Title: Comparison of Immediate Effect of Muscle Energy Technique in Upper Trapezius and Activation of its Antagonist Muscle i.e., Middle and Lower Trapezius with Thoracic Extension in Patients with Upper Trapezius Spasm
Abstract: Background:The most common reason for neck pain is trapezitis.With digilization coming into picture in recent years, adaption of incorrect posture has been a common issue.Patients with trapezitis presents with over-activity of the trapezius and levator scapula and decreased strength of deep cervical flexors along with its antagonist muscles.Exercises have shown improvement in posture related musculoskeletal imbalances.Since M.E.T. have been used earlier for pain relief in trapezitis, the present study compares its effect with activation of its antagonist muscle which are lower trapezius and rhomboids with thoracic extension exercises. Aim:To compare the effect of M.E.T. and activation of lower trapezius and rhomboids with thoracic extension exercises in patients with upper trapezius spasm.Objectives: To assess the effectiveness of M.E.T. in patients with upper trapezius spasm.To determine the effectiveness of activation of lower trapezius and rhomboids with thoracic extension exercises in patients with upper trapezius spasm.Comparison of both groups.Method: A total of 60 individuals were taken which was calculated using the sample size formula, 30 in each group were selected as per the inclusion and exclusion criteria.Outcome measures-tenderness grading scale, NRPS on rest and activity, intensity of pain using pain algometer, cervical range of motion-lateral flexion and rotation, scapular positioning, upper trapezius length, tragus to wall length, neck disability index were assessed pre and post intervention of three days. Result:The intra-group comparison between group A and B showed statistically and clinically significant improvement in all outcome measures.The inter-group comparison of Group A and Group B showed that, group A had better improvement in the muscle length and ranges than group B. And group B show better improvement in scapular positioning and tragus to wall distance than group A. Conclusion:The study concluded that both the techniques were equally effective in pain relief in individuals with trapezitis.M.E.T. was effective in improving the cervical range of motion and its length as M.E.T. directly works on upper trapezius muscle.And activation of anagonist muscles with thoracic extension exercises was effective in improving the posture as it works on the postural group of muscles of scapula.