HamstringsNCT06796491
Effects of PIR and PFS on Pain, ROM, and Disabilty in Tight Hamstring Syndrome
A study testing Post Isometric relaxation and Post Facilitation stretch in people with Hamstrings and Flexibility, run by Riphah International University at 1 site in Pakistan.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Hamstrings, Flexibility, Range of Motion
- What is being tested?
- Post Isometric relaxation and Post Facilitation stretch
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 sitePakistan
- Study dates
- 10 Mar 2025to 13 Jul 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 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)
Who cannot join
- 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)
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects of Post Isometric Relaxation and Post Facilitation Stretch on Pain, Range of Motion and Disability in Patients With Tight Hamstrings 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.
Read the detailed description
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.
- Conditions
- Hamstrings, Flexibility, Range of Motion, Disability
- Being tested
- Post Isometric relaxation, Post Facilitation stretch
- Keywords
- Hamstrings, Flexibility, Muscle Energy Techniques, Range of motion, Post Facilitation Stretching, Post Isometric relaxation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Post Isometric relaxationOther
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 stretchOther
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
| Study group | Role | What they receive |
|---|---|---|
| Post Isometric Relaxation | Experimental | Patient applied the sub-maximal contraction almost 20%. Isometric contraction will be held for 10 seconds and then slight stretch for 30 seconds will be maintained. 4 contractions per treatment with 3 seconds rest between each contraction. This protocol continues 3 days/week for 4 weeks Receives: Other: Post Isometric relaxation |
| Post Facilitation Stretch | Active comparator | Isometric contraction will be held for 10 seconds and then slight stretch for 30 seconds will be maintained. 4 contractions per treatment with 3 seconds rest between each contraction. This protocol continues 3 days/week 4 weeks. for hamstring flexibility Receives: Other: Post Facilitation stretch |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric pain rating scale
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.
Measured: 4th week
Secondary outcomes (2)
Active Knee Extension Test
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.
Measured: 4th week
Modified Oswestry Disability Index
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.
Measured: 4th week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Jan 2025
- Study start10 Mar 2025
- Primary completion1 Jul 2025
- Study completion13 Jul 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for HamstringsStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 46 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Hira Shaukat, TDPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06796491
- Sponsor's protocol ID
- REC/RCR&AHS/24/0155
- Status last verified
- Jul 2025
- First submitted
- 22 Jan 2025
- Last updated
- 15 Jul 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Castellote-Caballero Y, Valenza MC, Puentedura EJ, Fernandez-de-Las-Penas C, Alburquerque-Sendin F. Immediate Effects of Neurodynamic Sliding versus Muscle Stretching on Hamstring Flexibility in Subjects with Short Hamstring Syndrome. J Sports Med (Hindawi Publ Corp). 2014;2014:127471. doi: 10.1155/2014/127471. Epub 2014 Apr 15.
PubMed 26464889Duhig S, Shield AJ, Opar D, Gabbett TJ, Ferguson C, Williams M. Effect of high-speed running on hamstring strain injury risk. Br J Sports Med. 2016 Dec;50(24):1536-1540. doi: 10.1136/bjsports-2015-095679. Epub 2016 Jun 10.
PubMed 27288515Woods C, Hawkins RD, Maltby S, Hulse M, Thomas A, Hodson A; Football Association Medical Research Programme. The Football Association Medical Research Programme: an audit of injuries in professional football--analysis of hamstring injuries. Br J Sports Med. 2004 Feb;38(1):36-41. doi: 10.1136/bjsm.2002.002352.
PubMed 14751943Rahnama N. Prevention of football injuries. Int J Prev Med. 2011 Jan;2(1):38-40. No abstract available.
PubMed 21448404Skoffer B. Low back pain in 15- to 16-year-old children in relation to school furniture and carrying of the school bag. Spine (Phila Pa 1976). 2007 Nov 15;32(24):E713-7. doi: 10.1097/BRS.0b013e31815a5a44.
PubMed 18007232Arab AM, Nourbakhsh MR. Hamstring muscle length and lumbar lordosis in subjects with different lifestyle and work setting: comparison between individuals with and without chronic low back pain. J Back Musculoskelet Rehabil. 2014;27(1):63-70. doi: 10.3233/BMR-130420.
PubMed 23948840Hollman JH, Berling TA, Crum EO, Miller KM, Simmons BT, Youdas JW. Do Verbal and Tactile Cueing Selectively Alter Gluteus Maximus and Hamstring Recruitment During a Supine Bridging Exercise in Active Females? A Randomized Controlled Trial. J Sport Rehabil. 2018 Mar 1;27(2):138-143. doi: 10.1123/jsr.2016-0130. Epub 2018 Mar 1.
PubMed 28121207Kumazaki T, Ehara Y, Sakai T. Anatomy and physiology of hamstring injury. Int J Sports Med. 2012 Dec;33(12):950-4. doi: 10.1055/s-0032-1311593. Epub 2012 Aug 15.
PubMed 22895873
Study at a glance
From the registry record, last updated by the sponsor on 15 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Post Isometric Relaxation and Post Facilitation Stretch on Pain, Range of Motion and Disability in Patients With Tight Hamstrings Syndrome
- ClinicalTrials.gov ID
- NCT06796491
- Acronym / sponsor ID
- REC/RCR&AHS/24/0155
- Conditions
- Hamstrings, Flexibility, Range of Motion, Disability
- Keywords
- Hamstrings, Flexibility, Muscle Energy Techniques, Range of motion, Post Facilitation Stretching, Post Isometric relaxation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 46 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 10 Mar 2025 (actual)
- Primary completion
- 1 Jul 2025 (actual)
- Study completion
- 13 Jul 2025 (actual)
- First posted
- 28 Jan 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Post Isometric Relaxation | Experimental | Other: Post Isometric relaxationPatient applied the sub-maximal contraction almost 20%. Isometric contraction will be held for 10 seconds and then slight stretch for 30 seconds will be maintained. 4 contractions per treatment with 3 seconds rest between each contraction. This protocol continues 3 days/week for 4 weeks |
| Post Facilitation Stretch | Active comparator | Other: Post Facilitation stretchIsometric contraction will be held for 10 seconds and then slight stretch for 30 seconds will be maintained. 4 contractions per treatment with 3 seconds rest between each contraction. This protocol continues 3 days/week 4 weeks. for hamstring flexibility |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- 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)
Key exclusion criteria (7 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Post Isometric relaxationGroup 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 | Other | Post Isometric Relaxation |
| Post Facilitation stretchGroup 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 | Other | Post Facilitation Stretch |
Primary outcome
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.
2 secondary outcomes
Active Knee Extension Test
Time frame: 4th week
Modified Oswestry Disability Index
Time frame: 4th week
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jul 2025.
- Background: PubMed 26464889Castellote-Caballero Y, Valenza MC, Puentedura EJ, Fernandez-de-Las-Penas C, Alburquerque-Sendin F. Immediate Effects of Neurodynamic Sliding versus Muscle Stretching on Hamstring Flexibility in Subjects with Short Hamstring Syndrome. J Sports Med (Hindawi Publ Corp). 2014;2014:127471. doi: 10.1155/2014/127471. Epub 2014 Apr 15.
- Background: PubMed 27288515Duhig S, Shield AJ, Opar D, Gabbett TJ, Ferguson C, Williams M. Effect of high-speed running on hamstring strain injury risk. Br J Sports Med. 2016 Dec;50(24):1536-1540. doi: 10.1136/bjsports-2015-095679. Epub 2016 Jun 10.
- Background: PubMed 14751943Woods C, Hawkins RD, Maltby S, Hulse M, Thomas A, Hodson A; Football Association Medical Research Programme. The Football Association Medical Research Programme: an audit of injuries in professional football--analysis of hamstring injuries. Br J Sports Med. 2004 Feb;38(1):36-41. doi: 10.1136/bjsm.2002.002352.
- Background: PubMed 21448404Rahnama N. Prevention of football injuries. Int J Prev Med. 2011 Jan;2(1):38-40. No abstract available.
- Background: PubMed 18007232Skoffer B. Low back pain in 15- to 16-year-old children in relation to school furniture and carrying of the school bag. Spine (Phila Pa 1976). 2007 Nov 15;32(24):E713-7. doi: 10.1097/BRS.0b013e31815a5a44.
- Background: PubMed 23948840Arab AM, Nourbakhsh MR. Hamstring muscle length and lumbar lordosis in subjects with different lifestyle and work setting: comparison between individuals with and without chronic low back pain. J Back Musculoskelet Rehabil. 2014;27(1):63-70. doi: 10.3233/BMR-130420.
- Background: PubMed 28121207Hollman JH, Berling TA, Crum EO, Miller KM, Simmons BT, Youdas JW. Do Verbal and Tactile Cueing Selectively Alter Gluteus Maximus and Hamstring Recruitment During a Supine Bridging Exercise in Active Females? A Randomized Controlled Trial. J Sport Rehabil. 2018 Mar 1;27(2):138-143. doi: 10.1123/jsr.2016-0130. Epub 2018 Mar 1.
- Background: PubMed 22895873Kumazaki T, Ehara Y, Sakai T. Anatomy and physiology of hamstring injury. Int J Sports Med. 2012 Dec;33(12):950-4. doi: 10.1055/s-0032-1311593. Epub 2012 Aug 15.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Hira Shaukat, TDPT principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Post Isometric relaxation and Post Facilitation stretch in people with Hamstrings and Flexibility, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric pain rating scale (time frame: 4th week). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06796491, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2025.