Comparative Effects of PIR and PFS on Pain, Hip ROM, and Disability in Piriformis Syndrome

NCT07255053 | Completed

• 1 other identifier: TUF-PIRIFORMIS-RCT-2025
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized clinical trial evaluates the effectiveness of Post-Isometric Relaxation (PIR) and Post-Facilitation Stretching (PFS) for managing pain, improving hip abduction and internal rotation, and enhancing functional capacity in patients with Piriformis Syndrome. Thirty-six participants will be assessed at baseline and six weeks using pain scores, hip range of motion, and functional scales to determine which technique provides superior outcomes.

Conditions

Piriformis Syndrome

Outcome Measures

Primary Outcomes (1)

• Pain intensity in patients with Piriformis Syndrome

  Pain was measured using the Numeric Pain Rating Scale (NPRS), a 0-10 scale where 0 indicates no pain and 10 indicates worst possible pain.

  Baseline and 4 weeks after intervention completion

Secondary Outcomes (2)

• Hip Abduction and Internal Rotation Range of Motion

  Baseline and 4 weeks after intervention completion

• Functional Disability

  Baseline and at 4 weeks after intervention completion

Study Arms (2)

Post Isometric Relaxation (PIR)

EXPERIMENTAL

Type of technique: Muscle Energy Technique (MET) Patient position: Supine, affected leg flexed at hip and knee, crossed over the other leg, foot resting on the table Pelvis stabilization: Therapist hand on opposite ASIS to prevent pelvic movement Leg positioning: Other hand on lateral aspect of the knee Finding the barrier: Knee moved into abduction until first sign of resistance (pain-free end range) Isometric contraction: Patient pushes against the therapist's hand at \~20% strength for 7-10 seconds Relaxation and stretch: After contraction, leg moved slightly further into abduction Repetitions: 3 times per session

Procedure: Post Isometric Relaxation (PIR)

Post Facilitation Stretching (PFS)

EXPERIMENTAL

Patient position: Supine, affected leg slightly adducted and externally rotated, hip flexed \>60° Therapist hand placement: Inferior hand on table for support, superior hand guides leg movement Muscle positioning: Piriformis placed in intermediate range (between full stretch and rest) Isometric contraction: Patient externally rotates leg against resistance for 10 seconds Pause / Rest phase: 30-second relaxation after contraction; therapist applies deeper stretch into adduction and external rotation Next barrier: Leg gently moved to new barrier Repetitions: 3 times per session

Procedure: Post Facilitation Stretching (PFS)

Interventions

Post Isometric Relaxation (PIR) PROCEDURE

Participants received PIR exercises targeting the piriformis muscle three days per week for 4 weeks. The technique involved pain-free isometric contractions followed by gentle stretching to improve hip abduction and internal rotation

Also known as: Muscle Energy Technique (MET)

Post Isometric Relaxation (PIR)

Post Facilitation Stretching (PFS) PROCEDURE

Participants received PFS exercises targeting the piriformis muscle three days per week for 4 weeks. The technique combined isometric contractions with controlled stretching to enhance hip mobility and reduce pain.

Also known as: Muscle Energy Technique (MET)

Post Facilitation Stretching (PFS)

Eligibility Criteria

• Age: 35 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• \- Participants aged 35-55 years Both genders Positive findings on three or more of the following tests: Piriformis, Beatty, Freiberg, FAIR, Sign of Pace, Nagel tonic external rotation of hip Bilateral buttock pain caused by compression of the sciatic nerve or piriformis muscle spasm NPRS pain score between 3 and 7 Tenderness to palpation over the sciatic foramen Diagnosed sub-acute or chronic Piriformis Syndrome Willing to participate

You may not qualify if:

• Any pathology or recent injury around the hip, knee, or SI joint, or radiating pain from the spine, SI joint, or hip History of spinal surgery or vertebral fracture History of systemic disease, stroke, leprosy, or amputation Leg pain not related to Piriformis Syndrome (e.g., disc herniation, sacroiliac joint dysfunction, degenerative joint disease) History of spinal injury, joint disease, or congenital abnormalities Limb length difference SI joint dysfunction Hip joint dislocation or femoral fracture Any postural deformity or anomaly (e.g., scoliosis) Psychologically diagnosed condition

Sponsors & Collaborators

• University of Faisalabad: lead

Study Sites (1)

The University of Faisalabad

Faisalābad, Punjab Province, 38000, Pakistan

Location

MeSH Terms

Conditions

Piriformis Muscle Syndrome

Condition Hierarchy (Ancestors)

Sciatic Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Nerve Compression Syndromes; Neuralgia; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Pelvic Pain

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Open-label study; participants, care providers, and investigators are aware of the assigned interventions
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr

Model Details: Participants are randomly assigned to one of two groups: Post-Isometric Relaxation or Post-Facilitation Stretching, and interventions are delivered in parallel

Study Record Dates

• First Submitted: November 19, 2025
• First Posted: November 28, 2025
• Study Start: February 2, 2025
• Primary Completion: April 10, 2025
• Study Completion: August 20, 2025
• Last Updated: November 28, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: Data will become available 6 months after publication of the main results and will remain available for 5 years after study completion
• Access Criteria: Data will be shared with researchers who submit a methodologically sound proposal and agree to use data only for the stated purpose. Access will require signing a Data Use Agreement (DUA)

Locations

PA (1)