Deep Gluteal Syndrome
Conditions
Keywords
Neural Gliders, Extracorporeal Shock Wave Therapy, Deep Gluteal Syndrome, Piriformis Muscle
Brief summary
This study is a randomized controlled trial comparing Neural Gliders with and without Extracorporeal Shock Wave Therapy (ESWT) in patients with Deep Gluteal Syndrome. A total of 44 participants are divided equally into two groups: Group A receives neural gliders, ESWT, and conventional physiotherapy, while Group B receives neural gliders with conventional physiotherapy only. The study evaluates changes in pain, functional disability, and nerve mechano-sensitivity using NPRS, ODI, LEFS, Slump Test, FAIR Test, and SLR. Its aim is to determine whether adding ESWT provides greater clinical improvement than neural gliders alone.
Detailed description
This study is a randomized controlled trial designed to compare the effects of Neural Gliders with and without Extracorporeal Shock Wave Therapy (ESWT) in patients with Deep Gluteal Syndrome (DGS). A total of 44 participants will be randomly divided into two equal groups of 22. Group A will receive neural gliding exercises combined with ESWT and conventional physiotherapy, while Group B will receive neural gliding exercises with conventional physiotherapy only. The conventional treatment includes a hot pack and piriformis stretching. The main outcomes are pain intensity, functional disability, lower-limb function, and nerve mechano-sensitivity, assessed using the NPRS, ODI, LEFS, Slump Test, FAIR Test, and Straight Leg Raise (SLR). The intervention is planned for 3 sessions per week for 4 weeks, and the study aims to determine whether adding ESWT to neural gliders provides greater improvement in pain, function, and nerve mobility than neural gliders alone.
Interventions
OTHERGroup A= Neural Gliders with ESWT
We use Neural Gliders in Deep Gluteal Syndrome because the sciatic nerve can become irritated or restricted as it passes through the deep gluteal region. Neural gliding produces gentle alternating movements that allow the nerve to slide within its pathway, helping improve nerve mobility, reduce mechano-sensitivity, improve circulation around the nerve, and decrease pain and functional limitation. We combine Neural Gliders with ESWT because the two interventions target different components of the problem. Neural gliders mainly address nerve mobility and sensitivity, while ESWT is intended to act on the surrounding deep gluteal/piriformis tissues by helping reduce pain, improve blood flow, decrease tissue tightness, and stimulate healing.
OTHERGroup B= Neural Gliders without ESWT
We use neural gliders to improve sciatic nerve mobility and reduce nerve mechano-sensitivity. We add ESWT because it may reduce pain, improve circulation, and treat tight or restricted deep gluteal tissues. Therefore, the combination may address both the nerve and the surrounding soft tissues more effectively."
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 outcome assessor was masked to group allocation. The assessor did not know whether the participant belonged to the Neural Gliders + ESWT group or the Neural Gliders-only group. Treatment was provided by a separate therapist, and participants were instructed not to disclose their treatment to the assessor. The assessor only performed the pre- and post-treatment outcome measurements using NPRS, LEFS, Slump Test, FAIR Test, and SLR. This was done to reduce observer and assessment bias.
Intervention model description
This study follows a single-blinded randomized controlled trial model involving 44 patients with Deep Gluteal Syndrome, randomly allocated into two equal groups of 22 participants. Group A receives Neural Gliders combined with ESWT and conventional physiotherapy, while Group B receives Neural Gliders with conventional physiotherapy only. Both groups are treated 3 times per week for 4 weeks. Outcomes are assessed before and after treatment using NPRS, LEFS, Slump Test, FAIR Test, and SLR to evaluate pain, functional disability, lower-limb function, and nerve mechano-sensitivity. The model is designed to determine whether adding ESWT to Neural Gliders provides additional clinical benefit compared with Neural Gliders alone.
Eligibility
Sex/Gender
ALL
Age
25 Months 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 Gonimeter | 6 weeks | A Universal Goniometer is a simple clinical instrument used to measure joint range of motion in degrees. It consists of a central axis or fulcrum with one stationary arm and one movable arm, which are aligned with anatomical landmarks during measurement. In this study, the goniometer is used during the Straight Leg Raise (SLR) test to record the angle at which pain, tightness, or neural symptoms appear. A lower SLR angle indicates greater restriction or nerve mechano-sensitivity, while an increased angle after treatment suggests improved nerve mobility and functional recovery. |
| NPRS | 6 weeks | The NPRS is simple 0-10 scale used to measure pain intensity. Patients rate their pain where 0=no pain and 10=worst possible pain. In your study, it helps track changes in buttock and leg caused by deep gluteal syndrome. A score reduction after treatment indicates improvement. Clinically, a change of ≥ 2 points is considered meaningful |
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 . |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORHamza Zahid, MS OMPT
University of Management and Technology Sialkot Pakistan
STUDY_CHAIRDanyal Ahmad, PhD Scholar
University of Management and Technology Sialkot Pakistan
Outcome results
None listed