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Effects of Reciprocal Inhibition Versus Post Facilitation Muscle Energy Technique Along With Conventional Physical Therapy in Patients With Piriformis Syndrome: a Randomized Controlled Trial

Not Applicable
Recruiting
Conditions
Piriformis Syndrome
Interventions
Other: Reciprocal Inhibition MET
Other: Post-facilitation MET
Other: Conventional physical therapy
Registration Number
NCT06534788
Lead Sponsor
Foundation University Islamabad
Brief Summary

This study is a randomized controlled trial and the purpose of this study is to compare the effects of reciprocal inhibition versus post facilitation muscle energy technique along with conventional physical therapy in patients with piriformis syndrome in terms of pain, range of motion at hip joint and functional disability.

Detailed Description

This study aims to compare the effects of reciprocal inhibition with post facilitation muscle energy technique along with conventional physical therapy in terms of pain, functional disability and range of motion at hip joint in patients with piriformis syndrome to find the best suitable and effective treatment for it based on the outcomes.

Males and females between the age of 20-50 years, having buttock pain of ≥ 3 on NPRS since 3 months or more and a score of ≥ 8 on a 12-point clinical scoring system as well as any two of the positive screening tests will be recruited in this study as patients of piriformis syndrome.

These subjects will be selected via non-probability purposive sampling technique, followed by randomization into two groups using blocked randomization method.

A total of 6 treatment sessions will be given to each participant over the duration of 2 weeks with a total of 3 follow-ups after every 2 sessions.

TENS and hot pack followed by reciprocal inhibition technique will be given to the experimental group A, while the active comparator group B will be given TENS and hot pack followed by post-facilitation muscle energy technique.

Both the groups will be guided about the strengthening exercises given as a home plan.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
44
Inclusion Criteria
  • Age: 20-50 years
  • Both Genders
  • Chronic pain in buttock and hip area (≥ 3 on NPRS) lasting more than 3 months.
  • Shortened piriformis muscle (Internal rotation less than 30°) on muscle length assessment.
  • A score of ≥ 8 on a 12-point clinical scoring system.
  • At least two positive screening tests.
Exclusion Criteria
  • Active infection
  • Lower lumbar radiculopathy
  • Sacroiliac joint dysfunction
  • Malignancies
  • History of trauma
  • Hip Arthroplasty
  • Rheumatoid/ Osteoarthritis
  • Any neurological dysfunction

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PFS-MET groupConventional physical therapyPFS-MET group will receive 3-5 repetitions of post-facilitation stretch to the shortened piriformis muscle in supine and prone positions i.e. 20% maximal isometric contraction of the muscle to be stretched for 6-10 seconds, followed by a rapid stretch (through the new barrier) of 15 seconds hold. After stretch, the muscle is allowed to relax in the midrange for up to 30 seconds.Both groups will receive conventional physical therapy which they will be taught as a home plan. Following exercises are guided to the patient as home plan. * Resisted abduction with Thera/resistance band * Resisted bridging with Thera/resistance band * Resisted clam exercise with Thera/resistance band
RI-MET groupReciprocal Inhibition METRI-MET group A will receive 3-5 repetitions of reciprocal inhibition to the shortened piriformis muscle in supine and prone positions i.e. 30-50% isometric contraction of the muscle opposite to the muscle to be stretched for 7-10 seconds, followed by inhalation, exhalation and rest period of 5 seconds and then a stretch (through the new barrier with patients' assistance) of 10-60 seconds hold.both groups will receive conventional physical therapy which they will be taught as a home plan. Following exercises are guided to the patient as home plan. * Resisted abduction with Thera/resistance band * Resisted bridging with Thera/resistance band * Resisted clam exercise with Thera/resistance band
RI-MET groupConventional physical therapyRI-MET group A will receive 3-5 repetitions of reciprocal inhibition to the shortened piriformis muscle in supine and prone positions i.e. 30-50% isometric contraction of the muscle opposite to the muscle to be stretched for 7-10 seconds, followed by inhalation, exhalation and rest period of 5 seconds and then a stretch (through the new barrier with patients' assistance) of 10-60 seconds hold.both groups will receive conventional physical therapy which they will be taught as a home plan. Following exercises are guided to the patient as home plan. * Resisted abduction with Thera/resistance band * Resisted bridging with Thera/resistance band * Resisted clam exercise with Thera/resistance band
PFS-MET groupPost-facilitation METPFS-MET group will receive 3-5 repetitions of post-facilitation stretch to the shortened piriformis muscle in supine and prone positions i.e. 20% maximal isometric contraction of the muscle to be stretched for 6-10 seconds, followed by a rapid stretch (through the new barrier) of 15 seconds hold. After stretch, the muscle is allowed to relax in the midrange for up to 30 seconds.Both groups will receive conventional physical therapy which they will be taught as a home plan. Following exercises are guided to the patient as home plan. * Resisted abduction with Thera/resistance band * Resisted bridging with Thera/resistance band * Resisted clam exercise with Thera/resistance band
Primary Outcome Measures
NameTimeMethod
Pain Intensity2 weeks

The pre and post pain intensity will be measured using Numeric Pain Rating Scale (NPRS) comprising of 11 points from 0 - 10 where 0 indicates "no pain" while 10 is "maximally felt pain".

Hip range of motion2 weeks

Goniometer will be used to measure the pre and post treatment ranges of internal rotation, external rotation, abduction and adduction at hip joint in supine and sitting positions.

Functional Disability2 weeks

Lower Extremity Functional Scale comprising of 20 questions regarding lower extremity function will be used. The maximum possible score is 80 points, indicating very high function. The minimum possible score is 0 points, indicating very low function.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Foundation University College of Physical Therapy

🇵🇰

Rawalpindi, Punjab, Pakistan

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