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

NCT ID: NCT06534788

Last Updated: 2024-08-02

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 44 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-05-31
• Study Completion Date: 2025-01-30

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.

Conditions

Piriformis Syndrome

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

RI-MET group

RI-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

Group Type: EXPERIMENTAL

Reciprocal Inhibition MET

Intervention Type: OTHER

Reciprocal Inhibition MET will be applied to the shortened piriformis muscle in supine and prone positions with participants using 30-50% of their maximum voluntary isometric contraction. It will include 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. RI-MET group will receive 3-5 repetitions.

Conventional physical therapy

Intervention Type: OTHER

TENS and hot pack application to provide heating effect over the painful area (10 minutes) 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 group

PFS-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

Group Type: EXPERIMENTAL

Post-facilitation MET

Intervention Type: OTHER

Post-facilitation stretch technique for shortened piriformis muscle in supine and prone positions will be applied with participants using 20% of their maximum voluntary isometric contraction. It will include 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. PFS-MET group will receive 3-5 repetitions.

Conventional physical therapy

Intervention Type: OTHER

TENS and hot pack application to provide heating effect over the painful area (10 minutes) 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

Interventions

Reciprocal Inhibition MET

Reciprocal Inhibition MET will be applied to the shortened piriformis muscle in supine and prone positions with participants using 30-50% of their maximum voluntary isometric contraction. It will include 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. RI-MET group will receive 3-5 repetitions.

Intervention Type: OTHER

Post-facilitation MET

Post-facilitation stretch technique for shortened piriformis muscle in supine and prone positions will be applied with participants using 20% of their maximum voluntary isometric contraction. It will include 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. PFS-MET group will receive 3-5 repetitions.

Intervention Type: OTHER

Conventional physical therapy

TENS and hot pack application to provide heating effect over the painful area (10 minutes) 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

Intervention Type: OTHER

Eligibility Criteria

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

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Foundation University Islamabad

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Foundation University College of Physical Therapy

Rawalpindi, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Nimrah Haq, MS-MSKPT*

Role: CONTACT

nimrahhaq254@gmail.com

0311-5445539

Facility Contacts

Ruqia Begum, MS-OMPT

Role: primary

ruqia@fui.edu.pk

03115532544

Other Identifiers

FUI/CTR/2024/21

Identifier Type: -

Identifier Source: org_study_id