Piriformis Syndrome
Conditions
Keywords
Piriformis Syndrome, Post-Facilitation Stretch, Active Release Technique, Pain, Disability, Quality of Life, Range of Motion, Female
Brief summary
This clinical study aimed to compare the effectiveness of Post-Facilitation Stretch (PFS) and Active Release Technique (ART) on pain, disability, quality of life, and range of motion of hip internal and external rotation in female patients with piriformis syndrome. After recruitment, participants were randomly allocated into two groups using the chit-box method, either in group A Post-Facilitation Stretch, and group B Active Release Technique. Clinical outcomes including pain, disability, quality of life, and hip range of motion (abduction and internal rotation) were assessed at baseline, during the third week of treatment, and at the sixth-week follow-up from the National Institute of Rehabilitation and Medicine (NIRM) Hospital.
Detailed description
Background: Piriformis syndrome (PS) is a neuromuscular condition in which the piriformis muscle irritates the sciatic nerve, causing pain, numbness, and tingling in the buttock, hip, and posterior thigh, sometimes radiating to the low back or sacroiliac joint. Women are more commonly affected, comprising 35-79% of cases (Hopayian et al., 2010). Conservative physiotherapy interventions are effective in improving pain, function, and quality of life. Literature / Rationale: Post-Facilitation Stretch (PFS) involves isometric contraction followed by stretching of the piriformis to enhance hip range of motion (ROM) and reduce pain. Active Release Technique (ART) targets soft tissue adhesions to improve mobility and function. Prior studies indicate benefits of these techniques individually, but direct comparisons in female patients are limited. Methods: Forty female patients with PS at NIRM Islamabad were randomly allocated via chit-box into PFS and ART groups. Interventions were administered twice weekly for 3 weeks. PFS: Supine, hip \>60° flexion, slight adduction/external rotation; 10-sec isometric external rotation contraction + 30-sec relaxation; stretch into internal rotation/adduction 15 sec; repeat 5× per session(Shahzad et al., 2020). ART: Targeted soft tissue release of the piriformis muscle. Outcomes included pain (measured by NPRS), hip IR and abduction ROM (measured by goniometer), functional disability (measured by LEFS-U), and quality of life (measured by SF-36), assessed at baseline, week 3, and week 6.
Interventions
Following a 10-minute application of a moist hot pack, participants were positioned supine with the hip flexed beyond 60° and gentle resistance was applied to facilitate an isometric external rotation contraction. This was followed by a passive stretch held for 15 seconds, performed for 5 repetitions per session.
OTHERActive Release Technique
Following a 10-minute application of a moist hot pack, participants were positioned prone, and deep manual pressure was applied over the piriformis muscle for approximately 90 seconds while the patient actively moved the hip from internal to external rotation. This procedure was repeated for 10 repetitions per session.
Sponsors
Ibadat International University, Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* 25 to 45-year-old women. * Clinically diagnosed with piriformis syndrome by Orthopaedic Surgeon. * Unilateral pain. * Sitting exacerbates buttock pain. * External soreness in the vicinity of the greater sciatic notch. * Positive findings on standard piriformis syndrome clinical tests (FAIR, Beatty, Freiberg, and Pace). * Limited SLR ability
Exclusion criteria
* History of trauma and malignancies. * Hip dislocation, osteoporosis, and femur fractures. * Any postural abnormality, including disc pathology. * Patients with neurological symptom, metabolic disease (RA) and diagnosed psychological problem. * Pregnancy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Intensity | Assessment was done at baseline, 3rd week and 6th week | Pain was measured by Numerical Pain Rating Scale. On this scale, ten values range from 0 to 10, with 0 representing "no pain" and 10 representing "worst possible pain." |
| Disability | Assessment was done at baseline, 3rd week and 6th week | Disability was measured by the Urdu version of the Lower Extremity Functional Scale. It is a 20-item self-report questionnaire assessing functional difficulty in daily, work, and recreational activities for adults with lower limb musculoskeletal conditions. Ranging from 0 (extreme difficulty) to 80 (high function). |
| Quality of life of Patients | Assessment was done at baseline, 3rd week and 6th week | Quality of life was measured by the Short Form Health Survey (SF-36) questionnaire. The overall score goes from 0 to 100. Higher scores indicate a higher quality of life, while lower numbers indicate a lower quality of life. |
| Hip abduction and internal rotation range of motion | Assessment was done at baseline, 3rd week and 6th week | Hip abduction and internal rotation range of motion was measured by goniometer |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORMuhammad Nazim Farooq, PhD-PT
Ibadat International University
Outcome results
None listed