Comparative Effects of Post-isometric Relaxation and Active Release Technique Patients With Deep Gluteal Syndrome

NCT07063017 | Not Yet Recruiting

• 1 other identifier: REC/RCR &AHS/24/0161 Ujala
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

Deep gluteal syndrome included piriformis syndrome. Tight piriformis muscle gives symptoms of Sciatica in patients with Deep Gluteal Syndrome. Two different techniques which will be used to improve deep gluteal syndrome are Active release technique and Post-isometric relaxation. Active release therapy is a set of techniques for treating musculoskeletal problems. After feeling for the precise location of musculoskeletal dysfunction, practitioners aim to release affected tissues. The post-isometric relaxation technique begins by placing the muscle in a stretched position. Then an isometric contraction is exerted against minimal resistance. Relaxation and then gentle stretch follow as the muscle releases.

Conditions

Deep Gluteal Syndrome

Keywords

Pain; Disability; Range of motion

Outcome Measures

Primary Outcomes (3)

• Numerical Pain Rating Scale (NPRS)

  Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicated "worst pain".

  upto 4 weeks

• Universal Goniometer (UG)

  The range of motion will be measured using universal goniometer. A universal goniometer has 3 parts, which include the following: A body is designed like a protractor and may form a full or half-circle. It has a scale for the measurement of the angle. The scale can extend from 0 to 180 degrees for half-circle models or 0 to 360 degrees for full-circle models.

  upto 4 weeks

• Lower Extremity Functional Scale (LEFS)

  The Lower Extremity Functional Scale (LEFS) is a questionnaire containing 20 questions about a person's ability to perform everyday tasks. The LEFS can be used by clinicians as a measure of patients' initial function, ongoing progress and outcome, as well as to set functional goals.

  upto 4 weeks

Study Arms (2)

Post- Isometric Relaxation

EXPERIMENTAL

Post Isometric Relaxation Technique to Piriformis; Lay the patient in the supine position and have the practitioner stand on the same side as the affected piriformis muscle. Bend the knee of the affected side and place the foot of that side on the lateral aspect of the opposite knee. Have the practitioner push knee medially until meeting the restrictive barrier. Have the patient push against the practitioner's resistance for 3 to 5 seconds, allow for a period of isometric relaxation, then engage a new barrier; repeat three times. Return the patient to a neutral position and reassess using supine or prone piriformis testing.

Other: Post- Isometric Relaxation

Active Release Technique

EXPERIMENTAL

Active Release Technique: Patient position is side lying on the sound side. Therapist stands behind the patient. The upper leg must be in flexion on knee and slight extension Now apply pressure with both thumbs on piriformis and ask patient to flex and extend his hip and also external and internal rotation on hip in flexion. The gluteal muscle is taken from a shortened position to a fully lengthened position while the physiotherapist's contact hand holds tension longitudinally along the soft tissue fibers.

Other: Active Release Technique

Interventions

Post- Isometric Relaxation OTHER

Post Isometric Relaxation Technique to Piriformis; Lay the patient in the supine position and have the practitioner stand on the same side as the affected piriformis muscle. Bend the knee of the affected side and place the foot of that side on the lateral aspect of the opposite knee. Have the practitioner push knee medially until meeting the restrictive barrier. Have the patient push against the practitioner's resistance for 3 to 5 seconds, allow for a period of isometric relaxation, then engage a new barrier; repeat three times. Return the patient to a neutral position and reassess using supine or prone piriformis testing.

Post- Isometric Relaxation

Active Release Technique OTHER

Patient position is side lying on the sound side. Therapist stands behind the patient. The upper leg must be in flexion on knee and slight extension Now apply pressure with both thumbs on piriformis and ask patient to flex and extend his hip and also external and internal rotation on hip in flexion. The gluteal muscle is taken from a shortened position to a fully lengthened position while the physiotherapist's contact hand holds tension longitudinally along the soft tissue fibers.

Active Release Technique

Eligibility Criteria

• Age: 35 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age group between 35 and 55 years
• Both gender male and female
• Having pain and tenderness in gluteal space
• Gluteal pain radiating through the posterior of thigh and lower limb

You may not qualify if:

• Pregnancy
• Malignancies
• Degenerative spine disorders like lumber spondylosis, canal stenosis, spondylolisthesis, neural compressions due to intervertebral disc lesions
• Any vertebral or hip fracture.
• History of spinal surgery, TB spine, osteoarthritis, rheumatoid disease

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Ittefaq Hospital

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (8)

• Kizaki K, Uchida S, Shanmugaraj A, Aquino CC, Duong A, Simunovic N, Martin HD, Ayeni OR. Deep gluteal syndrome is defined as a non-discogenic sciatic nerve disorder with entrapment in the deep gluteal space: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2020 Oct;28(10):3354-3364. doi: 10.1007/s00167-020-05966-x. Epub 2020 Apr 3.

  PMID: 32246173 BACKGROUND

• Hernando MF, Cerezal L, Perez-Carro L, Abascal F, Canga A. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space. Skeletal Radiol. 2015 Jul;44(7):919-34. doi: 10.1007/s00256-015-2124-6. Epub 2015 Mar 5.

  PMID: 25739706 BACKGROUND

• Naz S, Sheikh SA, Sulaman M, Abid S, Saeed E, Faraz K. EFFECTS OF ACTIVE RELEASE TECHNIQUE VERSUS MULLIGAN TECHNIQUE ON PAIN AND FUNCTIONAL DISABILITY IN PATIENT WITH DEEP GLUTEAL SYNDROME.

  BACKGROUND

• Park JW, Lee YK, Lee YJ, Shin S, Kang Y, Koo KH. Deep gluteal syndrome as a cause of posterior hip pain and sciatica-like pain. Bone Joint J. 2020 May;102-B(5):556-567. doi: 10.1302/0301-620X.102B5.BJJ-2019-1212.R1.

  PMID: 32349600 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.

  PMID: 19011229 BACKGROUND

• Kage V, Ratnam R. Immediate effect of active release technique versus mulligan bent leg raise in subjects with hamstring tightness: a randomized clinical trial. Int J Physiother Res. 2014;2(1):301-4.

  BACKGROUND

• Michel F, Decavel P, Toussirot E, Tatu L, Aleton E, Monnier G, Garbuio P, Parratte B. The piriformis muscle syndrome: an exploration of anatomical context, pathophysiological hypotheses and diagnostic criteria. Ann Phys Rehabil Med. 2013 May;56(4):300-11. doi: 10.1016/j.rehab.2013.03.006. Epub 2013 Apr 30.

  PMID: 23684469 BACKGROUND

• Dworkin RH, O'Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, Kalso EA, Loeser JD, Miaskowski C, Nurmikko TJ, Portenoy RK, Rice ASC, Stacey BR, Treede RD, Turk DC, Wallace MS. Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain. 2007 Dec 5;132(3):237-251. doi: 10.1016/j.pain.2007.08.033. Epub 2007 Oct 24.

  PMID: 17920770 BACKGROUND

MeSH Terms

Conditions

Hip socket neuropathy; Pain

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Samrood Akram, PhD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Samrood Akram, PhD Scholar

CONTACT

03324806143; samrood.akram@riphah.edu.pk.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 3, 2025
• First Posted: July 14, 2025
• Study Start: July 1, 2025
• Primary Completion: September 1, 2025
• Study Completion: October 1, 2025
• Last Updated: July 14, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)