Piriformis Syndrome
Conditions
Keywords
Piriformis Syndrome, Muscle Energy Technique, Myofascial Release, Surface EMG, Pain Threshold, Muscle Strength, Rehabilitation
Brief summary
The aim of this study is to comparatively evaluate the effects of two different manual therapy approaches, Muscle Energy Technique (MET) and Myofascial Release Technique (MFR), on pain threshold, muscle activation patterns, and muscle strength in individuals diagnosed with piriformis syndrome. In this study, the physiological effects of both interventions on the musculoskeletal system will be assessed using objective measurement tools such as an algometer, digital dynamometer, and electromyography (EMG). The study aims to provide evidence-based data regarding the most effective and preferable manual therapy approach in the conservative treatment of piriformis syndrome.
Detailed description
Participants included in the study will complete the Sociodemographic Information Form, Oswestry Disability Index (ODI), Lower Extremity Functional Scale (LEFS), World Health Organization Quality of Life Scale Brief Form (WHOQOL-BREF), Pittsburgh Sleep Quality Index (PSQI), and the Short-Form McGill Pain Questionnaire (SF-MPQ). Additionally, participants will undergo the 6-Minute Walk Test (6MWT). Lower extremity muscle strength will be evaluated using a digital dynamometer, pain threshold will be assessed with an algometer, and muscle activation patterns will be evaluated using surface electromyography (sEMG) in the FAIR position. The entire assessment procedure will take approximately 30-40 minutes, and all measurements will be performed under standardized conditions by the same researcher. This study is a randomized controlled experimental trial aiming to compare the effects of two different manual therapy approaches, Muscle Energy Technique (MET) and Myofascial Release Technique (MFR), on pain threshold, muscle activation patterns, and muscle strength in individuals diagnosed with piriformis syndrome. The study is designed as a pretest-posttest trial. Participants will be randomly allocated into three groups: the MET group, the MFR group, and the control group. All groups will receive treatment for 8 weeks, with 2 sessions per week, totaling 16 treatment sessions.
Interventions
PROCEDUREMuscle Energy Technique
Muscle Energy Technique (MET) will be applied to participants by a trained physiotherapist in addition to conventional physical therapy. The intervention will be performed for 8 weeks, 2 sessions per week, totaling 16 sessions. The technique will include voluntary muscle contractions followed by relaxation and stretching procedures targeting the piriformis muscle.
PROCEDUREMyofascial Release Technique
Myofascial Release Technique (MFR) will be applied to participants by a trained physiotherapist in addition to conventional physical therapy. The intervention will be performed for 8 weeks, 2 sessions per week, totaling 16 sessions. The technique will involve sustained manual pressure and soft tissue release techniques targeting the piriformis muscle and surrounding fascia.
PROCEDUREConventional Physical Therapy
Participants in the control group will receive conventional physical therapy for 8 weeks, 2 sessions per week, totaling 16 sessions.
Sponsors
Igdir University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Participants were blinded to group allocation during the study period.Participants were blinded to group allocation throughout the study. Participants did not know which intervention group they were assigned to and had no interaction with participants from other groups.
Intervention model description
Participants will be randomly assigned into three groups: the Muscle Energy Technique (MET) group, the Myofascial Release Technique (MFR) group, and the control group. All participants will receive treatment for 8 weeks, with 2 sessions per week, totaling 16 sessions. Outcome measures will be assessed before and after the intervention period.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Individuals diagnosed with piriformis syndrome * Presence of piriformis tenderness and sciatic symptoms * Aged between 18 and 65 years * Voluntary agreement to participate in the study * No history of lumbar, hip, knee, or ankle surgery within the last year * Ability to cooperate with the assessment and treatment procedures
Exclusion criteria
* Individuals younger than 18 years or older than 65 years * Presence of any musculoskeletal disorder affecting the lower extremity * Presence of neurological, cardiac, pulmonary, or orthopedic disorders preventing participation in exercise * Presence of neurological deficits (muscle strength loss) * History of radiotherapy to the lumbar or hip region * Absence from more than 20% of treatment sessions * Inability to comply with the study procedures (e.g., cognitive impairment, communication problems, severe psychiatric disorders) * Corticosteroid or PRP injection within the last 3 months * Participation in another physical therapy program within the last 3 months * Use of analgesic, anti-inflammatory, or muscle relaxant medications within the last 48-72 hours * Use of psychotropic medications that may affect muscle activation or nervous system responses (e.g., antidepressants, antipsychotics, sedatives)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pressure Pain Threshold | Baseline and after 8 weeks of treatment | Assessment of pressure pain threshold using an algometer. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Strength | Baseline and after 8 weeks of treatment | Assessment of lower extremity muscle strength using a digital dynamometer. |
| Muscle Activation Pattern | Baseline and after 8 weeks of treatment | Assessment of muscle activation patterns using surface electromyography (sEMG) in the FAIR position. |
| Lower Extremity Functional Scale (LEFS) | Baseline and after 8 weeks of treatment | Assessment of lower extremity functional status using the Lower Extremity Functional Scale (LEFS). |
| Pain Severity (SF-MPQ) | Baseline and after 8 weeks of treatment | Pain intensity and pain characteristics will be evaluated using the Short-Form McGill Pain Questionnaire (SF-MPQ). Higher scores indicate greater pain severity. |
| World Health Organization Quality of Life Scale Brief Form (WHOQOL-BREF) | Baseline and after 8 weeks of treatment | Assessment of quality of life using the World Health Organization Quality of Life Scale Brief Form (WHOQOL-BREF). |
| Sleep Quality (PSQI) | Baseline and after 8 weeks of treatment | Assessment of sleep quality using the Pittsburgh Sleep Quality Index (PSQI). |
| 6-Minute Walk Test | Baseline and after 8 weeks of treatment | Assessment of functional exercise capacity using the 6-Minute Walk Test (6MWT). |
| Oswestry Disability Index (ODI) | Baseline and after 8 weeks of treatment | Assessment of disability level using the Oswestry Disability Index (ODI). |
Countries
Turkey (Türkiye)
Contacts
CONTACTNuran Akdağ Mirzaoğlu, Msc/PT/Lecture
CONTACTYavuz Yakut, Prof. Dr.
PRINCIPAL_INVESTIGATORYavuz Yakut, Prof. Dr.
Hasan Kalyoncu University Faculty of Health Sciences
Outcome results
None listed