Comparing the effects of instrumental assisted soft tissue mobilisation and muscle energy technique on improving ankle range of motion and reducing pain in schoolteachers with gastrocnemius and soleus muscles tightness: a randomised clinical trial

Background/Aims Gastrocnemius and soleus muscles tightness is common among individuals involve with prolong standing, and those with sedentary lifestyles, often leading to restricted range of motion and pain. The aim of the present study was to evaluate the effects of instrument-assisted soft tissue mobilisation and muscle energy technique on pain reduction and improvement in ankle range of motion and functionality in patients with gastrocnemius and soleus muscle tightness. Methods A randomised clinical trial was conducted. A non-probability purposive sampling technique was used to recruit participants who were randomly allocated into two different groups. Group A received instrument-assisted soft tissue mobilisation, while Group B received muscle energy technique. Both interventions were administered twice weekly for 6 weeks, resulting in a total of 12 treatment sessions. The Numerical Pain Rating Scale was used to measure pain, the Lower Extremity Functional Scale was used to measure functional ability and a universal goniometer was used to assess ankle range of motion. The data were examined for and parametric or non-parametric tests for within and between group analysis was applied accordingly. The within-group comparison of pain intensity and functional ability at baseline, week 3 and week 6 was conducted using repeated measures analysis of variance for both treatment groups. Assumptions of repeated measures analysis of variance, including normality and sphericity, were tested before analysis. Results A significant reduction in pain was experienced in both groups by weeks 3 and 6. Functional ability, ankle dorsiflexion and plantar flexion also improved significantly in both groups. A statistically significant difference was found between both groups in pain reduction ( P =0.032), functional ability ( P =0.008) and ankle planter and dorsiflexion ( P <0.05) at week 6 week. After 6 weeks, the MET group demonstrated a greater reduction in pain and greater improvements in functional ability, dorsiflexion, and plantar flexion (all P<0.001) compared with the IASTM group. Conclusions Both instrument-assisted soft tissue mobilisation and muscle energy technique were effective in reducing pain and improving lower extremity function and ankle range of motion over a 6-week period in patients with gastrocnemius and soleus muscle tightness. Muscle energy technique group showed statistically greater improvements, although the clinical difference was modest. Implications for practice Either of the treatments can be effectively used in the treatment of individuals with tightness in the gastrocnemius and soleus muscle group. Muscle energy technique could be more suitable especially for conditions where active involvement from the side of the patients is needed, while IASTM can be more effective in cases where a passive treatment modality is needed. Therefore, treatment selection should be individualised based on patient tolerance, clinical presentation, and therapist expertise rather than efficacy alone.