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Objective:  Drover and Forand did a (prospective case series) pilot clinical outcome study to determine if Active Release Technique (ART) protocols could be used as an effective way to influence strength and muscle inhibition in the quadriceps muscles of athletes with anterior knee pain. 

Methods:  The study sample consisted of 9 athletes (4 male athletes, 5 female athletes) who were identified as suffering from unilateral anterior knee pain. A Biodex dynamometer and the interpolated twitch technique were used to determine isometric strength and inhibition in the quadriceps muscles, respectively.  The treatment intervention consisted of the Active Release Technique treatment protocols for anterior knee pain.  The experimental leg and contralateral leg were tested pretreatment and posttreatment, and the experimental leg was tested a third time approximately 20 minutes posttreatment. 

Results:  Knee extensor moments were calculated by multiplying the moment arm by the forces measured by the Biodex dynamometer. Percentage of muscle inhibition was calculated by dividing the interpolated twitch torque (ITT) by the resting twitch torque (RTT), that is (ITT/RTT*100). A repeated measures analysis of variance (ANOVA) was used to compare pretreatment and posttreatment values for strength and muscle inhibition for the experimental and contralateral knees. The results showed no statistical significance.

Conclusion:  ART protocols did not reduce inhibition or increase strength in the quadriceps muscles of athletes with anterior knee pain. Further study is required.

Discussion:  Study was limited by patient number, lack of randomization, and lack of improvement.  Further study may be required.

TI: The Role of Active Release Manual Therapy for Upper Extremity Overuse Syndromes – A Preliminary Report

AU: Berit Schiottz-Christensen, Vert Mooney, Shadi Azad, Dan Selstad, Jennifer Gulick, and Mark Bracker

SO: the Journal of Occupational Rehabilitation, 1999 June.

Objective:  The study was carried out to evaluate the efficacy of Active Release for treatment of upper extremity overuse syndromes.

 Methods:  The treatment protocol was taught to an athletic trainer who had six months experience before initiating a prospective study. (Remember it takes 2 years of ART practice before you are proficient).  Most of the 28 patients who were in the study had failed previous medical treatment for epicondylitis, tendonitis, and carpal tunnel. The patients refused to be randomized as to routine medical care.  Success was measured both by objective and subjective measures ranging from function questionnaires through objective testing with standardized current clinical tests.

Results:  At three months follow-up, 71% of patients indicated treatment as good or better than previous medical treatment.

Conclusion:  The study's authors concluded that "ART demonstrated a 71% efficacy rate, which when compared to similar studies in the literature was superior". However, they added that most improvements were "only subtle", but "as a result of this study, recommendation of further use of this innovative technique is justified".

Discussion:  71% of patients indicated treatment as good or "subtly" better than the previous medical treatment that they had failed.  So 29% of patients indicated ART as worse than the previous medical treatment that had failed them, while the other 79% found ART no different from the treatment that had failed them.  Not very impressive results, but I guess "recommendation of the further use of this innovative technique is justified", NOT!  In this study, the only advantage of ART over medical treatment would be the cost.  ART treatment would consist of 3-6 treatments in the span of a few weeks and that is it.  Steroid injections are monthly and more expensive in the long run.

Quick Study Recap:  If you want to save a few bucks and be as satisfied as you are with your failed medical treatment for epicondylitis, tendonitis, and carpal tunnel, ART might be for you.