Effects of muscle energy technique on pain, range of motion and function in patients with post-surgical elbow stiffness: A randomized controlled trial.

Background: Elbow is a very functional joint. Elbow stiffness is a significant cause of disability hampering the function of the upper extremity as a whole. Muscle Energy Techniques (METs) are relatively pain-free techniques used in clinical practice for restricted range of motion (ROM).

Objective: To study the effects of MET on pain, ROM and function given early in the rehabilitation in post-surgical elbow stiffness.

Methods: An RCT was conducted on 30 patients post elbow fracture fixation. Group 1 was given MET immediately post removal of immobilization while Group 2 received MET 1 week later along with the rehabilitation protocol. Pain (Visual Analogue Scale), ROM (goniometry) and function (Disability of Arm, Shoulder and Hand questionnaire) were assessed pre and post 3 weeks.

Results: Group 1 showed greater improvement than Group 2, mean flexion and extension change between groups being $11.7\pm 2.8$ , 95%CI(5.9,17.4) and $8.5\pm 2.0$ , 95%CI(4.4,12.7), respectively. VAS and DASH scores improved better in Group 1, mean change being $1.2\pm 0.2$ , 95%CI(0.6,1.8) and $18.2\pm 2.2$ , 95%CI(13.5,22.8) for VAS and DASH scores, respectively.

Conclusion: MET can be used as an adjunct to the rehabilitation protocol to treat elbow stiffness and can be given safely in the early stages of post elbow fracture rehabilitation managed surgically with open reduction and rigid internal fixation.