Deep Gluteal Syndrome
Conditions
Keywords
Bowen therapy, Deep gluteal syndrome, Extracorporeal Shockwave Therapy
Brief summary
A single-blinded, randomized controlled trial consisting of 46 participants with Deep Gluteal syndrome, calculated by the G power tool with an attrition rate of 5 % will be conducted. Participants will be recruited using non-probability convenience sampling based on pre-defined inclusion and exclusion criteria. Participants will be randomly assigned into two groups with 23 participants each group. Group A will receive Bowen Technique with extracorporeal shockwave therapy. Group B will receive Bowen Technique without extracorporeal shockwave therapy in conjunction with conventional therapy. Primary outcomes like pain, functional level and ROM will be measured at baseline and post-intervention using the Lower extremity functional scale (LEFS), Numeric Pain Rating scale (NPRS), and Goniometer. Data will be analyzed by IBM SPSS 26.0 with the Shapiro-Wilk test to confirm the normality.
Detailed description
This randomized controlled trial investigates the effects of Bowen Technique with and without Extracorporeal Shockwave Therapy in patients with Deep Gluteal Syndrome. The study includes 46 participants, with 23 participants allocated to each group. Group A receives Bowen Technique combined with ESWT, while Group B receives Bowen Technique without ESWT, with both groups receiving standardized physiotherapy. The main outcomes assessed are pain intensity, lower-limb function, hip range of motion, and clinical provocation tests including the FAIR Test, Active Piriformis Test, and Seated Piriformis Stretch Test. NPRS, LEFS, universal goniometry, and the clinical special tests are used to evaluate changes from baseline to post-treatment. The study aims to determine whether adding ESWT to Bowen Technique provides greater clinical benefit than Bowen Technique alone in patients with Deep Gluteal Syndrom
Interventions
OTHERExperimental : Group A = Bowen With ESWT
Bowen Technique is a gentle manual fascial technique used to reduce muscle tension, pain, and soft-tissue restriction. ESWT is a non-invasive mechanical treatment that delivers shockwaves to promote analgesia, circulation, and tissue repair. In Deep Gluteal Syndrome, both can target the painful and restricted deep gluteal tissues, so my study compares Bowen alone with Bowen combined with ESWT to determine whether the addition of ESWT provides greater clinical benefit
OTHERControl Group: Group B= Bowen Techniques only
The Bowen Technique is a gentle manual soft-tissue technique developed by Thomas Bowen. It uses slow, precise, cross-fiber rolling movements over muscles, tendons, ligaments, and fascia, with short rest periods between sets of movements. In your study, the therapist applies gentle pressure to the deep gluteal muscles, holds the tissue briefly, then moves across it in a controlled manner.
Sponsors
University of Management and Technology Sialkot Pakistan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
The study followed a single-blinded design in which the outcome assessors were masked to the participants' treatment allocation. Assessors were not informed whether a participant belonged to the Bowen Technique with ESWT group or the Bowen Technique without ESWT group. This helped reduce assessment and observer bias during pre- and post-treatment measurements. Participants were aware of the treatment they received, but the assessors remained blinded throughout outcome evaluation
Intervention model description
This study uses a randomized controlled trial model to compare two physiotherapy interventions for Deep Gluteal Syndrome. A total of 46 participants are divided equally into two groups of 23 participants each. Group A receives Bowen Technique with Extracorporeal Shockwave Therapy, while Group B receives Bowen Technique without ESWT. Pain, lower-limb function, hip range of motion, and relevant clinical special tests are assessed before and after treatment. The model is designed to determine whether adding ESWT to Bowen Technique provides greater clinical improvement than Bowen Technique alone.
Eligibility
Sex/Gender
ALL
Age
25 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Individuals aged 25 to 45 years, including both genders 55 * Positive FAIR, Active Piriformis Test, Seated Piriformis Stretch Test 56,6,57 * NPRS pain score ≥ 3/10 55 * For a minimum of four weeks, there has been unilateral discomfort in the buttock, with or without accompanying posterior thigh pain, exacerbated by sitting 58
Exclusion criteria
* Previous surgery involving the ipsilateral hip, pelvis, lumbar spine, or sacroiliac joint 34 * Women who were pregnant or nursing were excluded 59 * Medical conditions such as tumors or fractures 60 * Neuromuscular disorders that impair normal lumbopelvic morphology or progressive neurologic disease 60 * Disc pathologies identified through radiological imaging 17 * Pathologies of the hip joint and soft tissues 17 * Recent trauma history 17 * History of polyneuropathy, sciatic nerve injury, rheumatological disease, or malignancy 17 * Corticosteroid therapy or opioid-derived analgesia for pain during the previous month 17
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| UNIVERSAL GONIOMETRY | 6 Weeks | A goniometer is a conventional clinical tool utilized to assess joint range of motion (ROM), offering objective and dependable measurements to assess mobility restrictions in musculoskeletal disorders72 . Goniometric measurement of passive hip ROM has good test-retest reliability, with ICC ranging from 0.82 to 0.94 across different hip movements79 * For goniometric evaluation of hip internal rotation, the minimal detectable change (MDC) is 8.6°, and for hip external rotation, it is 6.1° 18 * According to anchor-based methodology, the minimal clinically significant difference (MCID) for hip range of motion is 5.81° 80 |
| NUMERICAL PAIN RATING SCALE (NPRS) | 6 Weeks | The Numeric Pain Rating Scale (NPRS) is a self-reported metric utilized to evaluate pain severity in individuals with musculoskeletal conditions 70 * It is a simple 11-point scale that ranges from 0 (no pain) to 10 (worst pain imaginable) that can be administered verbally or in writing 74 * which shows multilevel likelihood ratios of 0.99 (scores 1-3), 2.67 (scores 4-6), and 5.60 (scores 7-10) for detecting pain-related functional interference, and an established sensitivity of 69 percent at ascore of 175 .Patients are asked to rate their current, best, and worst pain levels during the previous 24 hours, and the average of the three values is used to get the final pain intensity score 76 The NPRS minimal clinically significant difference (MCID) in this current study was set at two points 77 . The NPRS is widely used in research and clinical environments due to its ease of use, high reliability, validity, and responsiveness to clinically relevant changes in both acute and chronic |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| LEFS | 6 Weeks | The Lower Extremity Functional Scale (LEFS) is a patient-reported outcome measure utilized to evaluate functional impairments in individuals with lower extremity musculoskeletal disorders 71 . There are twenty items in the LEFS, and the scores range from 0 (extreme difficulty/unable to perform activity) to 4 (no difficulty). By adding up the scores for each item, the overall score can be found. Extreme limitations are indicated by a score of 0, while a maximum score of 80 denotes no functional limitations82 * When compared to the SF-36, the LEFS's construct validity was confirmed, and its sensitivity to change was higher than the SF-36's.The subgroup of patients with more chronic conditions showed excellent test-retest reliability (r = 0.94; 95 percent lower limit CI = 0.89) 71 * When tested against the Timed Up and Go (TUG) test as an external criterion, the LEFS showed exceptional diagnostic accuracy with a sensitivity of 92% and specificity of 96% at a cut-off score of 53 |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORHamza Zahid
University of Management and Technology Sialkot Pakistan
Outcome results
None listed