Comparative Effect of Active Release Technique Versus Self-myofascial Release in Improving Piriformis Syndrome
Condition: Piriformis Syndrome
MeSH terms: Piriformis Muscle Syndrome; Syndrome
Study type: Interventional

Summary: 
      The goal of this Randomized controlled trial is to examine comparative effect of active
      release technique versus self-myofascial release in improving piriformis syndrome. The main
      question it aims to answer is:

      • To compare the effects of Active release technique (ART) and Self-Myofascial release (SMFR)
      on pain intensity, hip internal rotation and functional disability in patients with
      piriformis syndrome.

      Participants will be a given consent form and after subjects read and sign the informed
      consent, they would be included in study according to eligibility criteria. 2 groups would be
      included in study, Active release technique will be applied on group A by the physiotherapist
      and self-myofascial release will be applied on group B by the patients themselves through the
      use of foam-rollers and massage ball to compare the results of both these techniques on
      reducing pain, improving range and functional disability among individuals with piriformis
      syndrome. We will measure outcome through different outcome measure tools.
    

Detailed description: 
      Piriformis is a key internal rotator of the hip which develops muscular imbalance due to
      overuse and pressure. There are various disabling conditions caused due to a simple tightness
      of Piriformis muscle like low back pain, sciatic nerve pain through muscle hypertrophy or a
      nearby anomaly due to its anatomically closeness to the sciatic nerve, pain and aesthesia in
      hip, thigh, calf and foot are symptoms that commonly occur in Piriformis syndrome. Piriformis
      syndrome is defined as a peripheral neuritis of the branches of the sciatic nerve caused by
      an abnormal condition of the piriformis muscle (PM), such as an injured or irritated muscle.

      MFR technique involves application of a low load-long duration stretch to the myofascial
      complex which intends to restore the optimal length, decrease pain and improve functional
      mobility of the muscle. A special technique within MFR is self-myofascial release (SMFR),
      performed by the patient independently, instead of by a therapist. This technique utilizes
      the patient's body mass and special tools such as massage balls or foam rollers to apply
      pressure and stretch the restricted soft tissue. Active Release Techniques (ART) are a soft
      tissue method that focuses on relieving tissue tension via the removal of fibrosis/adhesions
      which can develop in tissues as a result of overload due to repetitive use.

      Active release technique will be applied on group A by the physiotherapist and
      self-myofascial release will be applied on group B by the patients themselves through the use
      of foam-rollers and massage ball to compare the results of both these techniques on reducing
      pain, improving range and functional disability among individuals with piriformis syndrome.
    

Intervention name(s): Active release technique; Self-myofascial release
Intervention type(s): Other; Other
Intervention description(s): Active Release Technique was applied to patient in prone lying, knee flexed at 90. The therapist placed his elbow tip on taut band of piriformis and direct pressure applied, patient wias then asked to do internal rotation of hip, in order to achieve lengthening of the muscle. This was repeated 5-7 times.
A total of 18 sessions was given over a period of 6 weeks (3 sessions per week); Patient position in prone lying Therapist was standing beside the patient at the waistline, working on the contralateral side.
Piriformis muscle was located by an imaginary line drawn between the midpoint of the lateral aspect of the sacrum and the greater trochanter. A contact was established in the gluteal area about 3 cm from the sacrum. Patent was guided to use a foam roller followed by a massage ball.
A total of 18 sessions were given over a period of 6 weeks (3 sessions per week)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment