MET.ppt
- 1. MUSCLE ENERGY TECHNIQUES (MET)
- 2. Muscle energy technique is a manual therapy procedure that involves voluntary contraction of patient’s muscle in a precisely controlled direction, at varying levels of intensity. DEFINITION OF MUSCLE ENERGY-
- 3. USES OF MUSCLE ENERGY ▪ Use to lengthen a shortened, contractured or spastic muscle to strengthen a physiologically weakened muscle or group of muscles. ▪ To reduce localised edema. ▪ Relieve passive congestion. ▪ Mobilize a joint with restricted mobility, myofascia and trigger points.
- 4. MUSCLE MAKE-UP Muscle is made up of extrafusal & intrafusal fibers. extrafusal- during rest, some contracts while others rests, so whole muscle dosen’t contract. intrafusal- monitor length and tone of muscle - innervated by gamma fibers Golgi tendon apparatus *lies with extrafusal fibers *sensitive to muscle tension *as muscle contracts -> tension builds up in GTA -> GTA inhibit alpha motor neuron output ->> muscle relaxes.
- 5. Basic Concepts - ▪ Patients contractions in conjunction with therapists effort result in: 1.Isometric contraction ▪ Therapist Force applied = Patient Force applied 2.Isotonic Eccentric contraction ▪ Therapist Force applied > Patient Force applied 3.Isotonic Concentric contraction ▪ Therapist Force applied < Patient Force applied
- 6. Basic Concepts- ▪ Operator – Direct Method ▪ Patient contracts agonist muscle ▪ Chronic conditions ▪ Operator – Indirect Method ▪ Patient contracts antagonist muscle ▪ Acute conditions
- 7. 2 TYPES OF MET- ISOMETRIC MUSCLE ENERGY TECHNIQUES (AUTOGENIC INHIBITION)
- 8. ISOTONIC MUSCLE ENERGY TECHNIQUES (Reciprocal Inhibition) ▪ When an agonist muscle contracts and shortens, its antagonist must relax and lengthen so that motion can occur under the influence of the agonist muscle. ▪ The contraction of the agonist reciprocally inhibits its antagonist allowing smooth motion. ▪ The harder the agonist contracts, the more inhibition in the antagonist, causing relaxation.
- 9. SURROUNDING TISSUES- ▪ MET also influences the surrounding fasciae, connective tissues and interstitial fluids >> alters muscle physiology. ▪ When ms. contracts > length & tone alters > influnces biomechanical, biochemical & immunologic functions. ▪ Ms. Contraction requires energy > metabolic process results in CO2, lactic acid, other metabolic wastes that must be transported and metabolized.
- 10. APPLICATIONS OF MUSCLE ENERGY TECHNIQUES
- 11. INDICATIONS OF MET- Lengthen shortened ,contractured , & spastic muscle. strengthen weakened muscle or group of muscle. malposition of bony elements. Restoration of joint motion assosiated with joint dysfunction.
- 12. PRECAUTIONS OF MET – Unknown pathology Stress fractures Strains infections and diseases causing musculoskeletal pain osteoporosis or tumors in the area of treatment.
- 13. CONTRAINDICATIONS OF MET – Acute musculoskeletal injuries. Unset or unstable fractures. Unstable or fused joints. - GOOD RESULTS OF MET DEPENDS ON – accurate diagnosis, appropriate levels of force, and sufficient localization. - POOR RESULTS OF MET DEPENTS ON – inaccurate diagnosis, improperly localised force, or forces that are too strong.
- 14. Variations of MET ▪ Lewit’s Post-isometric Relaxation ▪ Hypertonic muscle is taken to a length short of pain / resistance ▪ Patient contracts (10-25%) muscle for 5 – 10 seconds while therapist supplies equal force ▪ Patient relaxes and muscle is taken to new range of motion ▪ Starting from gained ROM, repeated 2- 3 times
- 15. ▪ Janda’s Post-facilitation Stretch ▪ Affected muscle is placed in a midrange position ▪ Patient contracts (90-100%) for 5 – 10 seconds ▪ Rapid stretch to new ROM and hold for 10 seconds ▪ Relax for 20 seconds and repeated 3 – 5 times ▪ Sensations of warmth and weakness may be experienced for a short time with this method
- 16. ▪ Reciprocal Inhibition Method - Affected muscle is placed in mid- range - Patient contracts isometrically or isotonically for 5 – 10 seconds - Muscle is passively lengthened - Repeated 2 – 3 times
- 17. DIFFERENCE B/W THE TWO- JANDA’S PFS LEWIT’S PIR STARTS AT MIDRANGE AT BARRIER TYPE OF CONTRACTION STRONGER LESS STRONGER THAN PFS ACTION ON TISSUES TAKES TISSUE BEYOND THE BARRIER, ATTEMPTS TO PLACE STRETCH ON STRUCTURES TAKES TISSUES TO A NEW BARRIES OF RESISTANCE.
- 18. • In 2012, a comparative study on effectiveness of Muscle Energy Technique and Static Stretching for Treatment of subacute Mechanical Neck Pain by Richa Mahajan concluded that MET was superior than static stretching in decreasing pain intensity and increasing active cervical range of motion. International Journal of Health and Rehabilitation Sciences Volume 1 Number 1 ▪ Noelle M et al studied Short-Term Effect of Muscle Energy Technique on Pain in Individuals with Non-Specific Lumbopelvic Pain and concluded that subjects receiving MET demonstrated a decrease in VAS worst pain over the past 24 hours, thereby suggesting that MET may be useful to decrease LPP over 24 hours. The Journal of Manual & Manipulative therapy Volume 17 Number 1