Effect of muscle energy technique on pain, importance of physical activity, self-confidence, and posture in COPD patients with chronic neck pain: An experimental randomized controlled study

Abstract

Background: Excessive use of accessory respiratory muscles leads to postural abnormalities and pain in the cervical area in patients with chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the effects of the muscle energy technique (MET) on pain, importance of physical activity (PA), self-confidence, and posture in patients with moderate COPD and chronic neck pain. Methods: This study is a randomized controlled parallel-group trial with an experimental design that includes a longitudinal follow-up process. This study included 52 COPD patients (26 in the MET group) (mean forced expiratory volume in one second [FEV1%: 63.53 +/- 9.33] and 26 in the control group [CG] [FEV1%: 64.06 +/- 8.53]). The MET group received MET 3/week for 4 weeks. Both groups participated in a home-based exercise program. Pain intensity (visual analog scale), importance of PA (importance scale), self-confidence (confidence scale), and posture (New York Posture Rating Chart) of all individuals were evaluated before and after the 4-week treatment period, as well as at the end of the 6-week follow-up period. Results: Significant improvements were observed in both groups (P < .05). However, while a notable reduction in pain intensity was observed in the intervention group, significantly greater improvements were recorded in the perception of the importance of exercise, self-confidence in exercising, and postural alignment (P < .05). At week 4, pain data for both groups (resting, activity, and night pain scores, respectively) were as follows: low level pain (MET group: 25 +/- 96.2, 26 +/- 61.9, 26 +/- 100.0; CG: 13 +/- 50, 16 +/- 38.1, 16 +/- 61.5) and moderate level pain (MET group: 1 +/- 3.8, 0, 0; CG: 13 +/- 50, 10 +/- 100.0, 10 +/- 38.5). Additionally, the effects on the perception of exercise importance, self-confidence, and posture were maintained during the follow-up period (P < .05). Conclusion: MET performed on the accessory respiratory muscles improved pain intensity and the importance of PA, confidence, and posture. MET was found to provide superior responses compared to the control group. Therefore, MET should be included as an important part of treatment programs for COPD patients with chronic neck pain.