The effectiveness of active release technique and the combination of active release technique and muscle energy technique in the treatment of hamstring tightness associated with chronic lower back pain

Abstract

Background: Chronic lower back pain (CLBP) is one of the top ten causes of daily disability that affect large population globally. Musculoskeletal disorders account for 80% of lower back pain and in particular, hamstring tightness has been identified as one of the causative factors of chronic lower back pain. Massage, needling and cupping therapy have been proven to be effective treatment options. However, these treatments are prohibited for patients with contraindications such as pregnancy, cancer, sunburn, rash, deep vein thrombosis and diabetes mellitus. Therefore, it is important to establish treatment options that can be administered to patients who present with low back pain due to hamstring tightness, but who also present with contraindications to established treatment options. Techniques such as active release technique (ART) and muscle energy technique (MET) have been investigated in conditions like tension headache, chronic neck pain, tennis elbow, carpel tunnel syndrome, sciatic nerve pain and plantar fasciitis. However, these techniques have not been investigated in the treatment of chronic lower back pain caused by hamstring tightness. Aim: This study aimed to identify the effectiveness of active release technique alone versus the combination of muscle energy technique and active release technique in the treatment of chronic lower back pain due to hamstring tightness. Method: The proposed research study utilised a quantitative study design consisting of an experimental single blinded randomised and comparative clinical trial. The target population included participants between the ages of 18-55 years who reside in the eThekwini region of KwaZulu-Natal. A total sample size of 40 patients underwent a randomised controlled trial and took place with 2 groups of 20 participants each. Group A, received active release technique alone in the treatment of hamstring tightness causing chronic lower back pain, and Group B, received the combination of active release treatment and muscle energy technique in the treatment hamstring tightness of chronic lower back pain. Each group received 2 interventions and the results from group A and group B were compared to identify the effectiveness from the outcome. Throughout, a p-value of 0.05 was used to indicate significance levels. The analysis carried out using IMB SPSS Statistics 27 software. Result: The findings of this study revealed that there was a significant difference between the group receiving ART alone compared to the combination of ART and MET. Conclusion: In conclusion, this study revealed that the use of combination of ART and MET is more effective than the use of ART alone.