Comparative Effects of the Bowen Technique With and Without Extracorporeal Shock Wave Therapy in Patients With Deep Gluteal Syndrome

NCT07772661 | Enrolling By Invitation DMC

• 1 other identifier: kuhs/dpt/umt-skt-00261
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

A single-blinded, randomized controlled trial consisting of 46 participants with Deep Gluteal syndrome, calculated by the G power tool with an attrition rate of 5 % will be conducted. Participants will be recruited using non-probability convenience sampling based on pre-defined inclusion and exclusion criteria. Participants will be randomly assigned into two groups with 23 participants each group. Group A will receive Bowen Technique with extracorporeal shockwave therapy. Group B will receive Bowen Technique without extracorporeal shockwave therapy in conjunction with conventional therapy. Primary outcomes like pain, functional level and ROM will be measured at baseline and post-intervention using the Lower extremity functional scale (LEFS), Numeric Pain Rating scale (NPRS), and Goniometer. Data will be analyzed by IBM SPSS 26.0 with the Shapiro-Wilk test to confirm the normality.

Conditions

Deep Gluteal Syndrome

Keywords

Bowen therapy; Deep gluteal syndrome; Extracorporeal Shockwave Therapy

Outcome Measures

Primary Outcomes (2)

• UNIVERSAL GONIOMETRY

  A goniometer is a conventional clinical tool utilized to assess joint range of motion (ROM), offering objective and dependable measurements to assess mobility restrictions in musculoskeletal disorders72 . Goniometric measurement of passive hip ROM has good test-retest reliability, with ICC ranging from 0.82 to 0.94 across different hip movements79 * For goniometric evaluation of hip internal rotation, the minimal detectable change (MDC) is 8.6°, and for hip external rotation, it is 6.1° 18 * According to anchor-based methodology, the minimal clinically significant difference (MCID) for hip range of motion is 5.81° 80

  6 Weeks

• NUMERICAL PAIN RATING SCALE (NPRS)

  The Numeric Pain Rating Scale (NPRS) is a self-reported metric utilized to evaluate pain severity in individuals with musculoskeletal conditions 70 * It is a simple 11-point scale that ranges from 0 (no pain) to 10 (worst pain imaginable) that can be administered verbally or in writing 74 * which shows multilevel likelihood ratios of 0.99 (scores 1-3), 2.67 (scores 4-6), and 5.60 (scores 7-10) for detecting pain-related functional interference, and an established sensitivity of 69 percent at ascore of 175 .Patients are asked to rate their current, best, and worst pain levels during the previous 24 hours, and the average of the three values is used to get the final pain intensity score 76 The NPRS minimal clinically significant difference (MCID) in this current study was set at two points 77 . The NPRS is widely used in research and clinical environments due to its ease of use, high reliability, validity, and responsiveness to clinically relevant changes in both acute and chronic

  6 Weeks

Secondary Outcomes (1)

• LEFS

  6 Weeks

Study Arms (2)

GROUP A (Bowen Technique with ESWT)

EXPERIMENTAL

Group A will receive Bowen Technqiue with ESWT along with conventional Physiotherapy Protocol.

Other: Experimental : Group A = Bowen With ESWT

GROUP B (Bowen technique without ESWT)

ACTIVE COMPARATOR

Group B will receive Bowen Technqiue ONLY along with conventional Physiotherapy Protocol.

Other: Control Group: Group B= Bowen Techniques only

Interventions

Experimental : Group A = Bowen With ESWT OTHER

Bowen Technique is a gentle manual fascial technique used to reduce muscle tension, pain, and soft-tissue restriction. ESWT is a non-invasive mechanical treatment that delivers shockwaves to promote analgesia, circulation, and tissue repair. In Deep Gluteal Syndrome, both can target the painful and restricted deep gluteal tissues, so my study compares Bowen alone with Bowen combined with ESWT to determine whether the addition of ESWT provides greater clinical benefit

GROUP A (Bowen Technique with ESWT)

Control Group: Group B= Bowen Techniques only OTHER

The Bowen Technique is a gentle manual soft-tissue technique developed by Thomas Bowen. It uses slow, precise, cross-fiber rolling movements over muscles, tendons, ligaments, and fascia, with short rest periods between sets of movements. In your study, the therapist applies gentle pressure to the deep gluteal muscles, holds the tissue briefly, then moves across it in a controlled manner.

GROUP B (Bowen technique without ESWT)

Eligibility Criteria

• Age: 25 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Individuals aged 25 to 45 years, including both genders 55
• Positive FAIR, Active Piriformis Test, Seated Piriformis Stretch Test 56,6,57
• NPRS pain score ≥ 3/10 55
• For a minimum of four weeks, there has been unilateral discomfort in the buttock, with or without accompanying posterior thigh pain, exacerbated by sitting 58

You may not qualify if:

• Previous surgery involving the ipsilateral hip, pelvis, lumbar spine, or sacroiliac joint 34
• Women who were pregnant or nursing were excluded 59
• Medical conditions such as tumors or fractures 60
• Neuromuscular disorders that impair normal lumbopelvic morphology or progressive neurologic disease 60
• Disc pathologies identified through radiological imaging 17
• Pathologies of the hip joint and soft tissues 17
• Recent trauma history 17
• History of polyneuropathy, sciatic nerve injury, rheumatological disease, or malignancy 17
• Corticosteroid therapy or opioid-derived analgesia for pain during the previous month 17

Sponsors & Collaborators

• University of Management and Technology Sialkot Pakistan: lead

Study Sites (1)

University of Management and technology Sialkot Campus

Sialkot, Punjab Province, 51070, Pakistan

Location

Related Publications (4)

• Amjad F, Khalid A. Comparative effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome. J Orthop Surg Res. 2023 Nov 24;18(1):895. doi: 10.1186/s13018-023-04379-z.

  PMID: 37996838 RESULT

• De la Corte-Rodriguez H, Roman-Belmonte JM, Rodriguez-Damiani BA, Vazquez-Sasot A, Rodriguez-Merchan EC. Extracorporeal Shock Wave Therapy for the Treatment of Musculoskeletal Pain: A Narrative Review. Healthcare (Basel). 2023 Oct 26;11(21):2830. doi: 10.3390/healthcare11212830.

  PMID: 37957975 RESULT

• Kurkova S, Kyncl M, Ibrahim I, Lachman H, Sakmarova K, Machac S. Exploring non-invasive diagnostic tools for deep gluteal syndrome: a multimodal approach integrating clinical and imaging techniques. Quant Imaging Med Surg. 2025 Sep 1;15(9):8409-8422. doi: 10.21037/qims-2025-241. Epub 2025 Aug 13.

  PMID: 40893505 RESULT

• Carro LP, Hernando MF, Cerezal L, Navarro IS, Fernandez AA, Castillo AO. Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release. Muscles Ligaments Tendons J. 2016 Dec 21;6(3):384-396. doi: 10.11138/mltj/2016.6.3.384. eCollection 2016 Jul-Sep.

  PMID: 28066745 RESULT

Related Links

• Related Info

MeSH Terms

Conditions

Hip socket neuropathy

Study Officials

• Hamza Zahid

  University of Management and Technology Sialkot Pakistan

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The study followed a single-blinded design in which the outcome assessors were masked to the participants' treatment allocation. Assessors were not informed whether a participant belonged to the Bowen Technique with ESWT group or the Bowen Technique without ESWT group. This helped reduce assessment and observer bias during pre- and post-treatment measurements. Participants were aware of the treatment they received, but the assessors remained blinded throughout outcome evaluation
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head of the department

Model Details: This study uses a randomized controlled trial model to compare two physiotherapy interventions for Deep Gluteal Syndrome. A total of 46 participants are divided equally into two groups of 23 participants each. Group A receives Bowen Technique with Extracorporeal Shockwave Therapy, while Group B receives Bowen Technique without ESWT. Pain, lower-limb function, hip range of motion, and relevant clinical special tests are assessed before and after treatment. The model is designed to determine whether adding ESWT to Bowen Technique provides greater clinical improvement than Bowen Technique alone.

Study Record Dates

• First Submitted: August 10, 2026
• First Posted: August 19, 2026
• Study Start: May 1, 2026
• Primary Completion: June 25, 2026
• Study Completion: September 1, 2026
• Last Updated: August 21, 2026

Record last verified: 2026-08

Locations

PA (1)