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Rationale of this research is to evaluate the outcome of Comparison of Integrated Neuromuscular Inhibition technique versus Neuromuscular reeducation on pain in patients with Deep Gluteal Syndrome. The significance of this study is to identify which technique is superior in alleviating the symptoms of deep gluteal syndrome. This study will help gather evidence on the practice of incorporating trigger point therapy in the treatment of deep gluteal syndrome.
Deep gluteal syndrome is a common buttock and posterior hip pain caused by entrapment of the sciatic nerve in the posterior hip region. Nonoperative therapy involves treating the entrapment location, using rest, anti-inflammatories, musclerelaxants, and physical therapy to relieve compression. The purpose of the study was to evaluate the effects of Integrated Neuromuscular Inhibition Technique versus Neuromuscular Reeducation Technique on pain in subject with deep gluteal syndrome. It was a randomized, controlled trial, conducted among deep gluteal syndrome patients. Sample size was 54 by using G Power Tool software. Participantswere randomly assigned to the intervention or control group after a baseline assessment with a lottery ticket and an opaque envelope. All participants in both groups were evaluated on baseline and 12 th Session.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Integrated Neuromuscular Inhibition Technique | Experimental | Individuals in Group A, After palpating the trigger point ischemic compression were applied for 20-60 sec while strain counterstain for 60-90 sec and MET is for 7-10 sec. This technique was repeat 3-4 time per session Conventional treatment include Hot Pack for 5mins, AROM exercises ,Home plans include stretching exercise of glutes,hamstring and calf (5-7 reps x 10 sec hold, each). |
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| Neuromuscular Reeducation Technique | Active Comparator | Deep pressure were applied along origin and insertion of Piriformis and hamstring muscle combined with active movement of patient for 5 -15 time as per required (depend upon thickness of scar) per session, 10 sec rest b/w pressure. This technique given 5 time per session. Conventional treatment include Hot Pack for 5mins, AROM exercises ,Home plans include stretching exercise of glutes,hamstring and calf (5-7 reps x 10 sec hold, each). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Integrated Neuromuscular Inhibition Technique | Other | After palpating the trigger point ischemic compression were applied for 20-60 sec while strain Counterstain for 60-90 sec and MET is for 7-10 sec. |
| Measure | Description | Time Frame |
|---|---|---|
| NPRS | Numeric Pain Rate Scale used to assess pain intensity | 4th week |
| Goniometer | used to assess lower limb ranges | 4th week |
| Lower Extremity Functional scale | LEFS questionnaire have 20 questions will assess the impairment of a patient with lower extremity musculoskeletal condition or disorders | 4th week |
| Sciatica Bothersomeness Index | used to measure the participants' level of sciatica. The scale's ratings range from 0 to 24, with higher levels indicating severe sciatica discomfort. | 4th week |
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Inclusion Criteria:
Both genders Age: 30-50 years Pain due to a non-discogenic sciatic nerve entrapment in the sub gluteal space Pain, tightness and dysesthesias in the buttock area, posterior thigh Buttock pain aggravated with prolong sitting (>20-30 min) Buttock pain aggravated when sitting with limited straight leg raising ability (seated piriformis test) Pain with the passive internal rotation of hip (Freiberg sign) Pain increase in Flexion, Adduction and internal rotation (Positive FAIR test)
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ramsha Tariq, MS-OMPT | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gulberg green campus of Riphah International University | Islamabad | Punjab Province | 44000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29807785 | Background | Aguilera-Bohorquez B, Cardozo O, Brugiatti M, Cantor E, Valdivia N. Endoscopic treatment of sciatic nerve entrapment in deep gluteal syndrome: Clinical results. Rev Esp Cir Ortop Traumatol (Engl Ed). 2018 Sep-Oct;62(5):322-327. doi: 10.1016/j.recot.2018.03.004. Epub 2018 May 26. English, Spanish. | |
| 23015944 | Background |
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| ID | Term |
|---|---|
| C531783 | Hip socket neuropathy |
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| Neuromuscular Reeducation Technique | Other | Deep pressure were applied along origin and insertion of Piriformis and hamstring muscle combined with active movement of patient for 5 -15 time as per required |
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| Frank RM, Slabaugh MA, Grumet RC, Virkus WW, Bush-Joseph CA, Nho SJ. Posterior hip pain in an athletic population: differential diagnosis and treatment options. Sports Health. 2010 May;2(3):237-46. doi: 10.1177/1941738110366000. |
| 19011229 | Background | Boyajian-O'Neill LA, McClain RL, Coleman MK, Thomas PP. Diagnosis and management of piriformis syndrome: an osteopathic approach. J Am Osteopath Assoc. 2008 Nov;108(11):657-64. doi: 10.7556/jaoa.2008.108.11.657. |