Functional Improvement in Patients with Non-Specific Neck Pain: A Meta-Analysis of Muscle Energy Technique and Proprioceptive Neuromuscular Facilitation
PNF VS MET in Improving Non-specific Neck Pain
Keywords:
Neck pain, Muscle energy technique, Proprioceptive neuromuscular facilitation, Quality of lifeAbstract
Background: Neck pain is a common musculoskeletal disorder with significant societal and individual consequences. Proprioceptive Neuromuscular Facilitation (PNF) and Muscle Energy Technique (MET) are two physical therapy techniques that have shown potential in treating non-specific neck pain. This meta-analysis aims to evaluate the relative efficacy of PNF and MET to improve proprioception accuracy, minimize pain, and reduce disability in non-specific neck pain.
Methods: A thorough search was conducted across several databases, including Web of Science, PEDro, MEDLINE, Cochrane Library, EMBASE, and Google Scholar. Studies conducted between 2013 and 2023 assessed MET and PNF’s effects on functional improvement in patients with non-specific neck pain were considered. The criteria for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) were followed. Cochrane criteria were used to evaluate the risk of bias.
Results: Ten studies—five for the PNF and five for the MET interventions—met the inclusion criteria. The Neck Disability Index (NDI) and pain were subject to varying and non-significant effects from PNF. On the other hand, even with heterogeneity, MET showed a significant decrease in NDI scores and neck discomfort. The risk of biased study revealed that different studies’ levels of methodological quality varied. The analyses were performed on MedCalc statistical software.
Conclusion: PNF has inconclusive effects on non-specific neck pain and NDI, necessitating further research. In contrast, MET effectively reduces neck pain and improves NDI, emphasizing its potential as a therapeutic approach for non-specific neck discomfort.
References
Jahre H, Grotle M, Smedbråten K, Dunn KM, Øiestad BE. Risk factors for non-specific neck pain in young adults. A systematic review. BMC musculoskeletal disorders. 2020 Dec;21(1):1-2. DOI: https://doi.org/10.1186/s12891-020-03379-y
Collaborators GB. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. DOI: https://doi.org/10.1016/S0140-6736(18)32279-7
Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJ, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC musculoskeletal disorders. 2022 Dec;23(1):1-3. DOI: https://doi.org/10.1186/s12891-021-04957-4
Pourahmadi M, Sahebalam M, Bagheri R. Effectiveness of proprioceptive neuromuscular facilitation on pain intensity and functional disability in patients with low back pain: a systematic review and meta-analysis. Archives of Bone and Joint Surgery. 2020 Jul;8(4):479. DOI: https://doi.org/10.22038/abjs.2020.45455.2245
Rahnama L, Saberi M, Kashfi P, Rahnama M, Karimi N, Geil MD. Effects of Two Exercise Programs on Neck Proprioception in Patients with Chronic Neck Pain: A Preliminary Randomized Clinical Trial. Medical Sciences. 2023 Sep 8;11(3):56. DOI: https://doi.org/10.3390/medsci11030056
Anggiat L, Manurung NS, Manik JW. Proprioceptive neuromuscular facilitation approach for low back pain: A review study. International Journal of Sport, Exercise and Health Research. 2022;6(1):81-7.
Ghafoor F, Tabassum R, Rehman S, Naz I, Munawar A, Waseem SA. Comparison of Effectiveness of Muscle Energy Technique Versus PNF in Individuals with Hamstring Shortness. Biomedical Journal of Scientific & Technical Research. 2023 Apr 10;50(1):41234-41. DOI: https://doi.org/10.26717/BJSTR.2023.50.007891
Choksi P, Tank K. To Study the: Efficacy of muscle energy technique on muscle strength and flexibility in patients with knee osteoarthritis. Indian J Physiother Occup. 2016 Jan 10;10:40-5. DOI: https://doi.org/10.5958/0973-5674.2016.00080.0
Addala D, Kumar KS, Madhavi K. Effectiveness of Muscle Energy Technique on Pain and Range of Motion on Osteoarthrosis of Knee. Indian Journal of Physiotherapy and Occupational Therapy. 2013 Oct 1;7(4):29. DOI: https://doi.org/10.5958/j.0973-5674.7.4.117
Khan ZK, Ahmed SI, Baig AA, Farooqui WA. 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. BMC Musculoskeletal Disorders. 2022 Jun 13;23(1):567. DOI: https://doi.org/10.1186/s12891-022-05516-1
Widodo AF, Tien CW, Chen CW, Lai SC. Isotonic and isometric exercise interventions improve the hamstring muscles’ strength and flexibility: A narrative review. InHealthcare 2022 Apr 27 (Vol. 10, No. 5, p. 811). MDPI. DOI: https://doi.org/10.3390/healthcare10050811
Li Y, Zhou M, Zheng W, Yang J, Jiang N. Scaffold-based tissue engineering strategies for soft–hard interface regeneration. Regenerative Biomaterials. 2023 Jan 1;10:rbac091. DOI: https://doi.org/10.1093/rb/rbac091
Kim R, Wiest C, Clark K, Cook C, Horn M. Identifying risk factors for first-episode neck pain: A systematic review. Musculoskeletal Science and Practice. 2018 Feb 1;33:77-83. DOI: https://doi.org/10.1016/j.msksp.2017.11.007
Suresh V, Venkatesan P, Babu K. Effect of proprioceptive neuromuscular facilitation and cranio‐cervical flexor training on pain and function in chronic mechanical neck pain: A randomized clinical trial. Physiotherapy Research International. 2023 Nov 6:e2058. DOI: https://doi.org/10.1002/pri.2058
Gashi AI, Kovačič T, Gashi F, Azemi A. The effect of proprioceptive neuromuscular facilitation technique on treating cervical radiculopathy. Journal of Physical Education and Sport. 2023 Mar 1;23(3):722-9. DOI: https://doi.org/10.7752/jpes.2023.03089
Bansal R, Paul M. Effectiveness Of Motor Control Therapeutic Exercise Vs. Proprioceptive Neuromuscular Facilitation In Subjects With Cervical Spondylosis On Pain And Func-Tional Disability. Int J Physiother Res. 2020;8(5):3620-27. DOI: https://dx.doi.org/10.16965/ijpr.2020.162
Mahto PK, Malla S. Effect of Two Proprioceptive Training Programs on Cervical Repositioning Sense on Subjects with Chronic Non Specific Neck Pain. Executive Editor. 2019 Apr;13(2):220. DOI: https://doi.org/10.5958/0973-5674.2019.00077.7
Lee JH, Park SJ, Na SS. The effect of proprioceptive neuromuscular facilitation therapy on pain and function. Journal of physical therapy science. 2013 Jun 25;25(6):713-6. DOI: https://dx.doi.org/10.53389/JRCRS.20 22100105
Samiullah M, Khan UA, Anwer N. Comparison of muscle energy techniques with and without routine physical therapy in mechanical neck pain. Journal Riphah College of Rehabilitation Sciences. 2022 May 24;10(01). DOI: https://doi.org/10.1589/jpts.25.713
Nazir S, Arslan HR, Awan NG, Bilal H. To Compare the Effectiveness of Muscle Energy Technique and Deep Neck Flexors Training on Pain, Range of Motion and Functional Disability in Patients with Mechanical Neck Pain. Pakistan BioMedical Journal. 2022 Jan 31:296-9. DOI: https://doi.org/10.54393/pbmj.v5i1.308
Seemal P, Noor R, Riaz S, Afzal H, Anwaar S, Niaz M, Seemal P. Effects of Muscle Energy Technique with and without Bowen Therapy in Text Neck Syndrome. Pakistan Journal of Medical & Health Sciences. 2022 Jun 30;16(06):164-. DOI: https://doi.org/10.53350/pjmhs22166164
Lin LH, Lin TY, Chang KV, Wu WT, Özçakar L. Muscle energy technique to reduce pain and disability in cases of non-specific neck pain: A systematic review and meta-analysis of randomized controlled trials. Heliyon. 2023 Nov 17. DOI: https://doi.org/10.1016/j.heliyon.2023.e22469
Siddiqui M, Akhter S, Baig AA. Effects of autogenic and reciprocal inhibition techniques with conventional therapy in mechanical neck pain–a randomized control trial. BMC Musculoskeletal Disorders. 2022 Jul 25;23(1):704. DOI: https://doi.org/10.1186/s12891-022-05668-0
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