Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2022

01-12-2022 | Neck Pain | Research

Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, rom and qol in the management of non-specific neck pain: a randomized controlled trial

Authors: Zainab Khalid Khan, Syed Imran Ahmed, Aftab Ahmed Mirza Baig, Waqas Ahmed Farooqui

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Login to get access

Abstract

Background

Non-specific neck pain is the most prevailing musculoskeletal disorder which has a large socioeconomic burden worldwide. It is associated with poor posture and neck strain which may lead to pain and restricted mobility. Physical therapists treat such patients through several means. Post isometric relaxation and Myofascial release therapy are used in clinical practice with little evidence to be firmed appropriately. So, this study was conducted to explore the effect of Post-isometric relaxation in comparison to Myofascial release therapy for patients having non-specific neck pain.

Methodology

Sixty patients were randomly allocated to Post isometric group and the Myofascial group. The treatment period was of 2 weeks. All the patients were evaluated using the Visual analogue scale (VAS), Neck disability index (NDI), Universal Goniometer, and WHO BREF Quality of life-100 in the 1st and 6th sessions. Recorded data was entered on SPSS 21. Data were examined using two-way repeated ANOVA to measure the variance of analysis (group x time).

Results

Analysis of the baseline characteristics revealed that both groups were homogenous in terms of age and gender i.e. a total of 60 participants were included in this research study 30 in each group. Out of 60 patients, there were 20(33.3%) males and 40(66.7%) females with a mean age of 32.4(5.0) years. Participants in the Post Isometric group demonstrated significant improvements (p < 0.025) in VAS, NDI, Cervical Extension, left side rotation ranges, and QoL (Social Domain) at the 2-week follow-up compared with those in the Myofascial group. In addition, the Myofascial group indicated significantly better improvement in the mean score of CROM (flexion and right and left side bending).

Conclusion

The study demonstrated patients with nonspecific neck pain can benefit from the post isometric relaxation with significant improvement in pain, disability, cervical ROM, and Quality of life compared with myofascial release therapy.

Trial registration

Clinical Trial registered on clinicaltrial.gov (NCT number) NCT04638062, 20/11/2020 (prospectively registered).
Literature
1.
Campos T, Maher GC, Steffens D. Fuller Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. J Physiother. 2018;64(3):159–65.CrossRef
2.
Hurwitz E, Randhawa K, Yu H, Cote P, Haldeman S. The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. Euro spine J. 2018;27(6):796–801.CrossRef
3.
Ye S, Jing Q, Wei C, Lu J. Risk factors of non-specific neck pain and low back pain in computer-using office workers in China: a cross-sectional study. BMJ Open. 2017;7(4):1–7.CrossRef
4.
Hoy D, March L, Woolf A, Blyth F, Brooks P, Smith E, et al. The global burden of neck pain: Estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):130.CrossRef
5.
Moradi-Lakeh M, Forouzanfar MH, Vollset SE, et al. Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: findings from the Global Burden of Disease Study 2013. Ann Rheum Dis. 2017;76:1365–73.CrossRef
6.
Guzman J, Hurwitz EL, Carroll LJ, Haldeman S, Côté P, Carragee EJ, Peloso PM, et al. A new conceptual model of neck pain: linking onset, course, and care: the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. J Manipulative Physiol Ther. 2009;32(2):17–28.CrossRef
7.
Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010;9(2):49–59.CrossRef
8.
Paksaichol A, Janwantanakul P, Purepong N, Pensri P, van der Beek AJ. Office workers’ risk factors for the development of non-specific neck pain: a systematic review of prospective cohort studies. Occup Environ Med. 2012;69(9):610–8.CrossRef
9.
Yang H, Hitchcock E, Haldeman S, Swanson N, Lu ML, Choi B, Nakata A, Baker D, et al. Workplace psychosocial and organizational factors for neck pain in workers in the United States. Am J Ind Med. 2016;59(7):549–60.CrossRef
10.
Kindler LL, Jones KD, Perrin N, Bennett RM. Risk factors predicting the development of widespread pain from chronic back or neck pain. J Pain. 2010;11(12):1320–8.CrossRef
11.
Pillastrini P, Castellini G, Chiarotto A, Fasciani F, Marzioni F, Vanti C, Bertozzi L, Gianola S. Comparative effectiveness of conservative and pharmacological interventions for chronic non-specific neck pain: protocol of a systematic review and network meta-analysis. Medicine. 2019;98(33):e16762.CrossRef
12.
Jensen I, Harms-Ringdahl K. Neck pain. Best Pract Res Clin Rheumatol. 2007;21(1):93–108.CrossRef
13.
Gross A, Kay TM, Paquin JP, Blanchette S, Lalonde P, Christie T, Dupont G, Graham N, Burnie SJ, Gelley G, Goldsmith CH. Exercises for mechanical neck disorders. Cochrane Database of Syst Rev. 2015;1:CD004250.
14.
Leaver AM, Refshauge KM, Maher CG, McAuley JH. Conservative interventions provide short-term relief for non-specific neck pain: a systematic review. J Physiother. 2010;56(2):73–85.CrossRef
15.
Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I, Perez-Muñoz M, Mayoral-del-Moral O, Lluch-Girbés E, Prieto-Valiente L, Falla D. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain. 2016;157(9):1905–17.CrossRef
16.
Calamita SA, Biasotto-Gonzalez DA, De Melo NC, Fumagalli MA, Amorim CF, de Paula Gomes CA, Politti F. Immediate effect of acupuncture on electromyographic activity of the upper trapezius muscle and pain in patients with nonspecific neck pain: a randomized, single-blinded, sham-controlled, crossover study. J Manipulative Physiol Ther. 2018;41(3):208–17.CrossRef
17.
Franke H, Fryer G, Ostelo RWJG, Kamper SJ. Muscle energy technique for nonspecific low back pain. Cochrane Database Sys Rev. 2015;27(2):1–74.
18.
Frey G. Muscle energy technique: an evidence-based approach. Int J Osteopath Med. 2011;14(1):3–9.CrossRef
19.
Ajimsha MS, Daniel B, Chithra S. Effectiveness of myofascial release in the management of chronic low back pain in nursing professionals. J Bodyw Mov Ther. 2014;18(2):273–81.CrossRef
20.
Laimi K, Mäkilä A, Bärlund E, Katajapuu N, Oksanen A, Seikkula V, et al. Effectiveness of myofascial release in treatment of chronic musculoskeletal pain: a systematic review. ClinRehabil. 2018;32(4):440–50.
21.
Thomas E, Cavallaro AR, Mani D, Bianco A, Palma A. The efficacy of muscle energy techniques in symptomatic and asymptomatic subjects: a systematic review. Chiropr Man Therap. 2019;27(1):1–8.CrossRef
22.
Sbardella S, La Russa C, Bernetti A, Mangone M, Guarnera A, Pezzi L, Paoloni M, Agostini F, Santilli V, Saggini R, Paolucci T. Muscle energy technique in the rehabilitative treatment for acute and chronic non-specific neck pain: a systematic review. Healthcare. 2021;9(6):746.CrossRef
23.
Phadke A, Bedekar N, Shyam A, Sancheti P. Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial. Hong KongPhysiother J. 2016;35:5–11.CrossRef
24.
Kashyap R, Iqbal A, Alghadir A. Controlled intervention to compare the efficacies of manual pressure release and the muscle energy technique for treating mechanical neck pain due to upper trapezius trigger points. J Pain Res. 2018;11:3151–60.CrossRef
25.
Olson KA. Manual physical therapy of the spine. 3rd ed. Elsevier Health Sciences; chapter 2, Spinal examination and diagnosis in orthopedic manual physical therapy; 2015. p. 38–46.
26.
Kalterborn FM, Evjenth O, Kalterboen TB, Vallowtiz E. The spine: basic evaluation and mobilization techniques. 3rd ed. Oslo Norway; chapter 3, Functional test; 1993. p. 43–58. 
27.
Hawker GA, Main S, Kendzerska T, French M. Measures of Adult Pain. Arthritis Care Res. 2011;63(11):240–52.CrossRef
28.
Vernon H. The neck disability index: state-of-the-art, 1991–2008. J Manipulative PhysiolTher. 2008;31(7):491–502.CrossRef
29.
Youdas J, Carey J, Garrett T. Reliability of measurements of cervical spine range of motion- comparison of Three Methods. PhysTher. 1991;71(2):98–104.
30.
Skevington SM, Lotfy M, O’Connell KA, WHOQOL Group. The World Health Organization’s WHOQOL- BREF quality of life assessment: psychometric properties and results of the international field trial. a report from the WHOQOL group. Qual Life Res. 2004;13(2):299–310.CrossRef
31.
Chaitow L. An introduction to Muscle Energy Technique. 3rd ed. Churchill Livingstone; chapter 5, Sequental assesment and MET treatment of main postural muscles; 2004. p. 177–86. 
32.
Stanborough M. Direct release myofascial technique: An illustration guide for practitioners. 4th ed. Churchill Livingstone; chapter 9, The cervical region; 2004. p. 129–31.
33.
Magee DJ, Manske RC. orthopedic physical therapy assement. 7th ed. Elsevier Health Sciences; chapter 3, Cervical spine; 2020. p. 163–71.
34.
MacDowall A, Skeppholm M, Robinson Y, Olerud C. Validation of the visual analog scale in the cervical spine. J Neurosurg Spine. 2017;28(3):227–35.CrossRef
35.
Fryer G, Ruszkowski W. The influence of contraction duration in muscle energy technique applied to the atlanto-axial joint. J Osteopath Med. 2004;7:79–84.CrossRef
36.
El Laithy MH, Founda KZ. Effect of post isometric relaxation technique in the treatment of mechanical neck pain. Phys Ther Rehab. 2018;5(20):1–10.
37.
MacDermid JC, Walton DM, Avery S, Blanchard A, Etruw E, Mcalpine C, Goldsmith CH. Measurement properties of the neck disability index: a systematic review. J Orthop Sports Phys Ther. 2009;39(5):400–17.CrossRef
38.
Fletcher JP, Bandy WD. Intrarater reliability of CROM measurement of cervical spine active range of motion in persons with and without neck pain. J Orthop Sports Phys Ther. 2008;38(10):640–5.CrossRef
39.
Taylor DC, Brooks DE. Viscoelastic characteristics of muscle; passive stretching versus muscular contractions. Med Sci Sports Exerc. 1997;29(12):1619–24.CrossRef
40.
Gilani MHZ, Obaid S, Tariq M. Comparison between effectiveness of ischemic compression and muscle energy technique in upper trapezius myofascial trigger points. Isra Med J. 2018;10:230–4.
41.
Rodríguez-Huguet M, Gil-Salú JL, Rodríguez-Huguet P, Cabrera-Afonso JR, Lomas-Vega R. Effects of myofascial release on pressure pain thresholds in patients with neck pain: a single-blind randomized controlled trial. Am J Phys Med Rehabil. 2018;97(1):16–22.CrossRef
42.
Ilić I, Šipetić-Grujičić S, Grujičić J, Živanović Mačužić I, Kocić S, Ilić M. Psychometric properties of the world health organization’s quality of life (WHOQOL-BREF) questionnaire in medical students. Medicina. 2019;55(12):772.CrossRef
43.
Rodríguez-Fuentes I, De Toro FJ, Rodríguez-Fuentes G, de Oliveira IM, Meijide-Faílde R, Fuentes-Boquete IM. Myofascial release therapy in the treatment of occupational mechanical neck pain: a randomized parallel group study. Am J Phys Med Rehabil. 2016;95(7):507–15.CrossRef
Metadata
Title
Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, rom and qol in the management of non-specific neck pain: a randomized controlled trial
Authors
Zainab Khalid Khan
Syed Imran Ahmed
Aftab Ahmed Mirza Baig
Waqas Ahmed Farooqui
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Neck Pain
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-05516-1

Other articles of this Issue 1/2022

BMC Musculoskeletal Disorders 1/2022 Go to the issue

Research

Experiences of recovery and a new care pathway for people with pain after total knee replacement: qualitative research embedded in the STAR trial

Research

Effection of monoplanar pedicle screw on facet joint degeneration in thoracolumbar vertebral fractures

Research

Distribution of hounsfield unit values in the pelvic bones: a comparison between young men and women with traumatic fractures and older men and women with fragility fractures: a retrospective cohort study

Research

Application of an arched, Ni–Ti shape-memory connector in repairing distal tibiofibular syndesmosis ligament injury

Research

Treatment of ankylosing spondylitis complicated with a thoracolumbar Andersson lesion by posterior closed osteotomy, debridement and fusion through the fracture line

Research

An investigation of the control of quadriceps in people who are hypermobile; a case control design. Do the results impact our choice of exercise for people with symptomatic hypermobility?