The efficacy of cervical/thoracic active range of motion for detecting changes associated with individuals receiving muscle energy techniques

Background: Muscle energy techniques (METs) have been used to treat cervical and thoracic range of motion (ROM) restrictions for over 40 years. Of the trials published on METs, most have examined the effectiveness of METs on ROM in the cervical and thoracic spine. Objectives: The aim of this systematic review was to investigate the sensitivity of cervical and thoracic rotation active range of motion, as an objective measure of function, for detecting changes associated with individuals receiving METs compared to (1) individuals receiving no treatment and (2) individuals receiving manipulation. Methods: Relevant databases were searched from January 1970 up to March 2010. Methodological quality of each included study was assessed using the PEDro scale. Effect sizes (Hedges' g) and their 95% confidence intervals were calculated for active rotation ROM scores between and within the MET and comparison groups. Results: Five randomized controlled trials were included in this review. Four studies addressed the first clinical question and one study answered the second. The average PEDro score was 5.8. In general, between and within group effect sizes were moderate to strong in favour of METs. Conclusion: There is fair evidence that cervical and thoracic active range of motion is sensitive to changes associated with individuals who receive an MET. The change in ROM was associated with asymptomatic individuals having restricted rotation. Further studies with higher methodological quality are needed to make a stronger clinical conclusion about the effectiveness of METs.