Instrument-Assisted Soft Tissue Mobilization Versus PNF Stretching in Athletes With Piriformis Syndrome

NCT ID: NCT07090356

Last Updated: 2025-07-29

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-07-30
• Study Completion Date: 2025-08-30

Brief Summary

A 12-month randomized controlled trial will be conducted at Pakistan Sports Board, Lahore, with 40 athletes (18-35 years) randomly allocated to IASTM (n=20) or PNF (n=20) groups. Interventions were administered 3 times/week for 4 weeks. Outcomes included Numeric Pain Rating Scale (NPRS), goniometric hip ROM, and Oswestry Disability Index (ODI).

Detailed Description

The objective of this study will be to compare the effectiveness of IASTM versus PNF stretching to manage Piriformis Syndrome in a 4 - week randomized controlled trial (RCT). Random allocation was done to the IASTM group or the PNF stretching group. Physiotherapy interventions to reduce pain, increase muscle flexibility and increase functional outcomes will be given to both groups.

Before the intervention, all participants will underween a comprehensive assessment, including:

• Numeric Pain Rating Scale (NPRS) for pain intensity
• Oswestry Disability Index (ODI) for functional disability
• Goniometric measurement for hip joint range of motion (ROM)

Group A: Instrument-Assisted Soft Tissue Mobilization (IASTM) Group

IASTM therapy was provided to participants in whom a specialized instrument was used to apply controlled pressure over the piriformis muscle as well as surrounding soft tissues. The procedure included:

• Warm-up: Light aerobic exercise (5 minutes)
• IASTM Application: Applied over the piriformis muscle in a longitudinal and cross-fiber pattern for 5-7 minutes
• Static stretching of the piriformis and gluteal muscle activation exercises are completed next.
• Cool-down: Light stretching and relaxation

Group B: Proprioceptive Neuromuscular Facilitation (PNF) Stretching Group

PNF stretching (contract relax; hold relax) was implemented to stretch participants' muscles as flexibly and with as much control as possible. The procedure included:

• Warm-up: Light aerobic exercise (5 minutes)
• PNF Stretching:

• The second technique was based on hold-relax technique during which the participant actively contracted the piriformis muscle against resistance for 5 seconds, followed by a 10 seconds passive stretch.
• Contract relax technique: same as the above but with deeper stretches following an active contraction
• Repeated for 3 sets per session
• Exercises to strengthen the core and hip muscles to provide stability
• Gentle stretching and deep breathing for cool down

Physiotherapy Management (Common for Both Groups)

In addition, the following was provided to all the participants together with their respective interventions:

• Ice/heat application as needed (based on the individual).
• Education & Ergonomic Advice: Guidance on proper posture, activity modification, and self-care techniques Specific exercises will be assigned to maintain flexibility and strength (Home Exercise Program).

Conditions

Piriformis Syndrome

Study Design

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

Study Groups

Instrument-Assisted Soft Tissue Mobilization

IASTM therapy will be provided to participants in whom a specialized instrument wwill be used to apply controlled pressure over the piriformis muscle as well as surrounding soft tissues.

Group Type: EXPERIMENTAL

Instrument-Assisted Soft Tissue Mobilization

Intervention Type: OTHER

IASTM therapy will be provided to participants in whom a specialized instrument will be used to apply controlled pressure over the piriformis muscle as well as surrounding soft tissues.

Proprioceptive Neuromuscular Facilitation Stretching

PNF stretching (contract relax; hold relax) was implemented to stretch participants' muscles as flexibly and with as much control as possible.

Group Type: EXPERIMENTAL

Proprioceptive Neuromuscular Facilitation Stretching

Intervention Type: OTHER

PNF stretching (contract relax; hold relax) will be implemented to stretch participants' muscles as flexibly and with as much control as possible.

Interventions

Instrument-Assisted Soft Tissue Mobilization

IASTM therapy will be provided to participants in whom a specialized instrument will be used to apply controlled pressure over the piriformis muscle as well as surrounding soft tissues.

Intervention Type: OTHER

Proprioceptive Neuromuscular Facilitation Stretching

PNF stretching (contract relax; hold relax) will be implemented to stretch participants' muscles as flexibly and with as much control as possible.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Professional Athletes aged 18 to 35 years.
• Chronic pain in the buttock and hip area.
• Inability to sit for a prolonged time.
• Athletes having positive Faber test
• Both male and female athletes
• Practicing athletes who are in practice from last 2 years.

Exclusion Criteria

• Trauma history from last 6 months.
• Other injuries excluding hip pain.
• Systemic illness.
• Pre-existing neurological conditions affecting the lower limbs
• History of lower back surgery

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Muhammad Hassan, MSPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Pakistan Sports Board

Lahore, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

Imran Amjad, Phd PT

Role: CONTACT

imran.amjad@riphah.edu.pk

03324390125

Facility Contacts

Hafiz Amir

Role: primary

04299230383

Other Identifiers

REC/RCR&AHS/24/0460

Identifier Type: -

Identifier Source: org_study_id