Comparison of the effect of a 5-week series of positional release therapy and muscle energy technique on pain threshold and mobility of the cervical spine in people with the upper crossed syndrome

Background
Upper crossed syndrome (UCS) manifests as a distinctive posture resulting from imbalances in muscles and fascia in the upper body. Among the various therapeutic approaches addressing pain and limited range of motion in individuals with UCS, positional release therapy (PR) and muscle energy techniques (MET) are widely employed.

Aims
This study aims to compare the efficacy of PR and MET in inducing changes in pressure pain threshold and cervical spine range of motion among patients with UCS.

Material and methods
A group of 45 patients exhibiting myofascial trigger points (MTrPs) in the trapezius muscle were divided into three equal groups. Group A received a five-week series of PR treatments, while Group B underwent five series of MET treatments, both administered weekly. Both interventions targeted muscles shortened in UCS. Group C (control) received no treatment. Pressure pain threshold and cervical range of motion, assessed using a three-dimensional motion analysis system, were measured before and after the therapy.

Results
Both Groups A and B demonstrated a significant increase in the trapezius muscle pain threshold, while no changes were observed in Group C. Moreover, a noteworthy improvement in range of motion was observed: Group A exhibited enhancements in the sagittal and transverse planes, and Group B showed improvements in the frontal and transverse planes. No statistically significant changes were noted in other parameters.

Conclusions
MET and PR are equally effective in alleviating pain associated with MTrPs in patients with UCS. Furthermore, both techniques enhance range of motion, albeit in specific planes. The application of MET and PR proves effective in addressing pain and movement limitations attributed to MTrPs.