Comparison of Muscle Energy Technique and Eccentric Training on Hamstring Flexibility in Healthy Young Adults

Study Overview
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Brief Summary
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Flexibility is the ability of a muscle to lengthen and allow one joint (or more than one joint in series) to move through a full range of motion (ROM).Adequate flexibility is important to maintain balance, agility and musculoskeletal function. A decrease in muscular flexibility does not only reduces functional level of individual but also causes musculoskeletal injuries. Loss of muscle flexibility or muscle tightness is decreased ability of a muscle to lengthen which results in decreased ROM,and for hamstring reduced flexibility is the inability to achieve more than 160 degree of knee extension while the hip is flexed at 90 degree. Muscle energy technique (MET) is an manual technique developed by osteopaths and is now used in many different manual therapy professions, to treat soft tissue, mobilize joints, stretch tight muscles and fascia, reduce pain and to improve circulation and lymphatic drainage. Eccentric training allows the muscle to elongate naturally, this elongation is achieved by having the subjects eccentrically contract the antagonist muscle to move the joint through the full available range in slow controlled manner.

Detailed Description
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Flexibility is the ability of a muscle to lengthen and allow one joint (or more than one joint in series) to move through a full range of motion (ROM). Adequate flexibility is important to maintain balance, agility and musculoskeletal function. A decrease in muscular flexibility does not only reduces functional level of individual but also causes musculoskeletal injuries. Loss of muscle flexibility or muscle tightness is decreased ability of a muscle to lengthen which results in decreased ROM. and for hamstring reduced flexibility is the inability to achieve more than 160 degree of knee extension while the hip is flexed at 90 degree. Hamstring muscles have a great tendency to shortening even in normal circumstances, due to their multi-joint function and their tonic postural character. Techniques previously investigated for hamstring flexibility include static, ballistic and active assisted stretching exercise, ice, heat, soft tissue massage, ultra sound, Short Wave Diathermy, myofascial release, (PNF), kinesio taping, MET Each of these interventions has demonstrated clinical and experimental success; no agreement has been reached on a standard protocol for treatment. Muscle energy technique (MET) is an manual technique developed by osteopaths and is now used in many different manual therapy professions, to treat soft tissue, mobilize joints, stretch tight muscles and fascia, reduce pain and to improve circulation and lymphatic drainage. Eccentric training allows the muscle to elongate naturally, this elongation is achieved by having the subjects eccentrically contract the antagonist muscle to move the joint through the full available range in slow controlled manner. Eccentric resistance exercise may prevent injury to the muscle tendon unit by improving the muscle's ability to absorb more energy before failing and it is a better training strategy to improve the flexibility as it also increases strength and protects against muscle damage.

Official Title
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Comparison of Muscle Energy Technique and Eccentric Training on Hamstring Flexibility in Healthy Young Adults

Conditions
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Healthy

Intervention / Treatment
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* Other: Eccentric Training
* Other: Muscle Energy Technique (PIR)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • A deficit of >20° of knee extension with the hip at 90° Exclusion Criteria: lower extremities pathology. any history of hamstring injuries. acute or chronic low back pain. history of lower limb fracture. surgery of hamstring or back. pelvis, hip or knee deformity. Involved in any stretching routine

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Eccentric Training<br>Once achieved, this flexed hip position will be held for 5 seconds. This procedure will be repeated 6 times with no rest between repetitions | Other: Eccentric Training<br>* Once achieved, this flexed hip position will be held for 5 seconds. This procedure will be repeated 6 times with no rest between repetitions<br>Other: Muscle Energy Technique (PIR)<br>* The participant will be asked to resist the movement with no more than 25% of strength. The contraction will be held for 7-10 seconds followed by complete relaxation of the limb. On exhalation, the knee joint will be straightened (extended) towards its new barrier and through that barrier a stretch was applied and maintained for 30 seconds.3 repetitions of this process will be done<br>|
| Experimental: Muscle Energy Technique (PIR)<br>muscle energy technique | Other: Eccentric Training<br>* Once achieved, this flexed hip position will be held for 5 seconds. This procedure will be repeated 6 times with no rest between repetitions<br>Other: Muscle Energy Technique (PIR)<br>* The participant will be asked to resist the movement with no more than 25% of strength. The contraction will be held for 7-10 seconds followed by complete relaxation of the limb. On exhalation, the knee joint will be straightened (extended) towards its new barrier and through that barrier a stretch was applied and maintained for 30 seconds.3 repetitions of this process will be done<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Active Knee Extension Test | Active knee extension test is an objective test for measuring flexibility/tightness of hamstring muscles with goniometer. Every subject is set in recumbent position with hip and knee flexed in 90°.A wooden box is utilized to keep up the correct position of hip. The pelvis is strapped down to the table for stabilization and controlling any accessory movement and the participant's head is kept in a neutral position to avoid any neural tension. For goniometer the landmarks used are the greater trochanter of the femur, lateral femoral condyle and lateral malleolus. The subject is then asked to extend the dominant lower extremity as far as possible until a mild stretch sensation is felt and a full circle goniometer is then used to measure the angle. Assessment to be done at baseline,3rd session and 6th session. | two weeks | 
| Sit and Reach Test: | The test involves sitting on the floor with back and head against the wall, legs stretched out straight ahead. Shoes are removed and the sole of feet are placed flat against the box. Both knees should be locked and pressed flat on the floor with the palms facing downwards and the hands-on top of each other. Subject reaches forward along the measuring line as far as possible. assessment to be done at baseline,3rd session and 6th session. | two weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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muscle energy technique, eccentric training, hamstring flexibility, active knee extension