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Completed

NCT Number: NCT06796491

Effects of PIR and PFS on Pain, ROM, and Disabilty in Tight Hamstring Syndrome

This randomized clinical trial aims to compare the effects of post-isometric relaxation (PIR) and post-facilitation stretch (PFS) on pain, range of motion, and disability in individuals with tight hamstring syndrome. Conducted at Riphah Rehabilitation Clinic, Lahore, participants aged 18-35 years with posterior thigh pain will be divided into two groups. Both groups will receive hot pack therapy and core strengthening exercises, with Group A receiving PIR and Group B receiving PFS. Outcomes will be assessed at baseline and after 4 weeks using NPRS, a disability questionnaire, and a goniometer, with data analyzed using SPSS version 25.

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Key information

Conditions

Hamstrings Disability Flexibility Range of Motion

Age range

18 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Zafar Hospital lahore

Lahore, Punjab Province, 54810, Pakistan

About this study

Both PIR and PFS are subtypes of Muscle Energy Techniques (MET) that have shown potential in improving muscle flexibility and reducing discomfort. This study aims to address the impacts of PIR and PFS on pain, ROM, and disability in patients with tight hamstrings syndrome, providing valuable insights for clinical practice and enhancing the understanding of effective interventions for this common musculoskeletal issue.

The current literature on stretching techniques for musculoskeletal conditions reveals several gaps specifically relevant to the effects of Post Isometric Relaxation (PIR) and Post Facilitation Stretch (PFS) on tight hamstrings syndrome. Despite the high incidence of hamstring tightness and its association with conditions such as nonspecific low back pain, there is limited research directly comparing the effects of Post Isometric Relaxation (PIR) and Post Facilitation Stretch (PFS) on this condition. While studies have explored various stretching methods such as Muscle Energy Technique (MET), static stretching, and myofascial release, there is a notable lack of direct comparative research between PIR and PFS in patients with tight hamstrings. Additionally, existing studies had often focused on immediate or short-term outcomes, with limited investigation into the long-term effects of these techniques on pain, range of motion (ROM), and disability.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Both male and female
  • Age between 18 to 35 years(45)
  • Bilateral hamstring muscle tightness
  • Individuals having lack of Active knee extension more than 20 degrees(46)

Exclusion criteria

  • Low back pain radiating to the back of thigh
  • History of fracture, dislocation of hip(47)
  • Acute or chronic hamstring injury
  • Any neurological disease(48)
  • Congenital deformity of the lower limb
  • Inflammatory condition that affects motion
  • A history of a cervical whiplash injury(45)

Treatment and study plan

Post isometric relaxation

Other

Group A will receive Post Isometric Relaxation (PIR) Patient applied the sub-maximal contraction almost 20%. Isometric contraction was held for 10 seconds and then slight stretch for 30 seconds was maintained.4 contractions per treatment with 3 seconds rest between each contraction. This protocol continues 3 days/week for 4 weeks conventional treatment Hot pack for 10 minutes Pelvic bridging: The subjects will be asked to lie supine and with knee flexed and then raise the pelvis upward till the comfort then hold that position for 5 sec and repetitions were 10 times Cat and camel: The subjects will be requested to prone kneel and then take a deep breath from nose while making hump in the back (cat) and breathe out from mouth while curving the spine (camel) for 5 second 10 times repetitions

Post facilitation stretch

Other

Group B will receive Post Facilitation Stretch (PFS) Isometric contraction was held for 10 seconds and then slight stretch for 30 seconds was maintained. 4 contractions per treatment with 3 seconds rest between each contraction. This protocol continues 3 days/week 4 weeks. for hamstring flexibility conventional treatment Hot pack for 10 minutes Pelvic bridging: The subjects will be asked to lie supine and with knee flexed and then raise the pelvis upward till the comfort then hold that position for 5 sec and repetitions were 10 times Cat and camel: The subjects will be requested to prone kneel and then take a deep breath from nose while making hump in the back (cat) and breathe out from mouth while curving the spine (camel) for 5 second 10 times repetitions

Primary outcomes

  1. Numeric pain rating scale

    Time frame: 4th week

    The severity of pain will be measured by using the NPRS scale, which goes from '0' (meaning there is no pain) to 10'' (meaning there is most agony possible) ("pain is severe as you can imagine"). It was accepted that the scale was convenient for determining patients' pain thresholds. The NPRS scale has a score range of 0 to 10. It was a valid and reliable tool. Va;idity ranging from 0.79 to 0.95 and reliability from 0.67 to 0.96.

Secondary outcomes

  1. Active Knee Extension Test

    Time frame: 4th week

    AKE is an active test considered as a gold standard for hamstring flexibility assessment. The AKE test interrater reliability was excellent, with ICC2, values of 0.87 (0.58-0.97; 95%CI) for the dominant knee and 0.81 (0.41-0.94; 95%CI) for the nondominant knee and standard error of measurement (SEM) values of 3.5° (18.0°- 31.7°; 95%CI) and 3.8° (16.9°-31.7°; 95%CI) respectively. Minimal detectable change was between 9.7° and 10.5°. No significant difference in mean AKE measurements was noted between the first and second testing sessions for both raters (Table 4). The ICC3,1 values ranged from 0.78 to 0.92.

  2. Modified Oswestry Disability Index

    Time frame: 4th week

    The Oswestry Disability Index (ODI) has become one of the principal condition-specific outcome measures used in the management of spinal disorders. The ODI remains a valid and vigorous measure of condition-specific disability. The authors recommend the use of version 2.0. The data presented are a guide to the power of the instrument to detect meaningful changes in disability status.

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Effects of Post Isometric Relaxation and Post Facilitation Stretch on Pain, Range of Motion and Disability in Patients With Tight Hamstrings Syndrome

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jan 28, 2025
Registry last updated
Jul 15, 2025

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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