EFFECTIVENESS OF MYOFASCIAL RELEASE VERSUS MUSCLE ENERGY TECHNIQUE COMBINED WITH EXERCISE ON PAIN, DISABILITY, FEAR AVOIDANCE, AND LUMBAR MOBILITY IN CHRONIC NON-SPECIFIC LOW BACK PAIN: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Chronic non-specific low back pain (CNSLBP) is a common musculoskeletal condition associated with pain, functional disability, reduced mobility, and psychosocial impairments. Manual therapy combined with exercise is widely used in physiotherapy, but comparative evidence between Myofascial Release Technique (MFR) and Muscle Energy Technique (MET) remains limited.

Objective: To compare the effects of MFR plus exercise versus MET plus exercise on pain intensity, functional disability, fear-avoidance beliefs, and lumbar mobility in individuals with CNSLBP.

Methods: A prospective, assessor-blinded randomized controlled trial was conducted on 60 participants with CNSLBP recruited from private physiotherapy clinics in Peshawar, Pakistan. Participants were randomly allocated into two groups: MFR with exercise (n=30) and MET with exercise (n=30). Both interventions were administered three times weekly for six weeks. Outcome measures included Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire (FABQ), and Modified Schober Test. Assessments were taken at baseline, Week 3, and Week 6. Data were analyzed using repeated measures ANOVA with p < 0.05 considered significant.

Results: Both groups showed significant improvements in all outcomes over time (p < 0.001). However, the MFR plus exercise group demonstrated significantly greater improvements than the MET group. At Week 6, the MFR group showed lower pain scores (2.14 ± 0.83 vs 3.18 ± 0.91), reduced disability (16.82 ± 5.41 vs 23.61 ± 6.08), lower fear-avoidance beliefs (20.43 ± 4.72 vs 27.14 ± 5.06), and improved lumbar mobility (6.82 ± 0.74 cm vs 5.94 ± 0.68 cm), with statistically significant differences (p < 0.001).

Conclusion: Both interventions were effective in managing CNSLBP; however, MFR combined with exercise was superior to MET combined with exercise in improving pain, disability, psychosocial factors, and lumbar mobility. These findings support incorporating myofascial techniques into exercise-based rehabilitation for CNSLBP