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To compare the effects of Autogenic Inhibition and Reciprocal Inhibition Muscle Energy Techniques (METS) in Piriformis Syndrome
Piriformis syndrome is when the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness, and tingling along the back of the leg and into the foot (similar to sciatic pain). The functional limitations experienced by hip pain patients in the lower limb profoundly impact their quality of life. This study aims to investigate the effectiveness of an integrated approach that compares the Effects of Autogenic Inhibition versus Reciprocal Inhibition Muscle Energy Techniques on Pain, Range of motion, and Disability in patients with Piriformis Syndrome.
This randomized clinical trial will be conducted at DHQ Hospital Jhang over six months. The sample size will consist of 32 participants. Participants who meet the inclusion criteria will be taken through a non-probability convenience sampling technique, that will be randomized through a sealed envelope method. 16 Participants will be assigned to Group A that will be treated with the Autogenic Inhibition Muscle Energy Technique, 16 Participants will be assigned to Group B and will be treated with Reciprocal Inhibition Muscle Energy Technique at the frequency of 1 set and 3 repetitions per session for two sessions per week and total six sessions for three weeks with follow up at one month. The duration of contraction is 7-10 seconds. Pre and post-intervention values will be taken on the 1st day in the 3rd week and at one-month follow-up. Data will be collected using various assessment tools, including the FAIR test, Freiberg test, Lasegue test, Beatty test, Pace sign, Numeric Pain Rating Scale (NPRS), and Universal Goniometer. Pre-intervention assessments will be conducted for all two groups. The effects of the interventions will be measured either by parametric or non-parametric tests after assessing the normality of data by the Shapiro-Wilk test Independent t-test. Data analysis will be performed by using SPSS 25 software.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Autogenic Inhibition Muscle Energy Technique | Experimental | This group will receive Autogenic Inhibition Muscle Energy Technique |
|
| Reciprocal Inhibition Muscle Energy Technique | Active Comparator | This group will receive Reciprocal Inhibition Muscle Energy Technique |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Autogenic Inhibition Muscle Energy Technique | Procedure | No of repetitions: 1 set with 3 repetitions No of Sessions per week: 2 per weeks for 3 weeks (40 Min per Session) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Pain : Numeric Pain Rating Scale (NPRS) | Patients' overall assessment of pain will be provided using the numeric pain rating scale | 3 Weeks |
| Range of Motion : Universal Goniometer | It is frequently employed as a benchmark technique for the assessment of Range of Motion | 3 Weeks |
| Lower Extremity Functional Scale (LEFS) | The LEFS is a self-report questionnaire intended to assess functional status in patients with disability of the lower extremity (e.g., hip, thigh, ankle) containing 20 questions about a person's ability to perform everyday tasks | 3 Weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mateen Asghar, MS-DPT | Contact | 03046368317 | mateen04443@gmail.com | |
| Rabiya Noor, PhD | Contact | 03344355660 | rabiya.noor@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Rabiya Noor, PhD | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| IIMCT Railway General Hospital | Recruiting | Rawalpindi | Punjab Province | 46000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Sadiq M, Hussain SA, Meganath P. 'Hand on hip'sign: A novel screening test and diagnostic tool in piriformis syndrome. Journal of Orthopaedics, Trauma and Rehabilitation. 2020:2210491720961113. | ||
| 34557150 | Background | Siahaan YMT, Tiffani P, Tanasia A. Ultrasound-Guided Measurement of Piriformis Muscle Thickness to Diagnose Piriformis Syndrome. Front Neurol. 2021 Sep 7;12:721966. doi: 10.3389/fneur.2021.721966. eCollection 2021. | |
| Background | Tanveer F, Shahid S. Frequency of Piriformis tightness in professionals middle aged women. Rawal Medical Journal. 2018;43(4):685-. | ||
| 28836092 |
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| Reciprocal Inhibition Muscle Energy Technique | Procedure | No of repetitions: 1 set with 3 repetitions No of Sessions per week: 2 per week for 3 weeks (40 Min per Session) |
|
| Background |
| Hopayian K, Danielyan A. Four symptoms define the piriformis syndrome: an updated systematic review of its clinical features. Eur J Orthop Surg Traumatol. 2018 Feb;28(2):155-164. doi: 10.1007/s00590-017-2031-8. Epub 2017 Aug 23. |
| Background | Siahaan YMT, Ketaren RJ, Hartoyo V, Tiffani P. The predisposing factors of piriformis syndrome: Study in a referral hospital. MNJ (Malang Neurology Journal). 2019;5(2):76-9. |
| 31778837 | Background | Wu YY, Guo XY, Chen K, He FD, Quan JR. Feasibility and Reliability of an Ultrasound Examination to Diagnose Piriformis Syndrome. World Neurosurg. 2020 Feb;134:e1085-e1092. doi: 10.1016/j.wneu.2019.11.098. Epub 2019 Nov 25. |
| Background | Islam F, Mansha H, Gulzar K, Raza A, Raffique A, Haider S. Prevalence Of Piriformis Muscle Syndrome Among Individuals with Low Back Pain: Piriformis Muscle Syndrome Among Individuals with Low Back Pain. Pakistan Journal of Health Sciences. 2022:48-52. |
| 31102324 | Background | Probst D, Stout A, Hunt D. Piriformis Syndrome: A Narrative Review of the Anatomy, Diagnosis, and Treatment. PM R. 2019 Aug;11 Suppl 1:S54-S63. doi: 10.1002/pmrj.12189. Epub 2019 Jul 22. |
| 36712711 | Background | Ahmad Siraj S, Dadgal R. Physiotherapy for Piriformis Syndrome Using Sciatic Nerve Mobilization and Piriformis Release. Cureus. 2022 Dec 26;14(12):e32952. doi: 10.7759/cureus.32952. eCollection 2022 Dec. |
| 30137781 | Background | Chang C, Jeno SH, Varacallo MA. Anatomy, Bony Pelvis and Lower Limb: Piriformis Muscle. 2023 Nov 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK519497/ |
| ID | Term |
|---|---|
| D055958 | Piriformis Muscle Syndrome |
| D009043 | Motor Activity |
| D010146 | Pain |
| ID | Term |
|---|---|
| D020426 | Sciatic Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D009437 | Neuralgia |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D017699 | Pelvic Pain |
| D001519 | Behavior |
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