Effects of Hold Relax With Agonist Contraction and Active Release Therapy on Clinical Outcomes in Piriformis Syndrome

Study Overview
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Brief Summary
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The aim of this study is to compare the effects of hold relax agonist contraction and active release therapy on reducing pain intensity, improving functioning and sleep quality in patient with piriformis syndrome. Both these techniques are passive, non-invasive manual therapy techniques which are easy to perform and less time consuming and may yield better outcomes resulting improved quality of life.

Official Title
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Comparative Effects of Hold Relax With Agonist Contraction and Active Release Therapy on Pain, Functional Disability and Sleep Quality in Piriformis Syndrome

Conditions
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Piriformis Syndrome

Intervention / Treatment
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* Other: Hold Relax with Agonist Contraction
* Other: Active Release Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age group 25-55 years Both male and female. Gluteal pain with or without radicular symptoms. Patients of piriformis syndrome diagnosed by orthopedic consultant. Sub-acute and chronic piriformis syndrome. Unilateral pain. Pain score equal to and greater than 3 according to pain rating scale. Exclusion Criteria: Intermittent vascular claudication and spondylolisthesis. Past history of hip, femur or vertebral fracture Past history of spinal surgery. Spinal tuberculosis. Rheumatoid disease. Disc pathology, sacroiliac joint dysfunction or mechanical back pain. History of infectious disease. Leg length discrepancy. Any postural abnormality or deformity.

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Group A: Hold Relax with Agonist Contraction with Routine Physical Therapy Group B: Active Release Therapy with Routine Physical Therapy
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group A<br>This group of participants will receive Hold Relax with Agonist Contraction (HR-AC) technique with routine physical therapy. The protocol will be given to the participants for two weeks (6 sessions on alternate days, 3 session per week). Each session will be of 60 minutes. The data will be collected before applying intervention, at first week and at 2nd week. | Other: Hold Relax with Agonist Contraction<br>* Participant will be in prone lying and heating pad will be applied on gluteal region for 10 to 15 minutes. Passive sustained stretch to piriformis will be applied for 10 seconds. The participant will be asked to actively contract the muscle for about 10 seconds (isometric contraction) and then relax. Immediately after that participant is ask to again actively contract the muscle against therapist resistance for 6-10 seconds. Ask the participant to relax while therapist will apply stretch the muscle to its new tissue tension barrier position and this position will be maintained for 30 seconds. This maneuver is repeated for 3 to 4 repetitions, each starting from where the previous finished.<br>* Other names: Proprioceptive Neuromuscular Facilitation Technique;|
| Active Comparator: Group B<br>This group of participants will receive Active Release Therapy, a kind of soft tissue mobilization along with routine physical therapy. The protocol will be given to the participants for two weeks (6 sessions on alternate days, 3 session per week). Each session will be of 60 minutes. The data will be collected before applying intervention, at first week and at 2nd week. | Other: Active Release Therapy<br>* Specific muscle will be warmed up by applying heating pad for 10 to 15 minutes. Patient will be positioned prone lying and the therapist will be standing at the side of affected limb. Therapist will apply deep pressure at the area of tenderness while patient will actively move the limb from internal to external rotation repeatedly. This maneuver will take about 15 minutes to complete in one session and will be applied alternatively 3 days a week for two weeks. After this, cold pack is applied and general ROMs and strengthening exercises are performed to prevent soreness<br>* Other names: Soft Tissue Mobilization;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Pain Intensity | Numeric Pain Rating Scale will be used to measure the intensity of pain | Pain score will be measured at the baseline, at end of first session and at 6th session on 2nd week | 
| Change in Functional Disability | Ronald-Morris Disability Questionnaire will be used to a assess the level of disability | Change in functional status will be measured at the baseline, at end of first session and at end of 6th session | 
| Sleep Quality | Chronic Pain Sleep Inventory will be used to to assess the quality of sleep on a 100 mm VAS scale | Sleep quality will be measured at the baseline, at end of first session and at end of 6th session | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Function, Pain,Hold Relax ,Sleep Quality, Mobilization