Comparative Effects of Post Isometric Relaxation and Post Facilitation Stretching on Pain Reduction Hip Abduction and Internal Rotation Range, and Functional Disability in Patients With Piriformis Syndrome
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 36
- 试验地点
- 1
- 主要终点
- Pain intensity in patients with Piriformis Syndrome
研究概览
简要总结
This randomized clinical trial evaluates the effectiveness of Post-Isometric Relaxation (PIR) and Post-Facilitation Stretching (PFS) for managing pain, improving hip abduction and internal rotation, and enhancing functional capacity in patients with Piriformis Syndrome. Thirty-six participants will be assessed at baseline and six weeks using pain scores, hip range of motion, and functional scales to determine which technique provides superior outcomes.
详细描述
Piriformis Syndrome (PS) is a musculoskeletal condition characterized by pain in the buttock and hip, sometimes radiating to the lower back and thigh. It may arise from anatomical variations affecting the sciatic nerve, inflammation, hypertrophy, muscle spasms, or shortening of the piriformis muscle. PS can significantly reduce hip range of motion and functional capacity, affecting patients' quality of life.
This randomized clinical trial aimed to compare the effectiveness of two rehabilitation techniques, Post-Isometric Relaxation (PIR) and Post-Facilitation Stretching (PFS), in managing pain, improving hip abduction and internal rotation, and enhancing functional capacity in patients with PS. Thirty-six participants aged 35-55 years, of both genders, diagnosed with sub-acute or chronic PS, and meeting specific clinical criteria, were randomly assigned to either intervention group.
Inclusion criteria included positive findings on at least three of the following tests: Piriformis, Beatty, Freiberg, FAIR, Sign of Pace, and Nagel tonic external rotation of hip; bilateral buttock pain due to sciatic nerve or piriformis muscle spasm; NPRS pain score of 3-7; tenderness over the sciatic foramen; and willingness to participate. Exclusion criteria included spinal, hip, knee, or SI joint pathology, prior spinal surgery or vertebral fracture, systemic disease, limb length discrepancy, postural deformities (e.g., scoliosis), hip dislocation or femoral fracture, and any psychological conditions.
Group A (PIR) participants performed exercises lying supine with the affected leg flexed, pelvis stabilized, and piriformis muscle activated through resisted abduction. Group B (PFS) participants performed combined stretching and isometric contractions with the involved leg positioned in hip flexion, adduction, and external rotation. Interventions were conducted over a 4-week period.
Assessments were conducted at baseline and six weeks using:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
盲法说明
Open-label study; participants, care providers, and investigators are aware of the assigned interventions
入排标准
- 年龄范围
- 35 Years 至 55 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •- Participants aged 35-55 years Both genders Positive findings on three or more of the following tests: Piriformis, Beatty, Freiberg, FAIR, Sign of Pace, Nagel tonic external rotation of hip Bilateral buttock pain caused by compression of the sciatic nerve or piriformis muscle spasm NPRS pain score between 3 and 7 Tenderness to palpation over the sciatic foramen Diagnosed sub-acute or chronic Piriformis Syndrome Willing to participate
排除标准
- •Any pathology or recent injury around the hip, knee, or SI joint, or radiating pain from the spine, SI joint, or hip History of spinal surgery or vertebral fracture History of systemic disease, stroke, leprosy, or amputation Leg pain not related to Piriformis Syndrome (e.g., disc herniation, sacroiliac joint dysfunction, degenerative joint disease) History of spinal injury, joint disease, or congenital abnormalities Limb length difference SI joint dysfunction Hip joint dislocation or femoral fracture Any postural deformity or anomaly (e.g., scoliosis) Psychologically diagnosed condition
研究组 & 干预措施
Post Isometric Relaxation (PIR)
Type of technique: Muscle Energy Technique (MET)
Patient position: Supine, affected leg flexed at hip and knee, crossed over the other leg, foot resting on the table
Pelvis stabilization: Therapist hand on opposite ASIS to prevent pelvic movement
Leg positioning: Other hand on lateral aspect of the knee
Finding the barrier: Knee moved into abduction until first sign of resistance (pain-free end range)
Isometric contraction: Patient pushes against the therapist's hand at ~20% strength for 7-10 seconds
Relaxation and stretch: After contraction, leg moved slightly further into abduction
Repetitions: 3 times per session
干预措施: Post Isometric Relaxation (PIR) (Procedure)
Post Facilitation Stretching (PFS)
Patient position: Supine, affected leg slightly adducted and externally rotated, hip flexed >60°
Therapist hand placement: Inferior hand on table for support, superior hand guides leg movement
Muscle positioning: Piriformis placed in intermediate range (between full stretch and rest)
Isometric contraction: Patient externally rotates leg against resistance for 10 seconds
Pause / Rest phase: 30-second relaxation after contraction; therapist applies deeper stretch into adduction and external rotation
Next barrier: Leg gently moved to new barrier
Repetitions: 3 times per session
干预措施: Post Facilitation Stretching (PFS) (Procedure)
结局指标
主要结局
Pain intensity in patients with Piriformis Syndrome
时间窗: Baseline and 4 weeks after intervention completion
Pain was measured using the Numeric Pain Rating Scale (NPRS), a 0-10 scale where 0 indicates no pain and 10 indicates worst possible pain.
次要结局
- Hip Abduction and Internal Rotation Range of Motion(Baseline and 4 weeks after intervention completion)
- Functional Disability(Baseline and at 4 weeks after intervention completion)
研究者
Aqsa Bashir
Dr
University of Faisalabad