Neural Gliders With and Without ESWT for Deep Gluteal Syndrome

NCT07772674 | Enrolling By Invitation DMC

• 1 other identifier: kuhs/dpt/umt-skt-00262
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

This study is a randomized controlled trial comparing Neural Gliders with and without Extracorporeal Shock Wave Therapy (ESWT) in patients with Deep Gluteal Syndrome. A total of 44 participants are divided equally into two groups: Group A receives neural gliders, ESWT, and conventional physiotherapy, while Group B receives neural gliders with conventional physiotherapy only. The study evaluates changes in pain, functional disability, and nerve mechano-sensitivity using NPRS, ODI, LEFS, Slump Test, FAIR Test, and SLR. Its aim is to determine whether adding ESWT provides greater clinical improvement than neural gliders alone.

Conditions

Deep Gluteal Syndrome

Keywords

Neural Gliders; Extracorporeal Shock Wave Therapy; Deep Gluteal Syndrome; Piriformis Muscle

Outcome Measures

Primary Outcomes (2)

• Universal Gonimeter

  A Universal Goniometer is a simple clinical instrument used to measure joint range of motion in degrees. It consists of a central axis or fulcrum with one stationary arm and one movable arm, which are aligned with anatomical landmarks during measurement. In this study, the goniometer is used during the Straight Leg Raise (SLR) test to record the angle at which pain, tightness, or neural symptoms appear. A lower SLR angle indicates greater restriction or nerve mechano-sensitivity, while an increased angle after treatment suggests improved nerve mobility and functional recovery.

  6 weeks

• NPRS

  The NPRS is simple 0-10 scale used to measure pain intensity. Patients rate their pain where 0=no pain and 10=worst possible pain. In your study, it helps track changes in buttock and leg caused by deep gluteal syndrome. A score reduction after treatment indicates improvement. Clinically, a change of ≥ 2 points is considered meaningful

  6 weeks

Secondary Outcomes (1)

• LEFS

  6 WEEKS

Study Arms (2)

GROUP A (Neural Gliders with ESWT)

EXPERIMENTAL

Arm Description: Participants in Group A will receive neural gliding exercises combined with radial Extracorporeal Shock Wave Therapy (ESWT) along with standardized conventional physiotherapy. Neural gliders will be performed in supine lying with the hip flexed, while ESWT will be applied over the piriformis/deep gluteal region. Neural gliding will be performed as 2 sets of 10 repetitions, and ESWT will be delivered at 2000 shocks per session with a frequency of 10-15 Hz. Treatment will be given 4 sessions per week for 6 weeks, with both groups also receiving a hot pack and piriformis stretching.

Other: Group A= Neural Gliders with ESWT

GROUP B (Neural Gliders Without ESWT)

OTHER

Arm Description: Participants in Group B will receive Neural Gliding exercises without ESWT, along with standardized conventional physiotherapy. Neural gliders will be performed in supine lying with the hip flexed, targeting the piriformis region and sciatic nerve pathway. The exercises will be performed as 2 sets of 10 repetitions, with treatment provided 4 sessions per week for 6 weeks. Conventional physiotherapy will include a 10-minute hot pack and piriformis stretching, with no ESWT applied in this group

Other: Group B= Neural Gliders without ESWT

Interventions

Group A= Neural Gliders with ESWT OTHER

We use Neural Gliders in Deep Gluteal Syndrome because the sciatic nerve can become irritated or restricted as it passes through the deep gluteal region. Neural gliding produces gentle alternating movements that allow the nerve to slide within its pathway, helping improve nerve mobility, reduce mechano-sensitivity, improve circulation around the nerve, and decrease pain and functional limitation. We combine Neural Gliders with ESWT because the two interventions target different components of the problem. Neural gliders mainly address nerve mobility and sensitivity, while ESWT is intended to act on the surrounding deep gluteal/piriformis tissues by helping reduce pain, improve blood flow, decrease tissue tightness, and stimulate healing.

GROUP A (Neural Gliders with ESWT)

Group B= Neural Gliders without ESWT OTHER

We use neural gliders to improve sciatic nerve mobility and reduce nerve mechano-sensitivity. We add ESWT because it may reduce pain, improve circulation, and treat tight or restricted deep gluteal tissues. Therefore, the combination may address both the nerve and the surrounding soft tissues more effectively."

GROUP B (Neural Gliders Without ESWT)

Eligibility Criteria

• Age: 25 Months - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), 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)

• Martin HD, Reddy M, Gomez-Hoyos J. Deep gluteal syndrome. J Hip Preserv Surg. 2015 Jul;2(2):99-107. doi: 10.1093/jhps/hnv029. Epub 2015 Jun 6.

  PMID: 27011826 RESULT

• 3. Hopayian, K., et al. (2020-2024). Clinical features of piriformis syndrome. European Spine Journal. https://doi.org/10.1007/s00586-020-06543

  RESULT

• 2. Vanti, C., et al. (2023). Deep gluteal syndrome: Clinical features and management. Journal of Orthopaedic Research. https://doi.org/10.1002/jor. (search source: Wiley Online Library)

  RESULT

• 1. Metikala, S., & Sharma, V. (2022). Deep gluteal syndrome: Sciatic nerve entrapment. Cureus. https://doi.org/10.7759/cureus

  RESULT

MeSH Terms

Conditions

Hip socket neuropathy

Study Officials

• Hamza Zahid, MS OMPT

  University of Management and Technology Sialkot Pakistan

  PRINCIPAL INVESTIGATOR

• Danyal Ahmad, PhD Scholar

  University of Management and Technology Sialkot Pakistan

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The outcome assessor was masked to group allocation. The assessor did not know whether the participant belonged to the Neural Gliders + ESWT group or the Neural Gliders-only group. Treatment was provided by a separate therapist, and participants were instructed not to disclose their treatment to the assessor. The assessor only performed the pre- and post-treatment outcome measurements using NPRS, LEFS, Slump Test, FAIR Test, and SLR. This was done to reduce observer and assessment bias.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study follows a single-blinded randomized controlled trial model involving 44 patients with Deep Gluteal Syndrome, randomly allocated into two equal groups of 22 participants. Group A receives Neural Gliders combined with ESWT and conventional physiotherapy, while Group B receives Neural Gliders with conventional physiotherapy only. Both groups are treated 3 times per week for 4 weeks. Outcomes are assessed before and after treatment using NPRS, LEFS, Slump Test, FAIR Test, and SLR to evaluate pain, functional disability, lower-limb function, and nerve mechano-sensitivity. The model is designed to determine whether adding ESWT to Neural Gliders provides additional clinical benefit compared with Neural Gliders alone.

Study Record Dates

• First Submitted: August 10, 2026
• First Posted: August 19, 2026
• Study Start: August 15, 2026
• Primary Completion: August 25, 2026
• Study Completion: September 30, 2026
• Last Updated: August 21, 2026

Record last verified: 2026-08

Locations

PA (1)