring on the Range of Motion, Muscle Strength and Muscle Thickness

넙다리뒤근이 단축된 성인에게 시행된 근에너지기법과 도구를 이용한 연부조직가동술이 관절가동범위, 근력, 근 두께에 미치는 영향

  • Lee, Jun-yong (Dept. of Physical Therapy, Seoul Metropolitan bukbu Hospital) ;
  • Sim, Hyun-po (Dept. of Physical Therapy, Gangnam Severence Hospital) ;
  • Choi, Yul-jung (Dept. of Physical Therapy, Roi Hospital)
  • 이준용 (서울특별시 북부병원, 물리치료실) ;
  • 심현보 (강남세브란스병원, 물리치료실) ;
  • 최율정 (로이병원, 물리치료실)
  • Received : 2021.01.20
  • Accepted : 2021.02.19
  • Published : 2021.04.30

Abstract

Background: This study aimed to investigate the effects of muscle energy technique (MET) and instrument assisted soft tissue mobilization (IASTM) on knee extension ROM, knee extensor/flexor strength and muscle thickness immediately and after 24 hours. Methods: A total of 30 subjects participated in this study. The participants were assigned to either MET (n=15) or IASTM (n=15). 90-90 straight leg raise, knee extensor/flexor muscle strength, muscle thickness test were measured before, immediately after and 24 hours after the intervention. Results: Both groups significantly improved knee extension ROM on immediate (MET 10.7°, IASTM 10.21° increased) and after 24 hours assessment (MET 5.61°, IASTM 5.47° increased)(p<.05). In the MET group, knee extension and flexion muscle strength increased immediately after intervention (p<.05). In the IASTM group, knee extension muscle strength increased and knee flexor muscle strength decreased immediately after intervention (p<.05). Furthermore, both groups showed a pattern of returning to the initial strength after 24 hours. In both groups, no significant difference in muscle thickness immediately and after 24 hours was observed (p>.05). Conclusion: According to the results of the present study, MET and IASTM technique showed lasting effectiveness in flexibility of shortened hamstring immediately after and in 24 hours after the intervention. In both groups, MET increased muscle strength and increased ROM, while IASTM decreased muscle strength and increased ROM, with no change in muscle thickness.

Keywords

References

  1. Chaitow L. Muscle Energy Technique. Churchill Livingstone. 3rd ed. 2006.
  2. Choi YJ, Sim HP, Lee JY. The pilot study on the immediate effects of graston technique for lower extremity range of motion, muscle strength, walking ability in hemiplegic patients. Korean J Orthop Manu Ther. 2019;25(1):21-27.
  3. Forman J, Geertsen L, Rogers ME. Effect of deep stripping massage alone or with eccentric resistance on hamstring length and strength. J Bodyw Mov Ther. 2014;18(1):139-144. https://doi.org/10.1016/j.jbmt.2013.04.005
  4. Greenman PE. Principle of Manual Medicine. Lippincott Williams & Wilkins. 2003.
  5. Gunn LJ, Stewart JC, Morgan B, et al. Instrumentassisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial. J Man Manipulative Ther. 2019;27:15-23. http://doi.org/10.1080/10669817.2018.1475693
  6. Jang WS, Choi SH. The immediate effect of soft tissue mobilization before mobilization with movement on the ankle range of motion, muscle tissue, balance in stroke patients. Korean J Orthop Manu Ther. 2020;26(1):37-46.
  7. Johnson AW, Mitchell UH, Meek K, et al. Hamstring flexibility increases the same with 3 or 9 repetitions of stretching held for a total time of 90s. Phys Ther Sport. 2014;15(2):101-105. http://dx.doi.org/10.1016/j.ptsp.2013.03.006
  8. Joo DY, Kim YB, Jeong DH, et al. The effects of compound program of muscle energy tech nique and therapeutic massage on patient with chronic low back pain. Res On Phys Fit. 2007;29(1):87-98.
  9. Kim DH, Kim TH, Jung DY, et al. Effects of the graston technique and self-myofascial release on the range of motion of a knee joint. J Korean Soc Phys Med. 2014;9(4):455-463. http://doi.org/10.13066/kspm.2014.9.4.455
  10. Kisner C, Colby LA. Therapeutic Exercise: Foundations and Techniques. F.A. Davis Company. 6th ed. 2012.
  11. Lankhorst NE, Bierma-Zeinstra SM, van Middelkoop M. Factors associated with patellofemoral pain syndrome: a systematic review. Br J Sports Med.2013;47(4):193-206. http://dx.doi.org/10.1136/bjsports-2011-090369
  12. Lee J, Young A, Erb NJ, et al. Acute and residual effects of IASTM and roller massage stick on hamstring range of motion. J Allied Health. 2020;49(1):e51-e55.
  13. Lee Yh. Rehabilitation Imaging Anatomy. Daehan narae Publishing. 2018.
  14. Lim SH, Son JM, Park DS, et al. A comparative study on the muscle energy technique(MET) and stretching exercise effect of hamstring flexibility improvement. J Oriental Rehab Med. 2009;19(1):201-211.
  15. Magnusson SP, Simonsen EB, Aagaard P, et al. A mechanism for altered flexibility in human skeletal muscle. J Physiol. 1996;497(Pt 1):291-298. http://doi:10.1113/jphysiol.1996.sp021768
  16. Markovic G. Actue effects of instrument assisted soft tissue mobilization vs. foam rolling on knee and hip range of motion in soccer players. J Bodyw Mov Ther. 2015;19(4):690-696. https://doi.org/10.1016/j.jbmt.2015.04.01.0
  17. Mohr AR, Long BC, Goad CL. Effect of foam rolling and static stretching on passive hip-flexion range of motion. J Sport Rehabil. 2014;23(4):296-299. http://doi.org/10.1123/jsr.2013-0025.
  18. Nelson AG, Kokkonen J. Acute ballistic muscle stretching inhibits maximal strength per formance. Res Q Exerc Sport. 2001;72(4):415-419. http://doi:10.1080/02701367.2001.10608978
  19. Oh DW. Comparison of the immediate effects of the neural mobilization technique and static stretching exercise on popliteal angle and hamstring compliance in young women with short hamstring syndrome. Phys Ther Kor. 2017;24(2):9-18. http://doi.org/10.12674/ptk.2017.24.2.009
  20. Park JH, Shim JW, Cho WY, et al. Literature review of tool-based manipulation for musculoskeletal diseases-with focus on guasha and IASTM. J Korean Med Rehabi. 2016;26(4):57-65. http://doi.org/10.18325/jkmr.2016.26.4.57.
  21. Payla M, Gill M, Singal SK, et al. A comparison of the immediate and lasting effects between passive stretch and muscle energy technique on hamstring muscle extensibility. Indian J Physiother Occup Ther. 2018;12(1):24-29. https://doi:10.5958/0973-5674.2018.00005.9
  22. Pringle RK. Intra-instrument reliability of 4 goniometers. J Chrio Med. 2003;2(3):91-95. https://doi.org/10.1016/S0899-3467(07)60051-2
  23. Sadler SG, Spink MJ, Ho A, et al. Restriction in lateral bending range of motion, lumbar lordosis, and hamstring flexibility predicts the development of low back pain: A systematic review of prospective cohort studies. BMC Musculoskelet Disord. 2017;18:179-194. https://doi10.1186/s12891-017-1534-0
  24. Seong JH, Choi JD. Comparison of nerve mobilization, static stretching, and hold-relax on hamstring flexibility in stroke patients. Phys Ther Kor. 2010;17(2):67-74.
  25. Shadmehr A, Hadian MR, Naiemi SS, et al. Ham string flexibility in young women following passive stretch and muscle energy technique. J Back Musculoskelet Rehabil. 2009;22(3):143-148. https://doi:10.3233/BMR-2009-0227.
  26. Shim YH, Song HB, Kim YH, et al. The effect of functional kinesio taping on the forward head angle in computer work in adults with forward head posture. Korean J Orthop Manu Ther. 2019;25(2):57-64.
  27. Sim HP, Yoon HI, Lee JY. The immediate effects of active ankle ROM exercise on passive straight leg raising. Korean J Orthop Manu Ther. 2010;16(2):40-47.
  28. Singh AK, Nagaraj S. Palikhe RM, et al. Neurodynamic sliding versus PNF stretching on hamstring flexibility in collegiate students: A comparative study. Inter J Phys Edu Sports Health. 2017;4(1):29-33.
  29. Smith M, Fryer G. A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group. J Bodyw Mov Ther. 2008;12:312-317. https://doi:10.1016/j.jbmt.2008.06.011
  30. Spernoga SG, Uhl TL, Arnold BL, et al. Duration of maintained hamstring flexibility after a on e-time, modified hold-relax stretching protocol. J Athl Train. 2001;36(1):44-48.
  31. Teyhen. Rehabilitative ultrasound imaging symposium. J Orthop Sports Phys Ther. 2006;36(8):A1-A17. https://doi/10.2519/jospt.2006.0301
  32. Zoladz JA. Muscle and Exercise Physiology. 1st ed. Academic Press. 2018.