Muscle Energy Technique Versus Active Release Technique on Pain, Cervical Range Of Motion And Functional Disability

The study will be a randomized controlled trial. This study will be conducted in The University of Lahore Teaching Hospital, Lahore, Pakistan. A sample size of 86 will be randomly allocated into two experimental groups,(43 participants in each group), by using computer-generated random number list method. The participants randomly allocated into two experimental, group A will receive Muscle energy technique (METs) specifically, Post isometric relaxation technique for upper trapezius and levator scapulae muscles, 1 set of 5 repetitions and 10 seconds hold along with routine physical therapy as (Hot pack, transcutaneous electrical nerve stimulator, strengthening and stretching exercises).

Experimental group B will be delivered Active Release Technique on both sides of levator scapulae and upper trapezius muscles 1 set of 5 repetitions along with routine physical therapy as (Hot pack, transcutaneous electrical nerve stimulator, strengthening and stretching exercises).

Both experimental groups will receive twelve treatment sessions (3 sessions per week for 4 weeks)

Recruitment: Participants will be recruited and referred by orthopedic doctor from The University of Lahore Teaching Hospital to Physical Therapy Department.

Randomization and Allocation: The participants after confirming the eligibility criteria will be randomly allocated into two experimental groups (Group A, Group B) by using computer generated random number list method.

Blindness: The study will be single blinded, and an independent investigator will perform randomization and will inform the patients and the therapist about the allocation of participants and assessor will be blinded.

Intervention: The participants will be randomly allocated into two experimental groups (Group A, Group B). Experimental Group A will receive Muscle energy technique (METs) specifically, Post isometric relaxation technique for upper trapezius and levator scapulae muscles, 1 set of 5 repetitions, and 10 seconds hold along with routine physical therapy as (Hot pack, transcutaneous electrical nerve stimulator, strengthening and stretching exercises).

Experimental group B will be delivered Active Release Technique on both sides of levator scapulae and upper trapezius muscles 1 set of 5 repetitions along with routine physical therapy as (Hot pack, TENS, strengthening and stretching exercises).

Duration:Both experimental groups will receive twelve treatment sessions (3 sessions per week for 4 weeks, each session of 35-45 minutes)

Outcome Variables and Measures:

Pain (Numeric Pain Rating Scale) Range of Motion (Universal Goniometer) Functional Disability (Neck disability Index Questionnaire) Outcome measures will be taken at baseline, end of 6th treatment session (2nd week), end of 12th session (4th week) and follow up will be obtained after 1 month (8th week) and then collected data will be analyzed.

Eligibility Criteria:
Inclusion Criteria:

* • The diagnosed Upper cross syndrome patients aged 20-35 years will be included in this study

  * Both male and females will be included in this study.
  * Patients with pain of at least 3 points on NPRS.
  * The participants with neck disability of at least 10/50 on the Neck Disability Index (NDI) will be included in this study.

Exclusion Criteria:

* • Cervical radiculopathy or myelopathy.

  * History of trauma, whiplash injury, cervical instability or fractures in cervical spine.
  * Systemic illness i.e. cardiovascular disorders, respiratory disorders etc.
  * Inflammatory disease i.e. rheumatoid arthritis, ankylosing spondylitis, osteomyelitis.
  * Any pathology i.e. infection, osteoporosis, malignancy bony disease i.e. osteosarcoma.