Defining Muscle Energy: A Multidisciplinary Approach

Title: Defining Muscle Energy: A Multidisciplinary Approach Author: David Son, DO, MPH, Carter Newey, OMS-3, Kendi Hensel, DO, PhD, and Rita M. Patterson, PhD Abstract Purpose: Manual manipulation is predominantly practiced among three professions: osteopathic medicine, chiropractic, and physical therapy. One treatment modality involves patients’ muscle contraction against practitioners’ counterforce. It is known as Muscle Energy Technique (MET) by osteopathic physicians, Autogenic Inhibition (AI) by chiropractors, and Proprioceptive Neuromuscular Facilitation (PNF) by physical therapists. Although these techniques involve the same principles, little is known about how each profession perceives and applies it to their practice. Understanding the approaches of each field can not only clarify patients’ past treatment histories but also yield opportunities for effective co-management. The objective of this project is to discuss the similarities and differences of this type of manipulative therapy. Methods: Gathering and utilizing information obtained online and in written literature, this study compares treatment steps and applications of this form of muscle-based manual manipulation among osteopathic medicine, chiropractic, and physical therapy. Results: Osteopathic MET – 1) Affected segment taken to restrictive barrier 2) Sub-maximal isometric contraction 3) Relaxation for 3-5 seconds 4) Segment taken to new restrictive barrier 5) Repeat 3-5 times Chiropractic AI – 1) Post-Isometric Relaxation (PIR), which is identical to Osteopathic MET 2) Post-Facilitation Stretch (PFS): 2a) Maximal muscular contraction for 5-10 seconds 2b) Complete relaxation 2c) Rapid maximal stretch for 10 seconds 2d) Relaxation for 20 seconds Physical Therapist PNF – One continuous spiral motion of extremity in diagonal pattern via: 1) Passive range of motion 2) Active range of motion 3) Sustained isotonic contraction on full range of motion Conclusions: Understanding these variations in technique maximizes its potential to be taken into a more comprehensive and advanced treatment modality that can be communicated and utilized by all three professions. This can augment the quality of manual medicine in patient care.