EFFECTIVENESS OF MUSCLE ENERGY

TECHNIQUE AMONG SEWING MACHINE

USERS WITH CALF PAIN

STUDENT : Ms.V. SUBALAKSHMI

RESISTER NUMBER : RA1921001010086
GUIDE : Mr. D. VINCENT JEYARAJ., M.P.T.,
ORTHOPAEDICS

In partial fulfillment of the requirement for the Degree of

BACHELOR OF PHYSIOTHERAPY
JUNE-2023
A Project submitted to
SRM COLLEGE OF PHYSIOTHERAPY
SRM INSTITUTE OF SCIENCE AND TECHNOLOGY
(Deemed to be University u/s of UGC Act, 1956)
SRM Nagar, Kattankulathur,
Chengalpattu District – 603203
Tamil Nadu, India.
 EFFECTIVENESS OF MUSCLE ENERGY
TECHNIQUE AMONG SEWING MACHINE
USERS WITH CALF PAIN

INTERNAL EXAMINER:

Name _______________________

Signature with date _______________________

EXTERNAL EXAMINER:

Name _______________________

Signature with date ________________________

In partial fulfillment of the requirement for the Degree of

BACHELOR OF PHYSIOTHERAPY
JUNE -2023
A Project submitted to
SRM COLLEGE OF PHYSIOTHERAPY
SRM INSTITUTE OF SCIENCE AND TECHNOLOGY
(Deemed to be University u/s 3 of UGC Act, 1956)
SRM Nagar, Kattankulathur,
Chengalpattu District – 603203
Tamil Nadu, India.
 SRM COLLEGE OF PHYSIOTHERAPY
SRM INSTITUTE OF SCIENCE AND TECHNOLOGY
(Deemed to be University u/s 3 of UGC Act, 1956)
SRM Nagar, Kattankulathur – 603203
Chengalpattu (Dt), Tamil Nadu, India.
044- 27456729/ www.srmist.edu.in

CERTIFICATE

This is to certify that Ms. SUBALAKSHMI.V, REGISTER NO. RA1921001010086

has satisfactorily completed her project on the topic “EFFECTIVENESS OF

MUSCLE ENERGY TECHNIQUE AMONG SEWING MACHINE USERS

WITH CALF PAIN”. This project is submitted towards partial fulfillment of Degree

of BACHELOR OF PHYSIOTHERAPY Examination JUNE – 2023.

OFFICIAL SEAL WITH DATE DEAN

 SRM COLLEGE OF PHYSIOTHERAPY
SRM INSTITUTE OF SCIENCE AND TECHNOLOGY
(Deemed to be University u/s 3 of UGC Act, 1956)
SRM Nagar, Kattankulathur – 603203
Chengalpattu (Dt), Tamil Nadu, India.
044- 27456729/ www.srmist.edu.in

DECLARATION BY THE STUDENT

I hereby declare that this project entitled “EFFECTIVENESS OF MUSCLE
ENERGY TECHNIQUE AMONG SEWING MACHINE USERS WITH CALF
PAIN” is a bonafide and genuine research work carried out by me under the guidance
of Mr. D. VINCENT JEYARAJ, M.P.T., ORTHOPAEDICS

SIGNATURE OF THE STUDENT

CERTIFICATE BY THE GUIDE

This is to certify that the project entitled “EFFECTIVENESS OF MUSCLE
ENERGY TECHNIQUE AMONG SEWING MACHINE USERS WITH CALF
PAIN” is a bonafide research work done by Ms. SUBALAKSHMI.V,
RA1921001010086 towards partial fulfillment of the requirement for the Degree of
BACHELOR OF PHYSIOTHERAPY.

DATE: SIGNATURE OF THE GUIDE

PLACE:
 ACKNOWLEDGEMENT

First and foremost, I would like to thank the almighty, who showed his blessings
in all walks of my life.

I submit my Heartful thanks to Prof. T.S. VEERAGOUDHAMAN, M.P.T.,

M.S.W., DEAN I/c for the valuable advice and guidance towards this work.

I would like to thank Mr. T.N. SURESH, M.P.T., VICE PRINCIPAL, for
helping me with my project work.

I am highly indebted to my guide Mr. D. VINCENT JEYARAJ, M.P.T.,

ORTHOPAEDICS who took his real personal interest in providing me proper
guidance, encouragement and support at all levels.

I thank my Coordinator Mrs. G. YASMEEN IMTIAZ, M.P.T., ASSISTANT

PROFESSOR, who with all patience gave me helping hands whenever I needed.

I thank my best friends who spared his time and helped me whenever I needed.

My grateful thanks to all my subject Staff, who contributed their time and
energy in this project.

I thank the subjects who have given their consent for participating in my study
and co-operating till the procedure is been completed.

My entire effort stand credited at this moment only because of my family who
whole heartedly stood beside me always in each step of my career.

Last but not least, I would like to thank all my Friends for their valuable
suggestions and support in the completion of my project.

I DEDICATE THIS PROJECT TO MY PARENTS

 ABSTRACT

BACKGROUND: Sewing professionals frequently sit for extended periods of time

while repeating similar movements, particularly those involving the lower extremity.
Calf muscle has higher prevalence rate of pain. If these group of muscles are treated it
may provide with best result. OBJECTIVE: To find the effectiveness of muscle energy
technique among sewing machine users with calf pain. METHODS : Quasi
Experimental study. PROCEDURE: 30 subjects were selected by convenient sampling
method. Among them, 15 samples [group A] received static stretching and muscle
energy technique [post isometric relaxation] and other 15 samples [group B] received
static stretching. OUTCOME MEASURES: Numerical pain rating scale NPRS and
Ankle range of motion. RESULTS: Paired t-test was used for within group analysis.
Significant difference was found in the outcome measure between Muscle Energy
Technique and static stretching groups (p<0.05) and It found to be significantly better
than the control group (p<0.05). Statistically significant improvements were found in
all the groups for all the outcome measures (p<0.05). CONCLUSION: This study
concluded that both the treatment techniques, Muscle Energy Technique and Static
Stretching were effective in reducing pain and improve the ankle dorsiflexion and
plantarflexion in group A than the static stretching in group B as there was a significant
difference between the two groups, however MET was superior than static stretching
in decreasing pain intensity and improving ankle dorsiflexion and plantarflexion range
of motion.

KEYWORDS: Calf pain, Sewing machine users Ankle dorsiflexion, Ankle

Plantarflexion, Muscle Energy Technique, Static Stretching.
 INDEX

S.NO CONTENTS PAGE

NO.

1. INTRODUCTION 1

2. REVIEW OF LITERATURE 5

3. METHODS 8

4. DATA ANALYSIS 13

5. RESULTS 30

6. DISCUSSION 31

7. CONCLUSION 33

8. LIMITATIONS AND RECOMMENDATIONS 34

9. REFERENCES 35

10. ANNEXURES 37
 INTRODUCTION

The most significant occupational injuries in emerging nations are

musculoskeletal disorders1. The head, torso, and lower extremities are typically in a
sedentary position during sewing, which can lead to MSDs, particularly in the hands,
neck, and leg

Musculoskeletal disorders are characterised by pains or aches in the

musculoskeletal system of the body, which includes the muscles, joints, ligaments, and
tendons. Musculoskeletal problems are also correlated with cognitive and psychosocial
variables.2Females were reported to experience pain more frequently than males
(31.3% vs. 20.9%).3

Sewing professionals frequently sit for extended periods of time while repeating
similar movements, particularly those involving the lower extremity. They also
frequently handle equipment and things repeatedly.The drive mechanism and needle
are the two main risks for sewing machine employees. Long line drive system for the
foot. harm to the hip, knee, and especially the ankle from a long drive mechanism. It
could twist and injure the lateral ligaments of the ankle.4-6

The risk of musculoskeletal problem increases with age, years of experience

working, hours worked per day, and continuous work without taking breaks.7 The calf
region is made up of the two muscles (gastrocnemius and soleus) that attach to the heel
bone via the Achilles tendon.

Pain in the calf area might result from a direct hit to the region, a strain on one
of the calf muscles, or transferred pain from the lower back (lumbar spine) Numerous
disorders, such as deep vein thrombosis, achilles tendonitis, sciatica, contusion,
muscular cramps, and muscle tension, can result in calf discomfort.

The most frequent complaint is restricted movement due to calf pain. An

impression of stiffness and restricted range of motion may accompany calf pain, which
is frequently brought on or aggravated by ankle movement.According to Dr. Phillip
Geenman, muscular energy technique can affect every articulation that can be
manipulated by voluntary muscle movement.8

1
 The resistive duction was the term used by Dr. T. J. Ruddy, the first osteopathic
practitioner, to describe the usage of muscular energy in the 1940s and 1950s. which
he described as a succession of muscle contractions in opposition to resistance.In order
to treat a patient, a technique known as muscular energy technique uses the subject's
own muscles to contract against the practitioner's counterforce in a carefully controlled
manner.

Reduce muscle tone, increase range of motion, stretch tight muscles and fascia,
strengthen weak musculature, and loosen moveable joint limitation are all possible
outcomes of using muscle energy technique.10 It is a type of therapy that has the patient
contract their own muscles against the practitioner's counterforce in a carefully
controlled manner.

Muscle tightness and hypertonicity can be treated using muscle energy

technique, but joint dysfunction and joint capsule adhesions can also be treated with
it.11MET is a therapeutic method that primarily chiropractors, physiotherapists, and
osteopaths use. It alternates between facilitated stretching and resisted muscle
contractions.12

As stated by Jensen .C in 1990 muscle energy technique is effective in relieving

tension headaches. This study confirms the statement given by American physical
therapy association in an article in April 2003 that’s METs are appropriate for treating
patient whose symptoms are aggravated by certain postures or bodily position.

The term "static stretching" refers to holding a stretched-out position for a

prolonged period of time.13 and it is considered the gold standard in flexibility training
.Static stretching refers to the concept of retaining a position while lengthening muscles
to their absolute extent. According to some studies, a static stretch should last 30
seconds and should last between 15 and 30 seconds to increase range of motion.14-15

Stretching is known to increase mobility, avoid trauma, enhance sports or

muscular efficiency, enhance training economic benefits, promote recovery, and
possibly postpone the start of stiffness.16Stretching and the muscle energy technique
(MET) are both common physiotherapy treatments. MET is an advanced stretching
techniques17Consequently, research was conducted to see whether the Muscle Energy
Technique is beneficial in reducing pain associated with sewing machines.

2
HYPOTHESIS

NULL HYPOTHESIS

There is no significant effect of muscle energy technique among sewing

machine users with calf pain.

ALTERNATE HYPOTHESIS

There is significant effect of muscle energy technique among sewing machine

users with calf pain.

3
AIM OF THE STUDY
The aim of the study is to find the effectiveness of muscle energy technique
among sewing machine users with calf pain.

NEED OF THE STUDY

Calf pain is more common among sewing machine users. Various studies were
done on musculoskeletal disorders among sewing machine users. This study was
conducted to find out the best method to decrease the pain and improve range of motion
in sewing machine users with calf pain. This study is linked with the third Sustainable
Development Goal (SDG) to transform the World i.e. good health and wellness of
human beings.

4
 REVIEW OF LITERATURE
Nazish Anwar et al., (2020) stated that although most tailors had good posture at work,
upper back pain from this activity was prevalent.

Vanivijan et al., (2019) concluded that there is more significant difference in muscle
energy technique along with short wave diatherapy is effective when compare to
stretching with shortwave diatherapy on subject with piriform syndrome.

Dean huffer et al., (2017) concluded that According to the research examined, it was
unable to determine the degree to which strengthening therapies that enhance intrinsic
foot musculature may benefit symptomatic or at-risk groups for plantar fasciitis/heel
discomfort.

Priya Dwivedi et al., (2016) found that feeling, tailor as a result of their exposure to a
high level of repetitive activity and work pressure, the majority of tailors had pain in
their necks, shoulders, thighs, and legs. All of these circumstances lead to pressure, as
well as musculoskeletal pain and discomfort in various body areas.

S.Banerjee et al.,(2016) concluded that to prevent the crippling effects of

musculoskeletal problems among the workforce, a multifaceted strategy that takes into
account proper technique for operators' posture and an ergonomically sound
workstation is necessary.

Sagrike popli et al., (2014) recommended Retro walking is less effective than static
stretching at boosting hamstring flexibility.

Pooja et al., (2013) conducted a study on from Women who worked in tailors reported
light pain in the neck, shoulders, upper arms, and upper back. Equal percentages of
respondents (11.7%) also reported mild pain in the buttocks, which was reported by
85.50% of respondents, followed by lower arms (75%) and lower back (72%) and upper
back (68%)

Emad T. Ahmed et al., (2013) suggest that the hamstring muscle's flexibility after
a burn contracture can be improved more effectively with muscle energy technique than
static stretching alone.

5
Richa Mahajan et al., (2012) they concluded that both the treatment technique, MET
and static stretching were effective in alleviating the mechanical neck pain in term of
decreasing pain intensity and increasing cervical range of motion. However, MET
superior than static stretching in decrease pain intensity and cervical ROM.

Romulo Renan-Ordine et al., (2011) stated that in the treatment of patients with
plantar heel pain, this study shows that the addition of TrP manual therapy to a self-
stretching regimen led to better short-term outcomes than a self-stretching programme
alone.

Gangopadhyay et al., (2010) found that the suffered from Work-related soreness is
most common in the lower back (98%) and knees (85%) and shoulder (77%).

J. Goodridge et al., (2004) concluded that good results with muscle energy technique
depends on accurate diagnosis appropriate level of force and sufficient location. Poor
results are most often caused by inaccurate diagnosis, improperly force that are too
stress.

American physical therapy association et al., (2003) in an article has confirmed that
muscle energy technique is appropriate for treating patient whose symptoms are
aggravated by certain posture or bodily position.

Greenman.p et al., (2003) stated that muscle energy technique can be used to and
strengthen muscle, to increase the fluid mechanism and decrease local oedema and to
mobilise a restricted articulation.

Bandy and Irion et al., (2002) they reported that 30 and 60 seconds of static stretching
to hamstring was more effective than 15 seconds or no stretch.

Hutton RS et al., (2002) suggested that static stretching consists of sustained

elongation of desired muscle group with duration of 15 – 120 second. It increases range
of motion observed both at the time of single episode of stretching and after several
weeks of stretching.

Jensen et al., (2001) has stated that Mechanical neck pain can be treated with MUSCLE
ENERGY TECHINQUE.

6
Good ridg JP et al., (2001) Explained that PIRT [post isometric relaxation technique]
is an electrophysiological trick that encourages muscles to relax more quickly and
claims to assist lengthen tight muscles through the procedure of contraction and
relaxation.

Vadivelan kanniappan et al., (2000) concluded that among those who used sewing
machines, 86% reported low back pain, 84% knee pain, and 74% neck pain due to
musculoskeletal disorders.

Apoorva phadke et al., (2000) concluded that Stretching was less effective in reducing
pain and functional handicap in people with mechanical neck pain than the muscle
energy technique.

7
 METHODS
STUDY DESIGN : Quasi Experimental

STUDY TYPE : Pre and post type

SAMPLING METHOD : Convenient sampling method

SAMPLING SIZE : 30 subjects

Group-A: muscle energy technique group 15 subjects

Group-B: static stretching group 15 subjects

STUDY DURATION : 4 weeks

STUDY SETTING : Chengalpattu district

8
INCLUSION CRITERIA

Tailors with calf muscle pain

Age: Above 22 years

Gender: Both male and female

Year of experience: minimal 1 year

Numeric pain rating scale score :5-7

Only dominant side leg is involved

EXCLUSION CRITERIA

Fracture in lower limb

Dislocation of joint in lower limb
Deformities such as bowleg, knock-knee
Varicose vein and deep vein thrombosis
Malignancy

MATERIALS USED IN THE STUDY

• Couch
• Chair
• Goniometer
• Pillow
• Assessment chart

9
PROCEDURE:

Institutional Ethical Committee (IEC) of SRM Medical College Hospital and

Research Centre approved the study with IEC clearance no: SRMIEC-ST0922-131

Applying both inclusive and exclusive criteria,30 subjects were selected by

convenient sampling method.

Among them, 15 samples (group A) received static stretching and muscle

energy technique (post isometric relaxation) and other 15 samples (group B) received
static stretching .

GROUP A
15 subjects were treated with Muscle energy technique and static stretching

Patient treated with Muscle energy technique (post isometric relaxation):

• Number of repetitions : 3-5 times per day

• Duration : 7-8 seconds per each repetition

• Frequency of treatment : weekly thrice

• Force : 20%

• Treatment duration : 4 weeks

Patient were treated with static stretching:

• Number of repetitions : 3 -5 times per day

• Duration : 10-30 seconds per each repetitions

• Frequency of treatment : weekly thrice

• Treatment duration : 4 weeks

10
 FIGURE 1 MUSCLE ENERGY TECHNIQUE

GROUP B
15 subjects were treated with static stretching

Patient were treated with static stretching:

• Number of repetitions : 3 -5 times per day

• Duration : 10-30 seconds per each repetitions

• Frequency of treatment : weekly thrice

• Treatment duration : 4 weeks

Pre-test and post-test were taken using numerical rating scale. Both grading were
compared and effectiveness of muscle energy technique was identified.

11
OUTCOME MEASURES

• Pain intensity measured with Numeric pain rating scale.

• Ankle range of motion were measured using universal goniometer.

FIGURE 2 GONIOMETER

12
 DATA ANALYSIS

The collected data was analysed by using statistical package for social science
(SPSS) version 26. where the alpha level is below 0.05 were considered significant.

13
 TABLE-I
DEMOGRAPHIC DATA OF GROUP A

Variables N Minimum Maximum Mean SD

Age 15 23 64 42.93 10.173
Years of 15 6 40 20.87 10.260
experience

According to Table I, mean and standard deviation of age in group A is 42.93

and 10.173, mean and standard deviation of years of experience in group A is 20.87
and 10.260.

TABLE-II
DEMOGRAPHIC DATA OF GROUP B
Variables N Minimum Maximum Mean SD
Age 15 25 64 44.87 10.542
Years of 15 6 45 21.27 12.262
experience

According to Table II, mean and standard deviation of age in group B is 44.87
and 10.542, mean and standard deviation of years of experience in group B is 21.27 and
12.262.

14
 TABLE III
PRE-TEST AND POST-TEST OF NUMERICAL PAIN RATING
SCALE OF GROUP A

GROUP Mean N SD Paired ‘t’ SIG

A test

Numerical Pre-test 7.2 15

pain
Rating
Scale Post-test .72375 12.486 .000
4.86 15

According to Table III, the pre-test mean Numerical Pain Rating scale (NPRS)
score is 7.2 and the post-test mean value is 4.86, which shows significant changes in
Numerical Pain Rating scale (NPRS) score with Muscle Energy Technique and Static
Stretching.

15
 BAR DIAGRAM I
PRE-TEST AND POST TEST OF NPRS OF GROUP A

16
 TABLE IV
PRE-TEST AND POST-TEST OF GROUP A PLANTARFLEXION
AND DORSIFLEXION
GROUP A Mean N SD Paired ‘t’ SIG
test
(MET &
STRETCH)

Plantarflexion Pre-test 27.4 15

Post- 32.73 15 1.61245 -12.490 .000

test

Dorsiflexion Pre-test 22.6 15

1.43759 7.364 .000

Post- 19.87 15
test

According to Table IV, the pre-test mean Group A Plantarflexion score is 27.4
and the post-test mean value is 32.73 and the pre-test mean Group A Dorsiflexion score
is 22.6 and the post-test mean value is 19.87, which shows significant changes in
Muscle Energy Technique and Static Stretching.

17
 BAR DIAGRAM II
PRE-TEST AND POST-TEST OF PLANTARFLEXION
OF GROUP A

18
 BAR DIAGRAM III
PRE-TEST AND POST-TEST OF DORSIFLEXION
OF GROUP A

19
 TABLE V
PRE-TEST AND POST-TEST OF NUMERICAL PAIN RATING
SCALE OF GROUP B

GROUP Mean N SD Paired ‘t’ SIG

B test

Numerical Pre-test 6.4 15

Pain
Rating
Scale .50709 4.583 .000
Post-test 5.8 15

According to Table V, the pre-test mean Numerical Pain Rating scale (NPRS)
score is 6.4 and the post-test mean value is 5.8, which shows significant changes in
Numerical Pain Rating Scale (NPRS) score with Static Stretching.

20
 BAR DIAGRAM IV
PRE-TEST AND POST -TEST OF NPRS OF GROUP B

21
 TABLE VI
PRE-TEST AND POST-TEST SCORES OF GROUP B
PLANTARFLEXION AND DORSIFLEXION

GROUP B Mean N SD Paired ‘t’ SIG

test
(STRETCH)

Plantarflexion Pre-test 29 15

Post- 30.27 15 .88372 -5.551 .000

test

Dorsiflexion Pre-test 22.93 15

.96115 3.761 .002

Post- 22 15
test

According to Table VI, the pre-test mean Group B Plantarflexion score is 29

and the post-test mean value is 30.27 and the pre-test mean Group B Dorsiflexion score
is 22.93 and the post-test mean value is 22, which shows significant changes in Static
Stretching.

22
 BAR DIAGRAM V
PRE-TEST AND POST-TEST OF GROUP B
PLANTARFLEXION

23
 BAR DIAGRAM VI
PRE-TEST AND POST-TEST OF GROUP B
DORSIFLEXION

24
 TABLE VII
NPRS SCORE OF GROUP A AND GROUP B

GROUPS MEAN N SD

NPRS GROUP A 4.8667 15 .91548

GROUP B 5.8000 15 1.14642

According to Table VII, the mean value of NPRS in group A is 4.8667 and
group B is 5.8000, which shows significant changes in group A than in group B.

25
 BAR DIAGRAM VII
NPRS SCORE OF GROUP A AND GROUP B

26
 TABLE VIII
PLANTARFLEXION AND DORSIFLEXION VALUE OF
GROUP A AND GROUP B

GROUP MEAN N SD

GROUP A 32.7333 15 2.84019

PLANTARFLEXION

GROUP B 30.2667 15 3.12745

GROUP A 19.8667 15 2.23180

DORSIFLEXION

GROUP B 22.0000 15 1.25357

According to Table VIII, the mean value of plantarflexion in group A is

32.7333 and group B is 30.2667 and the mean value of dorsiflexion in group A is
19.8667 and group B is 22.0000, which shows significant changes in group A than in
group B.

27
 BAR DIAGRAM VIII
PLANTARFLEXION OF GROUP A AND GROUP B

28
 BAR DIAGRAM IX
DORSIFLEXION OF GROUP A AND GROUP B

29
 RESULTS
According to Table I, mean and standard deviation of age in group A is 42.93
and 10.173, mean and standard deviation of years of experience in group A is 20.87
and 10.260.

According to Table II, mean and standard deviation of age in group B is 44.87
and 10.542, mean and standard deviation of years of experience in group B is 21.27 and
12.262.

According to Table III and Bar diagram I, the pre-test mean Numerical Pain
Rating scale (NPRS) score is 7.2 and the post-test mean value is 4.86, which shows
significant changes in Numerical Pain Rating scale (NPRS) score with Muscle Energy
Technique and Static Stretching.

According to Table IV and Bar diagram II and III, the pre-test mean Group
A Plantarflexion score is 27.4 and the post-test mean value is 32.73 and the pre-test
mean Group A Dorsiflexion score is 22.6 and the post-test mean value is 19.87, which
shows significant changes in Muscle Energy Technique and Static Stretching.

According to Table V and Bar diagram IV, the pre-test mean Numerical Pain
Rating scale (NPRS) score is 6.4 and the post-test mean value is 5.8, which shows
significant changes in Numerical Pain Rating Scale (NPRS) score with Static
Stretching.

According to Table VI and Bar diagram V and VI, the pre-test mean Group
B Plantarflexion score is 29 and the post-test mean value is 30.27 and the pre-test mean
Group B Dorsiflexion score is 22.93 and the post-test mean value is 22, which shows
significant changes in Static Stretching.

According to Table VII and Bar diagram VII, the mean value of NPRS in
group A is 4.8667 and group B is 5.8000, which shows significant changes in group A
than in group B.

According to Table VIII and Bar diagram VIII and IX, the mean value of
plantarflexion in group A is 32.7333 and group B is 30.2667 and the mean value of
dorsiflexion in group A is 19.8667 and group B is 22.0000, which shows significant
changes in group A than in group B.

30
 DISCUSSION

The current research was conducted to assess the impact of Muscle Energy
Technique and static stretching on pain and discomfort among Sewing machine users
with calf pain.

After receiving their specific techniques, both populations showed a substantial

improvement on the NPRS. Muscle Energy Technique increased flexibility capacity
while reducing sensation of pain.17

The mechanoreceptors and proprioceptors of the muscle and joint are activated
when stretching and isometric clenching take place at the same time. The following
stretch would be easier and more bearable as a result of the diminished sensation of
pain. The MET group's results regarding pain management may be similar to previous
research in which pain intensity reduced after MET over the neck region and other body
regions.

The golgi tendon organs inhibitory effects, which reduce motor neuronal signals
and cause the musculotendinous unit to unwind by returning to its resting length and
Pacinian corpuscle change, may be responsible for the pain relief experienced after
passive stretching. These reactions will make it possible to lessen muscle-tendon strain
and pain perception. 18

Group A improved more than Group B in terms of pain and functional

condition. Ahmed noticed similar findings and concluded that the MET
dominated stretching in improving hamstring flexibility 19

The results of this study are also consistent with those of Mahajan et.al.,20, who
discovered that Muscle Energy Technique decreased discomfort and increased
functional ability in people with neck pain.

Even though Muscle Energy Technique includes isometric muscular contraction

followed by stretching, the effects of Muscle Energy Technique possibly concealed by
the repetitive motions.

31
 The consequences of conventional therapy must not be ignored. This entails
stretching and strengthening specific muscles that are prone to incorrect positioning as
well as applying heated compresses. Moist heat treatment reduces pain by decreasing
spasms and has a relaxing impact. By reducing the stiffness of viscoelastic collagen,
heat makes the connective tissue more flexible and less resistant to active or passive
stretching. 21

Static stretching increases calf muscle flexibility, reducing pain and preventing
re-injury. Static stretching is helpful because it increases circulation and reduces
muscular tension, according to the Canadian Centre for Occupational Health and Safety
in 2005.

Both the MET and the stretching method were found to be helpful in the
treatment of calf discomfort in this research. When compared to stretching, MET
appears to be more successful in decreasing pain and discomfort.

Thus, when treating individuals with calf discomfort, MET can be preferred
over stretching. The benefits of these methods, however, were examined as an addition
to traditional treatment, which involves movements and the use of a hot compress.
Thus, when addressing patients with calf discomfort, MET can be selected over
stretching in addition to traditional routines.

This research found that both muscle energy techniques and static stretching are
beneficial for calf pain, with the muscle energy technique providing greater and faster
alleviation than static stretching.

32
 CONCLUSION
This study concluded that there was a significant difference between the two
groups, this study found that both treatment methods, Muscle Energy Technique (MET)
and static stretching, were effective in reducing pain and improving ankle dorsiflexion
and plantarflexion range of motion in group A. However, MET was superior to static
stretching in reducing pain intensity and improving ankle dorsiflexion and
plantarflexion range of motion.

33
 LIMITATIONS AND RECOMMENDATIONS

LIMITATIONS

• Smaller sample size

• Limited study duration
• Comparison between male and female was not done.

RECOMMENDATIONS

• Can be done on the larger sample size

• Comparison between affected and normal leg

• The same study can be done for other professions.

34
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technique applied to the atlanto – axial joint of osteopathic medicine 2004; 79-84

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11. Chaiton leon. Muscle energy techniques. 2nd edition. Edinburgh chruchill
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36
 ANNEXURE I

INSTITUTIONAL ETHICAL CLEARANCE CERTIFICATE

37
 ANNEXURE II

INFORMED CONSENT FORM

I Mr. / Miss. ………………………………have been properly explained about
the procedure. I voluntarily agree to participate in the study conducted on
“EFFECTIVENESS OF MUSCLE ENERGY TECHNIQUE AMONG SEWING
MACHINE USERS WITH CALF PAIN” done by Ms.V. SUBALAKSHMI , BPT
FINAL YEAR, SRM COLLEGE OF PHYSIOTHERAPY, SRM INSTITUTE OS
SCIENCE AND TECHNOLOGY, KATTANKULATHUR, CHENGALPATTU-
603203.

All the information given by me will be kept strictly confidential and used only
for project purpose.

I have the option of discontinuing at any point of time according to my personal

needs or reasons.

DATE: PARTICIPANT’S SIGNATURE:

PLACE:

38
 ANNEXURE III
PHYSIOTHERAPY ASSESSMENT

NAME :
AGE :
GENDER :
OCCUPATION :
DATE OF ASSESSMENT :
PHONE NO :
ADDRESS :
CHIEF COMPLAINTS :
HAND DOMINANCE :
PRESENT HISTORY :
PAST HISTORY :
MEDICAL HISTORY :
YEARS OF EXPERIENCE :

39
 ANNEXURE IV
NUMERICAL PAIN RATING SCALE

Score =
DATA SCORE

PRE-TEST

POST- TEST

40
 ANNEXURE V
ANKLE RANGE OF MOTION

PRE-TEST
MOVEMENT LEFT RIGHT
PLANTARFLEXION
DORSIFLEXION

POST-TEST
MOVEMENT LEFT RIGHT
PLANTARFLEXION
DORSIFLEXION

41
 ANNEXURE VI
MASTER CHART
Group A (Muscle energy technique and static stretching)
S.NO AGE GENDER YEARS NPRS ANKLE ROM (PRE-TEST) ANKLE ROM (POST-TEST)
OF
EXPER
IENCE
PRE- POST- PLANTAR DORSI PLANTAR DORSI
TEST TEST FLEXION FLEXION FLEXION FLEXION
L R L R L R L R
1 49 Female 25 7 4 30° 26° 25° 25° 30° 34° 25° 25°
2 28 Female 6 9 6 40° 35° 15° 25° 40° 40° 15° 23°
3 42 Male 25 7 4 32° 25° 20° 22° 32° 28° 20° 19°
4 45 Male 30 6 5 30° 27° 21° 21° 30° 32° 21° 16°
5 60 Male 40 9 6 31° 29° 19° 24° 31° 34° 19° 20°
6 64 Male 20 6 4 32° 26° 22° 23° 32° 31° 22° 21°
7 36 Female 14 7 5 33° 30° 20° 23° 33° 35° 20° 19°
8 52 Male 30 5 3 33° 28° 20° 22° 33° 33° 20° 18°
9 37 Female 17 8 6 31° 27° 19° 21° 31° 32° 19° 18°
10 35 Female 10 7 5 31° 25° 21° 24° 31° 30° 21° 22°
11 40 Male 15 8 4 32° 28° 21° 23° 32° 34° 21° 20°
12 45 Female 12 7 5 33° 29° 20° 22° 33° 34° 20° 20°
13 56 Male 26 7 5 34° 26° 19° 23° 34° 32° 19° 19°
14 23 Female 8 8 6 34° 25° 21° 20° 34° 33° 21° 20°
15 52 Female 35 7 5 30° 25° 19° 21° 30° 29° 19° 18°

42
 Group B (Static Stretching)
S.NO AGE GENDER YEARS NPRS ANKLE ROM (PRE-TEST) ANKLE ROM (POST-TEST)
OF
EXPER
IENCE
PRE- POST- PLANTAR DORSI PLANTAR DORSI
TEST TEST FLEXION FLEXION FLEXION FLEXION
L R L R L R L R
1 52 Female 35 6 6 31◦ 27◦ 20◦ 25◦ 31◦ 27◦ 20◦ 24◦
2 34 Female 7 6 5 30◦ 29◦ 21◦ 22◦ 30◦ 31◦ 21◦ 22◦
3 44 Male 15 7 7 32◦ 30◦ 22◦ 21◦ 32◦ 31◦ 22◦ 21◦
4 30 Female 12 6 5 34◦ 33◦ 21◦ 24◦ 34◦ 35◦ 21◦ 22◦
5 64 Male 45 5 4 35◦ 35◦ 25◦ 26◦ 35◦ 36◦ 25◦ 25◦
6 55 Male 34 6 6 34◦ 32◦ 22◦ 24◦ 34◦ 32◦ 22◦ 21◦
7 42 Male 20 6 5 32◦ 31◦ 20◦ 21◦ 32◦ 33◦ 20◦ 21◦
8 25 Female 6 8 7 32◦ 29◦ 21◦ 22◦ 32◦ 31◦ 21◦ 22◦
9 40 Female 15 6 5 28◦ 26◦ 21◦ 23◦ 28◦ 26◦ 21◦ 21◦
10 46 Male 17 5 5 29◦ 26◦ 21◦ 23◦ 29◦ 27◦ 21◦ 23◦
11 56 Male 35 7 7 29◦ 27◦ 18◦ 21◦ 29◦ 27◦ 18◦ 21◦
12 52 Male 20 6 5 31◦ 26◦ 21◦ 23◦ 31◦ 28◦ 21◦ 22◦
13 52 Male 35 8 8 30◦ 30◦ 20◦ 23◦ 30◦ 32◦ 20◦ 21◦
14 42 Female 12 8 7 27◦ 25◦ 19◦ 24◦ 27◦ 27◦ 19◦ 23◦
15 39 Female 11 6 5 31◦ 29◦ 21◦ 22◦ 31◦ 31◦ 21◦ 21◦

43
 ANNEXURE VII
PLAGIARISM FORMAT
SRM INSTITUTE OF SCIENCE AND TECHNOLOGY
(Deemed to be University u/s 3 of UGC Act, 1956)
Office of Controller of Examinations

REPORT FOR PLAGIARISM CHECK ON THE PROJECT REPORTS FOR UG

PROGRAMMES
1. Name of the Candidate SUBALAKSHMI.V

2. Address of the Candidate 122/D Nehru Nagar,

Mobile Pattukkottai,
Thanjavur (Dt)
614601

Mobile Number: 9150744198

3. Registration Number
RA1921001010086
4. Date of Birth 04\01\2001
5. Department SRM College of Physiotherapy
6. Faculty Health Sciences

7. Title of the Project EFFECTIVENESS OF MUSCLE

ENERGY TECHNIQUE AMONG
SEWING MACHINE USERS
WITH CALF PAIN
8. Whether the above project is Individual or group: INDIVIDUAL
done by
9. Name and address of the Guide Mr.D.VINCENT
JEYARAJ,M.P.T,ORTHOPEADICS
ASSISTANT PROFESSOR
SRM COLLEGE OF
PHYSIOTHERAPY
SRM INSTITUTE OF SCIENCE
AND TECHNOLOGY

Mail ID : vincentd@srmist.edu.in
Mobile Number : 98841 94724
10. Name and address of the Co- NA
Supervisor / Co-Guide (if any)
11. Software Used TURNITIN

44
 12. Date of Verification 13\04\2023

13. Plagiarism Details: (to attach the final report from the software)
Enclosed
Title of the study Percentage Percentage % of
of similarity of Plagiarism
index similarity after
(Including index excluding
self citation) (Excluding Quotes,
self Bibliography,
citation) etc.,
Osteoporosis Knowledge, Self-
efficacy and Perception of Health -------- 9% 9%
belief among Collegiate girls
I declare that the above information have been verified and found true to the best of
my knowledge.

Signature of the Candidate Name & Signature of the Staff

(who uses the Plagiarism check
software)

Name & Signature of the Guide Name & Signature of the Co-
Supervisor/ Co-Guide

Name & Signature of the HOD

45
 ANNEXURE VIII
PLAGIARISM REPORT

46