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NCT Number: NCT07547059

Comparative Effects of Post Facilitation Stretch and Active Release Technique in Female Patients With Piriformis Syndrome.

This clinical study aimed to compare the effectiveness of Post-Facilitation Stretch (PFS) and Active Release Technique (ART) on pain, disability, quality of life, and range of motion of hip internal and external rotation in female patients with piriformis syndrome. After recruitment, participants were randomly allocated into two groups using the chit-box method, either in group A Post-Facilitation Stretch, and group B Active Release Technique. Clinical outcomes including pain, disability, quality of life, and hip range of motion (abduction and internal rotation) were assessed at baseline, during the third week of treatment, and at the sixth-week follow-up from the National Institute of Rehabilitation and Medicine (NIRM) Hospital.

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Key information

Conditions

Piriformis Syndrome Mononeuropathies Nerve Compression Syndromes Nervous System Diseases Neuralgia Neurologic Manifestations Neuromuscular Diseases Pain Pathological Conditions, Signs and Symptoms Pelvic Pain Peripheral Nervous System Diseases Piriformis Muscle Syndrome Sciatic Neuropathy Signs and Symptoms

Age range

25 year–45 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Faculty of Allied Health & Biological Sciences

Islamabad, Pakistan

About this study

Background: Piriformis syndrome (PS) is a neuromuscular condition in which the piriformis muscle irritates the sciatic nerve, causing pain, numbness, and tingling in the buttock, hip, and posterior thigh, sometimes radiating to the low back or sacroiliac joint. Women are more commonly affected, comprising 35-79% of cases (Hopayian et al., 2010). Conservative physiotherapy interventions are effective in improving pain, function, and quality of life.

Literature / Rationale: Post-Facilitation Stretch (PFS) involves isometric contraction followed by stretching of the piriformis to enhance hip range of motion (ROM) and reduce pain. Active Release Technique (ART) targets soft tissue adhesions to improve mobility and function. Prior studies indicate benefits of these techniques individually, but direct comparisons in female patients are limited.

Methods: Forty female patients with PS at NIRM Islamabad were randomly allocated via chit-box into PFS and ART groups. Interventions were administered twice weekly for 3 weeks.

PFS: Supine, hip >60° flexion, slight adduction/external rotation; 10-sec isometric external rotation contraction + 30-sec relaxation; stretch into internal rotation/adduction 15 sec; repeat 5× per session(Shahzad et al., 2020).

ART: Targeted soft tissue release of the piriformis muscle.

Outcomes included pain (measured by NPRS), hip IR and abduction ROM (measured by goniometer), functional disability (measured by LEFS-U), and quality of life (measured by SF-36), assessed at baseline, week 3, and week 6.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 25 to 45-year-old women.
  • Clinically diagnosed with piriformis syndrome by Orthopaedic Surgeon.
  • Unilateral pain.
  • Sitting exacerbates buttock pain.
  • External soreness in the vicinity of the greater sciatic notch.
  • Positive findings on standard piriformis syndrome clinical tests (FAIR, Beatty, Freiberg, and Pace).
  • Limited SLR ability

Exclusion criteria

  • History of trauma and malignancies.
  • Hip dislocation, osteoporosis, and femur fractures.
  • Any postural abnormality, including disc pathology.
  • Patients with neurological symptom, metabolic disease (RA) and diagnosed psychological problem.
  • Pregnancy.

Treatment and study plan

Post facilitation stretch

Other

Following a 10-minute application of a moist hot pack, participants were positioned supine with the hip flexed beyond 60° and gentle resistance was applied to facilitate an isometric external rotation contraction. This was followed by a passive stretch held for 15 seconds, performed for 5 repetitions per session.

Active Release Technique

Other

Following a 10-minute application of a moist hot pack, participants were positioned prone, and deep manual pressure was applied over the piriformis muscle for approximately 90 seconds while the patient actively moved the hip from internal to external rotation. This procedure was repeated for 10 repetitions per session.

Primary outcomes

  1. Pain Intensity

    Time frame: Assessment was done at baseline, 3rd week and 6th week

    Pain was measured by Numerical Pain Rating Scale. On this scale, ten values range from 0 to 10, with 0 representing "no pain" and 10 representing "worst possible pain."

  2. Disability

    Time frame: Assessment was done at baseline, 3rd week and 6th week

    Disability was measured by the Urdu version of the Lower Extremity Functional Scale. It is a 20-item self-report questionnaire assessing functional difficulty in daily, work, and recreational activities for adults with lower limb musculoskeletal conditions. Ranging from 0 (extreme difficulty) to 80 (high function).

  3. Quality of life of Patients

    Time frame: Assessment was done at baseline, 3rd week and 6th week

    Quality of life was measured by the Short Form Health Survey (SF-36) questionnaire. The overall score goes from 0 to 100. Higher scores indicate a higher quality of life, while lower numbers indicate a lower quality of life.

  4. Hip abduction and internal rotation range of motion

    Time frame: Assessment was done at baseline, 3rd week and 6th week

    Hip abduction and internal rotation range of motion was measured by goniometer

Sponsors and collaborators

Lead sponsor

Ibadat International University, Islamabad

Other

Registry information

Official study title

Comparative Effects of Post Facilitation Stretch and Active Release Technique on Pain, Disability, Quality of Life and Range of Motion in Female Patients With Piriformis Syndrome.

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Apr 23, 2026
Registry last updated
Apr 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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