Comparing the effects of proprioceptive neuromuscular facilitation and muscle energy technique in non-specific neck pain: a randomised clinical trial

Background/Aims Non-specific neck pain is a prevalent musculoskeletal problem marked by discomfort in the neck caused by postural and mechanical factors. This study compared the effects of muscle energy technique (post-isometric relaxation) and proprioceptive neuromuscular facilitation stretching (hold-relax technique) on neck pain, cervical range of motion and disability in patients with non-specific neck pain. Methods This was a randomised clinical trial with 32 participants. The duration of the study was 8 months from June 2022 to January 2023. Participants were recruited and randomly assigned to two groups of 16 people using convenience sampling. Group A practised the hold-relax technique, while Group B was given post-isometric relaxation. Treatment lasted 4 weeks, with three sessions a week on alternate days. The patients were assessed for cervical pain using a visual analogue scale, cervical disability using the Neck Disability Index, and cervical range of motion using a goniometer. Data were analysed using the Mann–Whitney U test and independent sample t-test. Results The mean age of the patients was 28.53 ± 4.34 years. Within-group analysis showed a statistically significant difference in pre- and post-treatment in pain (Group A: P=0.001, Group B: P=0.001), range (Group A: P =0.001, Group B: P =0.001) and neck disability (Group A: P =0.001, Group B P=0.001) Post-treatment results using a visual analogue scale showed a significant difference (Mann-Whitney U score=57.00, P=0.02) between groups A and B. The Mann–Whitney U test on the Neck Disability Index scores showed no statistical difference (Mann-Whitney U score = 130.50, P=0.84) between the two groups. The independent sample t-test on cervical range of motion revealed significant differences in cervical extension P=0.000) and lateral flexion (P=0.04) between groups A and B. Conclusions Both the hold-relax and post-isometric relaxation techniques were effective in alleviating pain intensity, improving neck disability and improving cervical range of motion. However, the hold-relax technique outperformed the post-isometric relaxation technique in reducing neck pain and improving cervical extension and lateral flexion. The results highlight the need for further research with a larger sample size. Implications for practice Physiotherapists may consider using the hold-relax technique, especially when prioritising pain alleviation and improving specific facets of cervical mobility.