Effects of MET and MFR on Piriformis Syndrome

Participants included in the study will complete the Sociodemographic Information Form, Oswestry Disability Index (ODI), Lower Extremity Functional Scale (LEFS), World Health Organization Quality of Life Scale Brief Form (WHOQOL-BREF), Pittsburgh Sleep Quality Index (PSQI), and the Short-Form McGill Pain Questionnaire (SF-MPQ).

Additionally, participants will undergo the 6-Minute Walk Test (6MWT). Lower extremity muscle strength will be evaluated using a digital dynamometer, pain threshold will be assessed with an algometer, and muscle activation patterns will be evaluated using surface electromyography (sEMG) in the FAIR position.

The entire assessment procedure will take approximately 30-40 minutes, and all measurements will be performed under standardized conditions by the same researcher.

This study is a randomized controlled experimental trial aiming to compare the effects of two different manual therapy approaches, Muscle Energy Technique (MET) and Myofascial Release Technique (MFR), on pain threshold, muscle activation patterns, and muscle strength in individuals diagnosed with piriformis syndrome.

The study is designed as a pretest-posttest trial. Participants will be randomly allocated into three groups: the MET group, the MFR group, and the control group. All groups will receive treatment for 8 weeks, with 2 sessions per week, totaling 16 treatment sessions.

Inclusion criteria

• Individuals diagnosed with piriformis syndrome
• Presence of piriformis tenderness and sciatic symptoms
• Aged between 18 and 65 years
• Voluntary agreement to participate in the study
• No history of lumbar, hip, knee, or ankle surgery within the last year
• Ability to cooperate with the assessment and treatment procedures

Exclusion criteria

• Individuals younger than 18 years or older than 65 years
• Presence of any musculoskeletal disorder affecting the lower extremity
• Presence of neurological, cardiac, pulmonary, or orthopedic disorders preventing participation in exercise
• Presence of neurological deficits (muscle strength loss)
• History of radiotherapy to the lumbar or hip region
• Absence from more than 20% of treatment sessions
• Inability to comply with the study procedures (e.g., cognitive impairment, communication problems, severe psychiatric disorders)
• Corticosteroid or PRP injection within the last 3 months
• Participation in another physical therapy program within the last 3 months
• Use of analgesic, anti-inflammatory, or muscle relaxant medications within the last 48-72 hours
• Use of psychotropic medications that may affect muscle activation or nervous system responses (e.g., antidepressants, antipsychotics, sedatives)