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. 2020 Dec;40(2):109-119.
doi: 10.1142/S1013702520500109. Epub 2020 Mar 20.

Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study

Wahyuddin Wahyuddin  1 , Mantana Vongsirinavarat  1 , Keerin Mekhora  1 , Sunee Bovonsunthonchai  1 , Rachaneewan Adisaipoapun  1
Affiliations

Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study

Wahyuddin Wahyuddin et al. Hong Kong Physiother J. 2020 Dec.

Abstract

Background: Facet joint is a potential structure to be the source of chronic low back pain (LBP) affecting lumbar motion, pain, and disability. Other than the recommended treatment of lumbar stabilization exercise (LSE), several manual procedures including muscle energy technique (MET) are commonly used in physical therapy clinic. However, little evidences of the effects of MET have been reported.

Objective: This study aimed to compare the immediate effects of MET and LSE in patients with chronic LBP with suspected facet joint origin.

Methods: Twenty-one patients with low back pain were recruited and randomly assigned to receive treatment either MET or LSE. The outcomes were kinematic changes, pain intensity, and disability level. Lumbar active range of motion (ROM) of flexion, extension, left and right lateral flexion, and left and right rotation were evaluated using the three-dimension motion analysis system at baseline and immediately after treatment. Pain intensity was evaluated using visual analogue scale (VAS) at baseline, immediately after, and two days after treatment. Thai version of the modified Oswestry disability questionnaire (ODQ) was utilized at baseline and two days after treatment. The mixed model analysis of variance was used to analyze all outcomes.

Results: The results showed that all outcomes were not different between groups after treatments. Although there were statistically significant improvements after the treatments when collapsing the groups, the minimal clinically important change was found only for pain but not for lumbar movements and disabilities scores.

Conclusion: The effect of MET and LSE alone in single session might not be intensive enough to improve movements and decrease disability in patients with chronic LBP with suspected facet joint origin.

Keywords: Chronic low back pain; facet joint; lumbar stabilization; muscle energy technique.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1.
Fig. 1.
CONSORT flow chart of participant recruitment.
Fig. 2.
Fig. 2.
Active ROM all motions for the MET and the LSE groups.
Fig. 3.
Fig. 3.
Visual analogue scale scores for the MET and the LSE groups. Notes: *significant difference between pre-treatment with 2-day post-treatment p=0.006. **significant difference between pre-treatment with 2-day post-treatment p<0.001.
Fig. 4.
Fig. 4.
Disability scores for the MET and the LSE groups.
See this image and copyright information in PMC

References

    1. Manchikanti L, Hirsch JA, Pampati V. Chronic low back pain of zygapophyseal (facet) joint origin: Is there a difference based on involvement of single or multiple spinal regions? Pain Physician 2003;6:399–405. - PubMed
    1. Manchikanti L, Pampati V, Fellows B, Ghafoor A. The inability of the clinical picture to characterize pain from facet joints. Pain Phys 2000;3:158–66. - PubMed
    1. Kalichman L, Li L, Kim DH, Guermazi A, Berkin V, O’Donnell CJ, Hoofmann U, Cole R, Hunter DJ. Facet joint osteoarthritis and low back pain in the community-based population. Spine 2008;33:2560–5. - PMC - PubMed
    1. Hestbaek L, Kongsted A, Jensen TS, Leboeuf-Yde C. The clinical aspects of the acute facet syndrome: Results from a structured discussion among European chiropractors. Chiropr Osteopat 2009;17:2. - PMC - PubMed
    1. Wilde VE, Ford JJ, McMeeken JM. Indicators of lumbar zygapophyseal joint pain: Survey of an expert panel with the Delphi technique. Phys Ther 2007;87:1348–61. - PubMed

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