A Movement-System-Impairment Approach to the Evaluation and Treatment
                    of a Patient with Piriformis Syndrome: A Case Report

Lim, Jin-yong; Lee, Il-woo; Kim, Dong-Hyun

doi:10.29273/jmst.2018.2.2.43

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…Regardless of the findings presented in the studies, caution should be exercised when determining cause and effect based on a single patient. [7][8][9] Objective: The study's goal was to determine the effects of hip abductors strengthening and piriformis stretching on pain, hip abductors strength, and lower extremity functional status in piriformis syndrome patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Hip Abductors Strengthening as Compared to Piriformis Muscle Stretching in Improving Lower Extremity Function in Patients with Piriformis Syndrome

Idrees¹,

Khan²,

Sharif³

et al. 2022

PJMHS

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Objective: The study's goal was to determine the effects of hip abductors strengthening and piriformis stretching on pain, hip abductors strength, and lower extremity functional status in piriformis syndrome patients. Methodology: A total of 60 patients were diagnosed with piriformis syndrome and referred to the Physiotherapy department from the NILD Assessment Clinic. Then, using simple random sampling, 60 patients were divided into two groups: Group-A (Hip abductor and Sciatic nerve mobilisation) and Group-B (no hip abductor and sciatic nerve mobilisation) (Sciatic nerve mobilisation and piriformis stretching). Each subject's demographic data was collected prior to the intervention. Data on pain severity, muscle strength (hip extensor and abductor), and lower extremity functional scale score were collected before and after treatment. Both groups continued to take their medications according to the evaluation clinic's recommendations. Results: Patient's average age was 57.18 ± 2.64 years. Out of 60 patients 19 belongs to age 35-45 year, 13 belongs to 45-55 year and 28 belongs to age group of 55-65 year. This table explains that mean difference of NPRS and Hip Abductor strength between two groups showed p-value 0.082 and 0.100 respectively statistically non-significant result, whereas, Hip Abductor strength and LEFS showed p-value 0.001 statistically significant difference between two groups. Conclusion: According to the findings piriformis syndrome can be treated without the use of stretching, electrophysical agents, or soft tissue mobilization. Considering that piriformis insertion is on greater trochanter. The excessive hip adduction and internal rotation shown during functional movement testing were exerting tension on this muscle, resulting in sciatic nerve compression. However only Group A improved in terms of hip abductor strength. Group A demonstrated considerable improvement in strength of hip abductor and lower extremity functional scale when compared to Group B.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Hip Abductors Strengthening as Compared to Piriformis Muscle Stretching in Improving Lower Extremity Function in Patients with Piriformis Syndrome

Idrees¹,

Khan²,

Sharif³

et al. 2022

PJMHS

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Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome

Danazumi

Yakasai

Ibrahim

et al. 2021

Journal of Osteopathic Medicine

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Context Studies have indicated that the muscle energy technique (MET) and the positional release technique (PRT) are effective in the management of piriformis syndrome (PS); however, evidence is scarce regarding the combination of these techniques in the form of an integrated neuromuscular inhibition technique (INIT) in the management of individuals with PS. Although a previous trial investigated the effect of INIT for PS, that study did not integrate Ruddy’s reciprocal antagonist facilitation (RRAF) method into the INIT protocol, nor did the authors diagnose PS according to established criteria. Objectives To examine the effects of INIT with integrated RRAF compared with PRT in the management of patients diagnosed with PS. Methods This study was designed as a single blind randomized clinical trial in which participants diagnosed with PS were randomly allocated into INIT and PRT groups. Each group attended two treatment sessions per week for 8 weeks. Patients in the INIT group received a protocol in which the patient’s tender point or trigger point was palpated in the belly of the piriformis approximately halfway between the inferior lateral angle of the sacrum and the greater trochanter, at which point the therapist applied an intermittent or sustained pressure and maintained the pressure for 20–60 seconds (depending on the participant’s response to pain reduction). For INIT patients, that protocol was also followed by RRAF, a method in which a patient introduces a series of tiny/miniature contractions or efforts (20 times per 10 seconds) against a therapist’s resistance. Patients in the PRT group were treated by palpating the same trigger point described in the INIT group, followed by application of light pressure at the location of the trigger point, which was maintained the pressure for 2 minutes or until the pain subsided (determined by asking the participant to report a pain score using a visual analog scale at 30 second intervals). For both groups, three repetitions of the INIT or PRT treatment were performed over 10 minutes at each clinical visit. Additionally, each group also received stretching exercises immediately after the INIT or PRT treatment session. Each participant was assessed at baseline, immediately posttreatment, and at 4 months posttreatment for pain, sciatica, functional mobility, quality of life, hip abduction, and internal rotation. A repeated measures analysis of variance (ANOVA) of within-between group interactions was used to analyze the treatment effect. Results Forty eight participants (age range, 25–47 years; mean age ± standard deviation, 32.81 ± 3.27 years) were randomized into the INIT and PRT groups, with 24 participants in each group. No significant between-group differences (p>0.05) were observed in the baseline demographic and clinical variables of the participants. A repeated-measures ANOVA indicated that there was a significant time effect for all outcomes, with a significant interaction between time and intervention (p<0.001). The Bonferroni post hoc analyses of time and intervention effects indicated that the INIT group improved significantly compared with the PRT group in all outcomes (p<0.05) immediately posttreatment and at the 4 months follow up period. Conclusions INIT was more effective than PRT in the management of individuals with PS. It should be noted the significant improvement achieved in both the groups may have also been contributed to by the stretching exercises that were used as adjunct therapies by both groups.

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A Movement-System-Impairment Approach to the Evaluation and Treatment of a Patient with Piriformis Syndrome: A Case Report

Cited by 2 publications

References 20 publications

Efficacy of Hip Abductors Strengthening as Compared to Piriformis Muscle Stretching in Improving Lower Extremity Function in Patients with Piriformis Syndrome

Efficacy of Hip Abductors Strengthening as Compared to Piriformis Muscle Stretching in Improving Lower Extremity Function in Patients with Piriformis Syndrome

Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome

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