A study to evaluate the effectiveness of a single application of muscle energy technique compared with passive stretch on hip extension range of motion in athletes

Aim of the Study: To evaluate the effectiveness of a single application of MET in comparison to passive stretch on hip extension ROM over a 30 minute follow up period. Material & Methodology: Study Design- Experimental trial using a controlled crossover design, Sample size-Total of 30 subjects i.e, n=30 (15 in each group), Type of sampling-purposive sampling with alternatively allocation to the experimental group. Study Duration-A total of 8 weeks were included to conduct the study. Inclusion criteria- healthy adult male athletes aged between 18-23 years, the athletes giving informed consent were included in the study, healthy athletes exhibited a “positive” Thomas test, athletes not having any mental illness or any psychiatric problem, athletes not currently receiving any manual therapy treatment or undertaking a flexibility training regime. Exclusion Criteria- Participants were excluded if they had history of hip, pelvic or lower back pain, congenital hip joint dysplasia, pathology or trauma, psychological illness, unconsciousness or uncooperative or unresponsive, open wounds, had a known musculoskeletal or neurological disorder; or were taking medications that affect the musculoskeletal system (e.g. muscle relaxants), severe sprain and strain. Goniometer was used both in diagnosis and in assessing the results of the treatment. A goniometer purpose to measure accurately the movements present in a simple or composite joint. Procedure - This study was a 8 week study including the selection and assessment and desired athletes involved in the study. Data collection took place within the MDU Sports complex, Rohtak, Haryana undertaken by the researcher who was a registered physiotherapist, and was instructed in the specific experimental protocol for the MET intervention. All participants completed both an MET and a passive stretch protocol. Group allocation was determined by logistical factors primarily on the basis of the availability of the practitioner performing the MET procedure. Assessment and testing took place at the same day, with 7 days between sessions. Participants were asked to retrain from vigorous exercise and stretching their hip flexors during the 7 day interval between both intervention trials. A table was placed in the field used in the assessment procedure. Pre ¬intervention - All participants undertook a warm-up exercise consisting of walking for 5 minutes at moderate speed immediately prior to commencement of the intervention. Following the warm-up, the participant was asked to sit with their sacrum at the very edge of the end of the table, they were then instructed to draw up their left knee and holding it with both hands, slowly rollback into a lying position while the researcher assisted with guiding the right leg up, simultaneously pulling the second (mobile) treatment table into place so that the participant was able to lie fully supine. The height of the second table was adjusted to be level with the first so that the participant could lie comfortably. The greater trochanter of the proximal femur and the lateral epicondyle of the distal femur of the right limb were palpated and marked with an indelible marker and overlaid with adhesive markers. The participant was then asked to bend their left hip and knee and hold the leg in the fully flexed position to maintain a flat lumbar spine and prevent pelvic tilt which was checked by the physical therapist. The physical therapist then removed the mobile treatment table while supporting the participant’s right leg by cupping their heel, and slowly lowering it, allowing the leg to extend at the hip and hang in are laxed manner. Results: Participants -The sample consisted of 30 male participants who were allocated to group A (n=15) or group B (n=15). The mean age of participants was 21.3 years (±1.6); the mean weight 64kg (±2.8); mean height 172.5cm (±3.6) and the mean hip extension at baseline was 20.16 degrees (±4.96). Immediate effect of intervention, Five minutes post intervention at 5 min, Ten minutes post intervention at 10 min, Fifteen minutes post intervention at 15 min, Twenty minutes post intervention at 20 min, Twenty five minutes post intervention at 25 min, and Thirty minutes post intervention at 30 min. Conclusions: The findings of this study indicate a “more significant” effect for increasing hip extension range of motion immediately following a single application of muscle energy technique to improve hip extension, and a “less significant” effect following passive stretch. Five minutes following the intervention the observed increase was “significant” for both groups and was maintained at 30 minutes. There was no evidence that an effect of either intervention was maintained following the 7-day interval. Therefore both MET and passive stretch appears to have a significant effect in increasing hip extension ROM for duration of up to 30 minutes.