Hamstring Tightness Is Common Health And Social Care Essay

Hamstring Tightness Is rough-cut Health And Social Cargon EssayAmong the massiveness under spill adaptive reduce, torment is the virtuoso commonly going for adaptive shortening. The torment comprises of lead large heftinesss namely semimembranosus, semitendinosus, and bicep femoris which arises from the tuberosity of ischium. They are present oer the tole locateerior compartment of the thigh and span the hip and knee joints. Hence they are the extensors of the hip and flexors of the knee.Hamstring tightfistedness is common in normal one-on-one because of immobilization of a tissue in a sawed-off position results in adaptive shortening. As the go through shortens, its elasticity of the normal tissue was diminish and a change in the aloofness tension relationship of the muscular tissue, loss of tract suitableness also occurs. Hamstring tenseness could make the musculo tendinous unit to a greater extent susceptible to injury, gain resistance to various anatomical struct ures, which may lead to overuse syndrome.Tightness could also leads to pathological conditions at the joint on which the go through acts, in particular on a muscle like hamstring which passes over the two joints. muscle density has a epochal impact on neuromuscular control. musculus tightness affects the normal length tension relationships. When one muscle in a force couple becomes tight or hypertonic, it alters the normal arthrokinematics of the involved joint. This affects the synergistic function of the entire kinetic chain, leading to abnormal stress, mild tissue dysfunction, neural compromise and vascular/lymphatic stasis.Muscle tightness also cause mutual inhibition. Increased muscle spindle employment in a specific muscle go out cause decreased neural drive to that muscles utilitarian antagonist. This alters the normal arthrokinematics of the involved segment.Flexibility has been defined as the susceptibility of a muscle to lengthen and book one joint (or more than one joint in a series) to move through a persist of motion.Anderson and Burke defined Flexibility as the range of motion available in a joint or a group of joint that is influenced by muscles, ligaments and bones. disadvantage of flexibility means decreased ability of a muscle to deform. Loss of flexibility may lead to decrease in lumbar lordosis, reduction of muscle strength and quadriceps dysfunction during gait, lumbar pelvic rhythm was disturbed, anterior pelvic tilt was restricted, lumbar motion was addd. Excessive mobility of lumbar spine leads to over reaching of lumbar ligaments and consequently hassle and instability. (Levangie and Norkin, two hundred1)Loss of flexibility can also cause pain arising from muscle, joining tissue or periosteum. (Hardy, 1989 Tillmann and Cummings, 1992)With regard to all-important(prenominal) role of hamstring flexibility restoration of its normal length is necessary. Muscle tissue length is notion to play an important role in effi ciency and takingsiveness of human movement.Benefits of flexibility is to enhance the range of motion, alter body position, potential relief of aches and pain, protection against low tail end pain and injuries, reduction of adventure exercise muscle soreness, and promotes uncompressation.Hamstring tightness can be bank billd utilise the (1) dynamic one-party straight leg raise rill, (2) Passive unilateral straight leg raise probe, (3) Sit and tense up test, (4)Active knee quotation test. Straight leg raise test are widely utilise as a neurologic tests, wherefore they do not give valid measures of hamstring tightness because of pelvic rotation that occurs during the test. Active knee cite test is the reliable test.Continuous ultrasonography therapy increases muscularity length by changing their viscousness and plasticity (Ziskin et al, 1986). Skeletal muscles have a higher rate of preoccupancy of sonography waves when examined to fatty tissue. (Dyson, 1987 Low a nd Reed, 1990).Elevation of collagen tissue temperature affects on mechanical and natural characteristics of tissues and urge ons deformation of the collagen. As pain and discomfort was reduced during reaching and collagen fiber ability to tolerate greater forces was increased. Ultrasound increases wanton tissue extensibility and may be an pictureive adjunct in the intercession of knee contractures secondary to continuative tissue shortening (Folconer et al, 1992).Static stint allow the muscle spindle to accommodate, reduces their firing rate hence nonoperational profane is effective in change magnitude the length of muscle. (Gordon and Ghez, 1991).Longer hold epochs during broadening of the hamstring muscles resulted in a greater rate of gains in range of motion (Feland et al, 2001).Stretch succession lower than 30 seconds did not increase muscle flexibility (Beaulien, 1981). Static load of 30 seconds is capable to increases the hamstring muscle length.Combination of ultrasound therapy with 30 seconds stretch is more effective than ultrasound therapy with 15 seconds stretch in increasing hamstring flexibility (A.Akbari, H.Moodi, A.A.Moein, and R.Nazok 2006).Muscle aptitude techniques (MET) are manually utilise stretching techniques that use dogmas of neurophysiology to relax overactive muscle and stretch chronically trim back muscles.Muscle goose egg techniques (MET) have the ability to relax overactive muscles or stretch tight muscles and their associated fascial percentages when connective tissue or viscoelastic changes have occurred.When victimization Muscle heftiness techniques (MET), it is important to relax/inhibit the neuromuscular component before attempting to stretch the involved musculature. Two fundamental neurophysiologic principles account for the neuromuscular inhibition. The first principle of Muscle impartcode techniques (MET) is post contraction inhibition / autogenic inhibition / post isometric rest. The second p rinciple is reciprocal inhibition. Muscle power technique produced an immediate increase in passive knee extension in individuals with hamstring tightness (Ballantyne 2003). Muscle zippo technique is significantly modify the hamstring flexibility in collegiate males (Wassim .M et al 2009).1.1 NEED FOR THE STUDYContinuous ultrasound therapy, static stretching, muscle qualification technique (MET) are significant in meliorate hamstring flexibility in individuals with hamstring tightness. These methods of treatment are well accepted and practised by various researchers according to previous literature, but in that respect was no body of work to compare the effect of muscle vim technique ( MET) and ultrasound therapy with static stretching in up(a) the hamstring flexibility in individuals with hamstring tightness.So the purpose of this study is to take the efficacy of muscle elan vital technique and ultrasound therapy with static stretching in improving the hamstring flexibili ty in individuals with hamstring tightness.1.2 AIMSTo find out the effect of muscle energy technique versus ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.1.3 OBJECTIVESTo study the effect of muscle energy technique in improving the hamstring flexibility in individuals with hamstring tightness.To study the effect of ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.To compare the effect of muscle energy technique and ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.1.4 KEYWORDSHamstring flexibility, Muscle energy technique, Ultrasound therapy with static stretching, Active knee extension test.1.5 HYPOTHESIS1.5.1 NULL HYPOTHESISThere is no significant effect of muscle energy technique in improving the hamstring flexibility in individuals with hamstring tightness.There is no significant effect of ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.There is no significant difference between the effect of muscle energy technique and ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.1.5.2 tack together HYPOTHESISThere is a significant effect of muscle energy technique in improving the hamstring flexibility in individuals with hamstring tightness.There is a significant effect of ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.There is a significant difference between the effect of muscle energy technique and ultrasound therapy with static stretching in improving the hamstring flexibility in individuals with hamstring tightness.II.REVIEW OF LITERATUREHAMSTRING TIGHTNESSWorrel et al (2003) stated that hamstring injuries in athletes is mainly re ferable to the lack of hamstring flexibility.Kishner and Colby et al (2002) stated that adequate mobility of light tissues and joints is thought to be an important factor in prevention of injury (or) reinjury to soft tissues.Donald E Hartig et al (1999)declared that increase in hamstring flexibility decreases overuse injuries in lower extremities.Sarhmann.S et al (1997) verbalise that muscle tightness and hypertonicity has a significant impact on the neuromuscular control. Muscle tightness affects the normal length tension relationship.Bullock-Saxton.J, Lewit.K et al (1997, 1984) verbalise that muscle tightness alters the normal arthrokinematics of the involved joint. This affects the synergistic function leading to abnormal joint stress, soft tissue dysfunction, neural compromise and vascular or lymphatic stasis.Ronald F, Zernickle et al (1996) stated that extracting flexibility changes related with structural and physiological changes influence the level of physical activity.Zach azewski et al (1989) give tongue to that loss of flexibility of hamstring may lead to decrease in lumbar lordosis, reduction of muscle strength and quadriceps dysfunction during gait.Cummings, GS, Crutchfeld, CA, Barnes et al (1983) express that tightness is referred to mild shortening of a healthy musculo tendinous unit otherwise referred to as a mild transient contracture. A muscle that is tight can be lengthened to all but the outer limits of its range. Normal individual who do not regularly participate in a flexibility program can conk out mild myostatic contractures or tightness, particularly in two joint muscles such as hamstrings, rectus femoris or gastronemius.Fox E.L et al (1979)Stated that flexibility enhances movement by improving body awareness with greater ease and dexterity.Lawrence Gold et alStated that the hamstrings are the muscles that run from behind and below the knees up to the back of the thigh till the sitbones. Soft tissue injuries, knee pain, torn menisci, chondromalacia patella and poor posture very much come from tight hamstrings. Tight hamstrings can prevent the individual from reaching full extension or from bending over completely.ULTRASOUND THERAPY WITH STATIC stretchinessShadmer.A, Astaneh.H.N, et al (2010)Conducted a study to analyse the effect of two different modes (Continuous versus Pulsed) in decreasing the shortening of hamstrings. Thirty non impaired men aged 20 to 30 years were included. Ultrasound was applied over short hamstrings. Hamstring flexibility was measured by passive knee extension test. Continuous ultrasound of 2W/Cm, 1MHZ, five minutes and Pulsed ultrasound of 200s burst of 1MHZ, 0.5W/Cm, five minutes was use. They concluded that the heating effects of ceaseless(prenominal) ultrasound may be more effective than non thermal properties of pulsed ultrasound for increasing the flexibility of shortened hamstrings.Meroni, Roberto, Cerri, Cesare Giuseppe, Lanzarini, Carlo, Barindelli, Guido, Morte, Giancesare D ella, Gessaga, Viviana, Cesana, Gian Carlo, DeVito, Giovanni et al (2010)Stated that the gain in flexibility was maintained for a period of 4 weeks later the point of training. This improvement was more significantly noticed in active stretching group by using active knee extension test than the passive stretching group.Buker N., Aslan E., Kitis A., Carluk U et al (2008)Stated that the picayune (or) deep heat applications before static stretching exercises shows positive effects to increasing flexibility of hamstring muscles.Nichole Lee Lounsberry et al (2008)Stated that the ultrasound treatment produced greater immediate gains in hamstring extensibility than wet heat packs treatment.A.Akbari, H.Moodi, A.A.Moein and R.Nazok et al (2006)Stated that the gains in range of passive knee extension obtained in sustained therapeutic ultrasound and 30 seconds stretch group were significantly greater than therapeutic ultrasound and 15 seconds stretch group in subjects with tight hamstrin gs.Denegar C, Saliba E, et al (2006)Stated that 3 MHZ ultrasound provides superficial heating, 1MHZ ultrasound heats tissue at depth of 3-5 cms and is considered to be a deep heating agent.Odunaiya N.A, Hamzat T.K, Ajayi O et al (2004)Stated that statically stretching tight hamstrings for every duration between 15 and 120 seconds on throw days for six weeks would significantly increase its flexibility. The effect was also sustained for upto 7 days post intervention.Trae Sakiyo Tashiro et al (2003)Stated that the clinically practical parameters of thermal ultrasound in conjunction with static stretching is an effective way of increasing hamstring extensibility but ultrasound application location didnt showed difference in increasing knee extension range of motion in a healthy population.C.D.Weijer et al (2003)Stated that the static stretching is one of the safest and most commonly performed stretching methods utilise to measure muscle length.Feland et al (2001)Reported that longer hold times during stretching of the hamstring muscles resulted in a greater rate of gain in range of motion.Prentice WE, McClure M, Becker RO et al (2001)Stated that when slow stretch applied to muscle, golgi tendon organ get stimulated and thereby muscle tension is reduced. This leads is to an increase in length of muscle.Robert and Wilson et al (1999)Stated that static stretching increases muscle length by allowing muscle spindle to adapt extra time and cease fired. It also elicits golgi tendon response and therefore provides an effective flexibility training stimulus.William D arciform et al (1996)Stated that a static stretch of 30 seconds at a frequency of oneness session is sufficient to increase the muscle length.Bandy WD, Irion JM et al (1995)Stated that the duration of 30 seconds of stretching is an effective time of enhancing the flexibility of the hamstring muscles.Bandy WD, Irion JM et al , Lentell G, Hetherington T et al, Madding SW et al (1994 )Stated that Static str etching is a method of stretching in which the muscles and connective tissue being stretched are held in a stationary position at their greatest possible length for some period. When using static stretching on a clinical basis, stretches should be held a minimum of 15 to 30 seconds.Chan et al (1993)Stated that tendon reaches greater temperature and heat more quickly than muscle and the tendon was able to maintain vigorous heating for longer period than muscle.Draper D, Sunderland S, Kirkendall et al (1993)Stated that tendon tissue is less vascularized than muscle tissue tendons will retain heat for longer periods of time.Folconer et al (1992)Stated that ultrasound increases soft tissue extensibility and may be an effective adjunct in the treatment of knee contractures secondary to connective tissue shortening.Gordon and Ghez et al (1991)Stated that static stretching may be effective in increasing the length of muscle due to the prolonged stretching which allows the muscle spindle to adapt over time and cease firing.Low and Reed et al (1990) , Dyson et al (1987)Stated that low absorption of ultrasound waves is seen in tissues that are in water content (eg.,fat), whereas absorption is higher in tissues easy in protein (e.g., pinched muscle).Warren C, Lehman J, Koblanski J, Strickler T, Malone T, Masock A, Garrett W et al (1990)Stated that ultrasound therapy can be used to target the collagen rich tendinous unit of the hamstring muscle because of its ability to penetrate deeper tissues, and shown that increasing the temperature of collagen to 40 Celsius will increase the elasticity of the tissue. This increased extensibility allows for an even distribution of force and reduces the stress on localized areas of the tissue.Gajdosik RL , Godges JJ et al (1989)Stated that a low intensity maintained stretch that is applied gradually is less likely to promote the stretch reflex and increase tension in the muscle being lengthened. This is called static stretch.Ziskin et al (1986)Stated that an increasing in tendon length following continuous ultrasound therapy is due to change of their viscosity and plasticity.Beaulien et al (1981)Stated that stretch duration lower than 30 seconds didnt increase muscle flexibility.Coakley et al (1978)Stated that frequency of 1MHZ ultrasound used for patients with more subcutaneous fat who sustained injuries at deeper level because of its perspicacity to a depth of 3 to 5 cms.Lehman et al (1968)Emphasized on the thermal effects of continuous ultrasound compared to other heating modalities in increasing hamstring flexibility.De Vries HA et al (1962)Stated that static stretching offers advantages of using less overall force, decreasing the danger of exceeding the tissue extensibility limits, lower energy requirement, and a lower likelihood of muscle soreness. Static stretching also has less effect on the Ia and II spindle afferent fibres than ballistic stretching, which would tend to increase a muscles resistance to stretch and facilitate golgi tendon organ, thereby reducing the contractile elements resistance to deformation.MUSCLE skill techniqueAhmad Faheem, Ahmad Shamin, Anjani Agarwal, Begum Shabana, Ram C.S, Waseem Mohd et al (2010)Conducted a study in Indian collegiate males on hamstring flexibility by canvass the effectiveness of muscle energy technique and eccentric training. Total of twenty males with hamstring tightness dropping between age group of 18-25 years were included in the study. Hamstring tightness was measured by popliteal angle/active knee extension test. One group was treated with muscle energy technique and the other with eccentric training. This study stated that hamstring flexibility can be improved with muscle energy technique using post isometric relaxation than eccentric training.Wassim M et al (2009)Reported that muscle energy technique using post isometric relaxation significantly improving the hamstring flexibility (by active knee extension test) in normal Indian collegiate males with hamstring tightness.Azadeh Shadmehr, Mohmmed Reza Hadian, Sedigheh Sadet Naiemi, Shohreh Jalaie et al (2009)Concluded that the hamstring stretches in normal young women using either static stretch or muscle energy technique had similar effects on restoring flexibility to hamstrings.Madeline Smith, Gary Fryer et al (2008)Stated that the muscle energy technique is effective in increasing hamstring extensibility, and there appeared to be sustained improvement one week following the initial treatment.Ross A, Clark et al (2008)Stated that muscle energy technique can produces creep and plastic changes in the connective tissue thereby the length of the muscle can be increased.Lindsey Samilian et al (2007)Stated that muscle energy technique is a method used to strengthen weak muscles, lengthen the short muscles (or) increase a muscles range of motion. These techniques involve stretch during which a reciprocal force is imposed on the targeted muscle for short per iod of time, causing the muscle to relax and stretch further.Ballantyne F, Fryer G, MC.Laughlin P et al (2003)Conducted a study to find the effectiveness of muscle energy technique in increasing passive knee extension and to explore the mechanism behind any detect change. Forty asymptomatic subjects between age of 18 to 45 years were randomly allocated to data-based and control group. Experimental group was given with muscle energy technique and Control group with no treatment. They concluded that muscle energy technique produced an immediate increase in passive knee extension. This observed change is due to an increased tolerance to stretch.Chaitlow L, Liebenson C et al (2001)The other name for Muscle energy technique is active muscular relaxation technique.Freyer G et al (2000), Richard L, Gajodsik, Melonie A, Rieck and Debra K et al (1993)Stated that an increase in flexibility after muscle energy technique occurred due to biomechanical or neurophysiologic changes or due to an in crease in tolerance to stretching.Lewit et al (1999)Concluded that post isometric relaxation is directed towards relaxation of hypertonic muscle, especially if this relates to reflex contraction or the involvement of myofascial trigger points.Lewit, Libenson, Murphy et al (1999)Stated that post isometric relaxation is an excellent technique for treating neuromuscular component muscle of a stiff, shortened or tight muscle.Lewit et al (1999), Greenman et al (1989)Suggested that in muscle energy technique, the holding time of 7-10 seconds is more effective than 3-5 seconds.Kuchera et al (1997)Stated that increase in range of motion of a joint after Muscle energy technique is based on neurological mechanism via inhibitory golgi tendon reflex. Muscle energy technique activates this reflex during isometric muscle contraction. Muscle energy technique produces a stretch on golgi tendon organ and a reflex relaxation of muscle.Goodridge and Kuchera et al (1997)Suggested that 3 repetitions of isometric contractions is optimum in applying muscle energy technique.Lederman et al (1997)Stated that a viscoelastic change in muscle is responsible for the increase in muscle flexibility after muscle energy technique.Chaitlow L et al (1997)Stated that the isometric contraction should be held for 10 seconds. This is the time required to stimulate the excitatory scepter of the golgi tendon organ, which has a neurophysiologic inhibitory effect on the muscle spindle. This provides the opportunity to take the muscle into a bran-new range of motion. Following the isometric contraction, there is a latency period of approximately 25 to 30 seconds, during which the muscle can be stretched.Philip Greenman et al (1996)Stated that manual medicine treatment surgery includes Muscle energy technique which involves the contraction of the subjects muscle by the wilful effort in a precisely controlled direction, at different levels of intensity, against a counterforce applied by the operator. T his procedure can be used to lengthen a shortened, contracted or spastic muscle to strengthen a physiologically slashed muscle to reduce localized oedema, to mobilize an articulation with restricted mobility.Ward, Robert C et al (1990)Stated that muscle energy technique is an active, direct technique (engaging the barrier) that promotes muscle relaxation by activating the golgi tendon reflex.Libenson et al (1989)Stated that muscle energy technique is effective in treating the muscle tension disorder and it efficaciously relaxes stretches, strengthens the muscles and re-educate abnormal sensory motor pathway.Lewit et al (1986)Stated that when a muscle is isometrically contracted its antagonist will be inhibited and reduce tone immediately.Stiles and Greenman et al (1984)Suggested that muscles which requires stretching (agonist) should be the main source of energy for isometric contractions and masters a more significant degrees of relaxation and so a more useful ability to subsequ ently stretch the muscle were the relaxation effect being achieved through use of antagonist (using reciprocal inhibition).ACTIVE knee joint EXTENSION TESTC.M. Norris et al (2005)Stated that active knee extension test when used in conjunction with goniometry, accurate surface making, and manual monitoring of the test leg is a reliable measure of hamstring muscle length.M.Mathews et al (2005)Stated that active knee extension represents supreme length of hamstring muscles.Denise M. Cameron, Richard W. Bohannon et al (1985)Stated that active knee extension test is said to be a useful alternative to the straight leg raise test for providing an indication of hamstring muscle length.Gajdosik R.L et al (1983)Stated that active knee extension test is a more objective measure of hamstring tightness which produces high reliability co-efficient.III. METHODOLOGY3.1 STUDY DESIGNPre test and post test experimental group study design.3.2 STUDY SETTINGStudy will be conducted at physical therapy Out Patient Department, KG College of Physiotherapy, Coimbatore.3.3 STUDY DURATIONTotal duration was one year. Individual sure the treatment for the duration of one week.3.4 POPULATION STUDIED30 normal individuals with hamstring tightness who set up the predetermined inclusive and exclusive criteria were selected and divided into two experimental groups by simple random consume method. Each group consists of 15 patients. meetings are named as group A and group B3.5 CRITERIA FOR pickax3.5.1 INCLUSIVE CRITERIAAge between 18 to 25 yearsBoth males and femalesNormal individuals with tight hamstrings (inability to achieve greater than 160 knee extension with hip at 90 flexion.)3.5.2EXCLUSIVE CRITERIALow back pain Acute or chronic.Hamstring injury Acute or chronic.Soft tissue injuries around knee.Pregnancy. coat implants in lower extremity.Recent fracture and stiffness in lower extremity.3.6 VARIABLES3.6.1 INDEPENDENT VARIABLESMuscle energy technique.Ultrasound therapy with Static s tretching.3.6.2 DEPENDENT VARIABLESHamstring flexibility.3.7 PARAMETERSHamstring flexibility3.8 MEASUREMENT TOOLSActive knee extension test.Active knee extension test was used for measurement of hamstring tightness. The subject was instructed to lie on their back with hip and knees bent 90 degrees. Pelvic movement was controlled by the use of straps. By using the lateral condyle of femur as the goniometric axis, the stationary arm positioned along the femur, and the movable arm was positioned parallel to the leg. wait hip and knee in 90 degrees then instruct the subject to straighten the knee as for as possible till a sensation of stretch being felt. Repeat the same for three times and mean were measured as the final result.3.9 PROCEDURE base A MUSCLE ENERGY TECHNIQUE.TECHNIQUE USED Post isometric relaxation.INDIVIDUALS POSITION Supine lying.PROCEDUREAsk the individuals to assume unerect position. Therapist flexes the affected hip fully and then extends the flexed knee with the ba ck of lower leg resting on the shoulder of the healer who stands facing the head of the table. Individual is asked to flex i.e. causing downward pressure against the therapist shoulder with the back of lower leg at the same time therapist resist the individuals voluntary effort so that, slight isometric contraction of hamstrings develops and individuals hold this for 10 seconds.After this effort, the individual is asked to emanate and relax the muscle completely. Then the therapist takes the muscle to its new restriction barrier without stretch. Starting from this new barrier, the same procedure is repeated two or three more times.FREQUENCY OF TREATMENT erstwhile in a day.TREATMENT DURATION One week.GROUP B ULTRASOUND THERAPY WITH STATIC STRETCHINGULTRASOUND THERAPYINDIVIDUALS POSITION Prone lyingPARAMETERSFREQUENCY 1 MHzINTENSITY 2W/cm direction Continuous.AREA OF APPLICATION Hamstring areaDURATION Five Minutes daily (Two minutes for average hamstrings, Two minutes for lateral hamstrings and One min for between the two tendon).FREQUENCY OF TREATMENT in one case in a dayTREATMENT DURATION One weekSTATIC STRETCHINGTECHNIQUE USED Active static stretching.INDIVIDUALS POSITION Standing position.PROCEDURESubjects performed the hamstring stretch by stand erect with the foot planted on the floor and toes pointed forward. The heel of the foot to be stretched was placed on a plinth with the toes directed towards the ceiling. The subject then flexed forward at the hip, maintaining the spine in torpid position while reaching the arm forward.The subjects continued to flex the hip until a gentle stretch was felt in the posterior thigh. Then hold this position for 30 seconds and then relax for 10 seconds and repeat the same procedure for three more times a day.FREQUENCY OF TREATMENT erst in a day.TREATMENT DURATION One week3.10 STATISTICAL TOOLSThe following statistical tools used in this study is Paired t-test and Unpaired t-testFormula Paired t-test=Where,= differe nce between the pre test versus post test= mean difference= total number of subjects= standard deviationUnpaired t-test was used to compare the mean difference between Group A and Group B.Formula Unpaired t-testWhere,= Mean of Group A= Mean of Group B = sum of the valuen1 = number of subjects in Group An1 = number of subjects in Group BS = standard deviationLevel of significance 5%IV.DATA ANALYSIS AND INTERPRETATIONTABLE-1PAIRED t TESTPRE TEST AND POST TEST VALUES OF GROUP AGROUP A MUSCLE ENERGY TECHNIQUEHAMSTRING FLEXIBILITY ACTIVE KNEE EXTENSIONThe comparative mean value, mean differences, standard deviation and Paired t test values of Group A , who were treated with Muscle energy Technique.S.NOGROUP AMEANMEAN going