The Effects of a Short Course of Muscle Energy Technique on Sacral Dysfunction in Patients with Acute Lumbosacral Pain

The purposes of this research study were to examine the effects of treating patients with suspected acute iliosacral rotational dysfunction with muscle energy techniques (MET) on (1) disability, (2) perceived pain during lumbar motion in neutral, flexion, and extension, (3) lumbar range of motion in flexion and extension, and (4) sagittal innominate rotation. Subjects were randomly assigned to the experimental and placebo groups. Experimental subjects received MET treatments, and placebo subjects received a stretching placebo treatinent. Subjects were treated four times over the course of one week. The initial examination and treatment occurred within 72 hours of the onset of pain. Subjects were only included if they demonstrated a negative McKenzie mechanical lumbar assessment, two positive sacroiliac pain provocation tests, and sacroiliac joint specific pain referral patterns. Perceived disability was measured with the modified Oswestry Disability Questionnaire. Perceived pain was measured using a 10 centimeter visual analog scale. Lumbar range of motion data was obtained using double inclinometer measurements. Innominate rotation was assessed using the Palpation Meter, A repeated measures analyses of variance statistical model was used to determine group differences for all variables. Statistical significance was set a priori at p&0.05. The results of this study demonstrated that innominate rotation decreased to near neutral rotation in subjects receiving MET compared to the placebo group over the course of treatment. Although subjects were randomly assigned to groups, a significant difference was found between the groups' re-measurements for Palpation Meter scores. Although the MET was successful in bringing the dysfunctional innominate into near neutral rotation, it did not improve pain scores, disability scores or lumbar ROM measurements. The results of this study suggest that MET aimed at connecting iliosacral rotation dysfunctions will not produce decreases in pain, disability or improve lumbar range of motion in the first week after onset of lumbosacral pain in patients with suspected iliosacral rotational dysfunctions (in spite of correcting the innominate rotation). Future research should continue to examine the effects of MET on acute sacroiliac joint pain in other physically active patients.