Effects of Fascial Distortion Model With and Without Neuromuscular Inhibition in Patients With Piriformis Syndrome

Study Overview
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Brief Summary
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The aim of study will be to find the effects of fascial distortion model (FDM) with and without the Integrated neuromuscular inhibition technique (INIT) in piriformis syndrome.

Detailed Description
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Piriformis syndrome is a misdiagnosed cause of sciatica leg or buttock pain and disability. The male and female incidence ratio of PS is 6.1. The fascial distortion model is a targeted manual technique and decodes categorized manual gestures (pain-related body language) to 6 pathophysiological mechanisms involved in the etiology of pain. Integrated neuromuscular inhibition technique(INIT) is a combination of muscle energy technique(MET) and positional release technique(PRT). All previous studies in which integrated neuromuscular inhibition technique(INIT) and fascial distortion model(FDM) has been performed on different muscles of the body has shown greater improvement as compared to other techniques. Comparative effects of fascial distortion model with integrated neuromuscular inhibition technique and fascial distortion model on Piriformis Syndrome has not been addressed yet. There is very limited data available on this protocol. Therefore, this study aims to compare the effects of facial distortion model with and without integrated neuromuscular inhibition technique.

Official Title
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Comparative Effects of Fascial Distortion Model With and Without Neuromuscular Inhibition Technique on Pain, Range of Motion and Quality of Life in Patients With Piriformis Syndrome

Conditions
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Piriformis Syndrome

Intervention / Treatment
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* Other: Fascial distortion method with neuromuscular inhibition technique
* Other: Fascial distortion method


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Unilateral buttock pain and radiculopathy due to spasms of the piriformis muscle or sciatic nerve compression. Aggravate buttock pain in sitting and limited SLR. Patient with Freiberg test positive. Patient with FAIR test positive. Patient with positive Pace test. Patient with positive Beatty's maneuver. Exclusion Criteria: Lumbar spinal pathology and recent injury around the hip, sacroiliac joint, or lumbar spine. Patient with a positive Faber test SIJ Pathology like SIJ dysfunction, innominate anterior or posterior rotation dysfunction, etc. Deep gluteal syndrome. Recent surgery like hip arthroplasty, surgical emplacement of a gluteal implant (buttock prosthesis); lip sculpture (fat transfer and liposuction); and body contouring (surgery and lip sculpture).

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Fascial distortion method with neuromuscular inhibition technique<br>27 participants will receive the fascial distortion method followed by the neuromuscular inhibition technique for trigger points. After this, neural mobilization will be given as stander treatment. | Other: Fascial distortion method with neuromuscular inhibition technique<br>* 27 participants will receive FDM with INIT followed by neural mobilization for a total of 20 to 30 minutes, 3 times per week on alternate days for 6 weeks.<br>|
| Active Comparator: Fascial distortion method<br>Fascial distortion will be applied to 27 participants where the tip of the thumb worms its way through the peripheral tissue until it rests on the distortion. Force is focused directly on the most painful spot until the provider feels like a button-slipping-into-a-buttonhole. After this, neural mobilization will be given as a stander treatment. | Other: Fascial distortion method<br>* 27 participants will receive FDM followed by neural mobilization for a total of 20 to 30 minutes, 3 times per week on alternate days for 6 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NPRS for pain | The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). | 6th week | 
| Sciatica bothersomeness Index for sciatica | It is a composite score of four questions (each score ranging from 0-6) that include elements of leg pain and sensory and motor disturbances. | 6th week | 
| Short Form Health Survey (SF-36) questionnaire for quality of life | It is used to indicate the health status of particular populations, to help with service planning and to measure the impact of clinical and social interventions. | 6th week | 
| Goniometer for range of motion | It is a tool used to measure range of motions of different joints | 6th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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integrated neuromuscular inhibition technique, muscle energy technique, piriformis syndrome, positional release technique, fascial distortion model