International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064 Index Copernicus Value (2015): 78.96 | Impact Factor (2015): 6.391 Volume 6 Issue 5, May 2017 www.ijsr.net Licensed Under Creative Commons Attribution CC BY Effect of Muscle Energy Technique versus Positional Release Technique on Pain and Functions in Patients with Trapezitis–A Comparative Study Reema Joshi 1 , Manisha Rathi 2 1 Assistant Professor, Dr .D.Y.Patil College of Physiotherapy, Dr. D.Y.Patil Vidyapeeth, Pimpri, Pune 2 Professor, Dr .D.Y.Patil College of Physiotherapy, Dr. D.Y.Patil Vidyapeeth, Pimpri, Pune Abstract: Research Background : Mechanical neck pain affects 45-54% of general population at after carrying sitting posture for prolong period of time which may sometimes leads to conditions like trapezitis. Muscle energy technique is used for achieving tonus release in a muscle before stretching which involves the introduction of an isometric contraction to the affected muscle producing post isometric relaxation. Positional release therapy is a manual technique that restores a muscle to it’s normal resting tone. In this study we compared the effect of both the technique on trapezitis. Aim and Objective : To Compare the effect of MET versus PRT On pain and function in patient with trapezitis. Method and procedure : Ethical approval of the study was taken from institutional ethical committee. Patient having neck pain screened initially and subjects whoever fulfilled inclusion and exclusion criteria 30 subjects having tapezitis , both male and female between age 20-50 year were included, which again divided into two Group A Muscle Energy Technique (MET) and Group B Positional Release Technique (PRT). Pre-and Post-assessment of pain and function was done by using NPRS (Numerical pain rating scale) and NDI (Neck disability index) score. Result : On comparison both MET and PRT shows improvement in pain and function of neck mobility where p= 0.000 which was statistically significant. Conclusion : The study concludes Clinically Muscle energy technique was more effective than positional release technique in subjects having trapezitis with non-specific neck pain. Keywords: MET, PRT, Trapezitis 1. Introduction Neck pain is very commonly site of traumatic and Non- traumatic musculoskeletal pain. [1] Roughly two thirds of the general population have neck pain at some time in their lives and the prevalence is highest in middle age.[2]. Trapezitis is defined as inflammation of upper, middle and lower fibers of trapezius muscle Trapezius is a big diamond shaped muscle with 3 parts: the upper, middle and lower portions. Trapezius forms the slope of the shoulder. It arises from the back of the skull and from the spine of the C7to T2 vertebrae. It attaches to the outer one third of the collarbone and acromion process and the spine of the shoulder border. It receives nerve supply from the accessory nerve and the C1 to C4 cervical nerve roots. Most patients who complain of neck pain or shoulder pain will be invariably showing the pain to be at slope between the base of the neck and the shoulder, in the region of upper trapezius. With pain and tightness in the trapezius, patient may have symptoms of headaches, dizziness, neck pain and mid-back pain. Upper trapezius muscle is designated as postural muscle and it is highly susptable to over use. The pain is present during rest and is aggregated by activity it may be alive refer to other area from the site of primary inflammation. Passive range of motion may be painful and restricted due do pain and protective spasm in agonistics group of muscle recent studies have hypothecated that the trapezitis pathogenesis result from the over loading and injury of muscle tissue leading to involuntary shortening of localized fiber. The area of stressed soft tissue receive less oxygen, glucose hence subsequently accumulates high level of metabolic waste product the end result of this event is the development of trigger point. MET may be used to decrease pain, stretch tight muscle and fascia, reduce muscle tonus, improve local circulation, strengthen weak musculature and mobilize joint restriction. According to Leon Chaitow, mechanism of PRT intervention include aberrant neuromuscular activity mediated by muscle spindles known as Proprio-ceptive theory which is based on neurophysiologic regulation of muscle spindle activity and local circulation or in inflammatory reaction influenced by sympathetic nervous system[4,5]. MET is used for achieving tonus release in a muscle before stretching which involves the introduction of an isometric contraction to the affected muscle producing post isometric relaxation. Strain counter strain or also called as positional release technique involves identification of the active Trapezius followed by application of pressure until a nociceptive response is produced. The area is then positioned in such as manner as to reduce the tension in the affected muscle and subsequently the pain in the Trapezius. When the position of ease or pain reduction is attained, the stressed tissues are felt to be at their most relaxed and a local reduction of tone is produced. Muscle energy technique is a direct technique originally developed .The purpose of this technique is to treat joint hypo mobility (stiffness) and restore proper biomechanical and physiological function to the joints. The result are prioritized to find the most dominant dysfunction, restriction .The dominant segmental is then specifically localized using the motion barrier concept. Different patient position, are utilized to engage the restriction before asking the patient to perform an isometric contraction to pull the restricted segment into a new motion barrier. The isometric contraction is performed in a precisely controlled direction against a Paper ID: ART20173758 2113