Piriformis SyndromePIR-PFS RCTNCT07255053
Comparative Effects of PIR and PFS on Pain, Hip ROM, and Disability in Piriformis Syndrome
A study testing Post Isometric Relaxation (PIR) and Post Facilitation Stretching (PFS) in people with Piriformis Syndrome, run by University of Faisalabad at 1 site in Pakistan.
Trial summary
This randomized clinical trial evaluates the effectiveness of Post-Isometric Relaxation (PIR) and Post-Facilitation Stretching (PFS) for managing pain, improving hip abduction and internal rotation, and enhancing functional capacity in patients with Piriformis Syndrome. Read more about this study
- Who is it for?
- Ages 35 to 55 yearsHealthy volunteers can take part
- Conditions the study is for
- Piriformis Syndrome
- What is being tested?
- Post Isometric Relaxation (PIR) and Post Facilitation Stretching (PFS)
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 2 Feb 2025to 20 Aug 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 35 to 55 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Participants aged 35-55 years Both genders Positive findings on three or more of the following tests: Piriformis, Beatty, Freiberg, FAIR, Sign of Pace, Nagel tonic external rotation of hip Bilateral buttock pain caused by compression of the sciatic nerve or piriformis muscle spasm NPRS pain score between 3 and 7 Tenderness to palpation over the sciatic foramen Diagnosed sub-acute or chronic Piriformis Syndrome Willing to participate
Who cannot join
- Any pathology or recent injury around the hip, knee, or SI joint, or radiating pain from the spine, SI joint, or hip History of spinal surgery or vertebral fracture History of systemic disease, stroke, leprosy, or amputation Leg pain not related to Piriformis Syndrome (e.g., disc herniation, sacroiliac joint dysfunction, degenerative joint disease) History of spinal injury, joint disease, or congenital abnormalities Limb length difference SI joint dysfunction Hip joint dislocation or femoral fracture Any postural deformity or anomaly (e.g., scoliosis) Psychologically diagnosed condition
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
The University of Faisalabad
Faisalābad, Punjab Province, 38000
About this study
Official title: Comparative Effects of Post Isometric Relaxation and Post Facilitation Stretching on Pain Reduction Hip Abduction and Internal Rotation Range, and Functional Disability in Patients With Piriformis Syndrome
This randomized clinical trial evaluates the effectiveness of Post-Isometric Relaxation (PIR) and Post-Facilitation Stretching (PFS) for managing pain, improving hip abduction and internal rotation, and enhancing functional capacity in patients with Piriformis Syndrome. Thirty-six participants will be assessed at baseline and six weeks using pain scores, hip range of motion, and functional scales to determine which technique provides superior outcomes.
Read the detailed description
Piriformis Syndrome (PS) is a musculoskeletal condition characterized by pain in the buttock and hip, sometimes radiating to the lower back and thigh. It may arise from anatomical variations affecting the sciatic nerve, inflammation, hypertrophy, muscle spasms, or shortening of the piriformis muscle. PS can significantly reduce hip range of motion and functional capacity, affecting patients' quality of life.
This randomized clinical trial aimed to compare the effectiveness of two rehabilitation techniques, Post-Isometric Relaxation (PIR) and Post-Facilitation Stretching (PFS), in managing pain, improving hip abduction and internal rotation, and enhancing functional capacity in patients with PS. Thirty-six participants aged 35-55 years, of both genders, diagnosed with sub-acute or chronic PS, and meeting specific clinical criteria, were randomly assigned to either intervention group.
Inclusion criteria included positive findings on at least three of the following tests: Piriformis, Beatty, Freiberg, FAIR, Sign of Pace, and Nagel tonic external rotation of hip; bilateral buttock pain due to sciatic nerve or piriformis muscle spasm; NPRS pain score of 3-7; tenderness over the sciatic foramen; and willingness to participate. Exclusion criteria included spinal, hip, knee, or SI joint pathology, prior spinal surgery or vertebral fracture, systemic disease, limb length discrepancy, postural deformities (e.g., scoliosis), hip dislocation or femoral fracture, and any psychological conditions.
Group A (PIR) participants performed exercises lying supine with the affected leg flexed, pelvis stabilized, and piriformis muscle activated through resisted abduction. Group B (PFS) participants performed combined stretching and isometric contractions with the involved leg positioned in hip flexion, adduction, and external rotation. Interventions were conducted over a 4-week period.
Assessments were conducted at baseline and six weeks using:
Numeric Pain Rating Scale (NPRS) to quantify pain intensity
Goniometer - to measure hip abduction and internal rotation range
Lower Extremity Functional Scale (LEFS) to assess functional disability; a 20-item scale rated on a Likert scale (total score 0-80), with lower scores indicating greater disability
The objective of this study was to determine which rehabilitation technique, PIR or PFS, is more effective in alleviating pain, improving hip range of motion, and enhancing functional outcomes, ultimately aiming to improve the quality of life for patients diagnosed with Piriformis Syndrome.
- Conditions
- Piriformis Syndrome
- Being tested
- Post Isometric Relaxation (PIR), Post Facilitation Stretching (PFS)
- Medical subject headings
- Piriformis Muscle Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Post Isometric Relaxation (PIR)Procedure or surgery
Also called Muscle Energy Technique (MET)
Participants received PIR exercises targeting the piriformis muscle three days per week for 4 weeks. The technique involved pain-free isometric contractions followed by gentle stretching to improve hip abduction and internal rotation
Post Facilitation Stretching (PFS)Procedure or surgery
Also called Muscle Energy Technique (MET)
Participants received PFS exercises targeting the piriformis muscle three days per week for 4 weeks. The technique combined isometric contractions with controlled stretching to enhance hip mobility and reduce pain.
| Study group | Role | What they receive |
|---|---|---|
| Post Isometric Relaxation (PIR) | Experimental | Type of technique: Muscle Energy Technique (MET)
Patient position: Supine, affected leg flexed at hip and knee, crossed over the other leg, foot resting on the table
Pelvis stabilization: Therapist hand on opposite ASIS to prevent pelvic movement
Leg positioning: Other hand on lateral aspect of the knee
Finding the barrier: Knee moved into abduction until first sign of resistance (pain-free end range)
Isometric contraction: Patient pushes against the therapist's hand at ~20% strength for 7-10 seconds
Relaxation and stretch: After contraction, leg moved slightly further into abduction
Repetitions: 3 times per session Receives: Procedure: Post Isometric Relaxation (PIR) |
| Post Facilitation Stretching (PFS) | Experimental | Patient position: Supine, affected leg slightly adducted and externally rotated, hip flexed >60°
Therapist hand placement: Inferior hand on table for support, superior hand guides leg movement
Muscle positioning: Piriformis placed in intermediate range (between full stretch and rest)
Isometric contraction: Patient externally rotates leg against resistance for 10 seconds
Pause / Rest phase: 30-second relaxation after contraction; therapist applies deeper stretch into adduction and external rotation
Next barrier: Leg gently moved to new barrier
Repetitions: 3 times per session Receives: Procedure: Post Facilitation Stretching (PFS) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity in patients with Piriformis Syndrome
Pain was measured using the Numeric Pain Rating Scale (NPRS), a 0-10 scale where 0 indicates no pain and 10 indicates worst possible pain.
Measured: Baseline and 4 weeks after intervention completion
Secondary outcomes (2)
Hip Abduction and Internal Rotation Range of Motion
Hip range of motion was measured using a goniometer to assess internal rotation and abduction angles.
Measured: Baseline and 4 weeks after intervention completion
Functional Disability
Functional capacity was assessed using the Lower Extremity Functional Scale (LEFS), a 20-item questionnaire evaluating lower limb function in daily activities. Lower scores indicate greater disability
Measured: Baseline and at 4 weeks after intervention completion
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Nov 2025
- Study start2 Feb 2025
- Primary completion10 Apr 2025
- Study completion20 Aug 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Piriformis SyndromeStudies of the same condition, open and under way.
- 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
- Model description
- Participants are randomly assigned to one of two groups: Post-Isometric Relaxation or Post-Facilitation Stretching, and interventions are delivered in parallel
- Masking
- None (open label)
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Faisalabad
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Aqsa Bashir, University of Faisalabad
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07255053
- Sponsor's protocol ID
- TUF-PIRIFORMIS-RCT-2025
- Acronym
- PIR-PFS RCT
- Status last verified
- Nov 2025
- First submitted
- 19 Nov 2025
- Last updated
- 28 Nov 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: De-identified individual participant data from this study, including pain scores (NPRS), hip range of motion (internal rotation and abduction), and functional scores (LEFS), will be shared with qualified researchers upon reasonable request. The shared data will be used for secondary analyses, meta-analyses, and reproducibility studies related to Piriformis Syndrome interventions.
Study at a glance
From the registry record, last updated by the sponsor on 28 Nov 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Post Isometric Relaxation and Post Facilitation Stretching on Pain Reduction Hip Abduction and Internal Rotation Range, and Functional Disability in Patients With Piriformis Syndrome
- ClinicalTrials.gov ID
- NCT07255053
- Acronym / sponsor ID
- PIR-PFS RCT / TUF-PIRIFORMIS-RCT-2025
- Conditions
- Piriformis Syndrome
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- University of FaisalabadUniversity, hospital or other
- Study start
- 2 Feb 2025 (actual)
- Primary completion
- 10 Apr 2025 (actual)
- Study completion
- 20 Aug 2025 (actual)
- First posted
- 28 Nov 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 evaluates the effectiveness of Post-Isometric Relaxation (PIR) and Post-Facilitation Stretching (PFS) for managing pain, improving hip abduction and internal rotation, and enhancing functional capacity in patients with Piriformis Syndrome. Thirty-six participants will be assessed at baseline and six weeks using pain scores, hip range of motion, and functional scales to determine which technique provides superior outcomes.
Detailed description
Piriformis Syndrome (PS) is a musculoskeletal condition characterized by pain in the buttock and hip, sometimes radiating to the lower back and thigh. It may arise from anatomical variations affecting the sciatic nerve, inflammation, hypertrophy, muscle spasms, or shortening of the piriformis muscle. PS can significantly reduce hip range of motion and functional capacity, affecting patients' quality of life.
This randomized clinical trial aimed to compare the effectiveness of two rehabilitation techniques, Post-Isometric Relaxation (PIR) and Post-Facilitation Stretching (PFS), in managing pain, improving hip abduction and internal rotation, and enhancing functional capacity in patients with PS. Thirty-six participants aged 35-55 years, of both genders, diagnosed with sub-acute or chronic PS, and meeting specific clinical criteria, were randomly assigned to either intervention group.
Inclusion criteria included positive findings on at least three of the following tests: Piriformis, Beatty, Freiberg, FAIR, Sign of Pace, and Nagel tonic external rotation of hip; bilateral buttock pain due to sciatic nerve or piriformis muscle spasm; NPRS pain score of 3-7; tenderness over the sciatic foramen; and willingness to participate. Exclusion criteria included spinal, hip, knee, or SI joint pathology, prior spinal surgery or vertebral fracture, systemic disease, limb length discrepancy, postural deformities (e.g., scoliosis), hip dislocation or femoral fracture, and any psychological conditions.
Group A (PIR) participants performed exercises lying supine with the affected leg flexed, pelvis stabilized, and piriformis muscle activated through resisted abduction. Group B (PFS) participants performed combined stretching and isometric contractions with the involved leg positioned in hip flexion, adduction, and external rotation. Interventions were conducted over a 4-week period.
Assessments were conducted at baseline and six weeks using:
Numeric Pain Rating Scale (NPRS) to quantify pain intensity
Goniometer - to measure hip abduction and internal rotation range
Lower Extremity Functional Scale (LEFS) to assess functional disability; a 20-item scale rated on a Likert scale (total score 0-80), with lower scores indicating greater disability
The objective of this study was to determine which rehabilitation technique, PIR or PFS, is more effective in alleviating pain, improving hip range of motion, and enhancing functional outcomes, ultimately aiming to improve the quality of life for patients diagnosed with Piriformis Syndrome.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Participants are randomly assigned to one of two groups: Post-Isometric Relaxation or Post-Facilitation Stretching, and interventions are delivered in parallel
| Arm | Type | Receives |
|---|---|---|
| Post Isometric Relaxation (PIR) | Experimental | Procedure: Post Isometric Relaxation (PIR)Type of technique: Muscle Energy Technique (MET) Patient position: Supine, affected leg flexed at hip and knee, crossed over the other leg, foot resting on the table Pelvis stabilization: Therapist hand on opposite ASIS to prevent pelvic movement Leg positioning: Other hand on lateral aspect of the knee Finding the barrier: Knee moved into abduction until first sign of resistance (pain-free end range) Isometric contraction: Patient pushes against the therapist's hand at ~20% strength for 7-10 seconds Relaxation and stretch: After contraction, leg moved slightly further into abduction Repetitions: 3 times per session |
| Post Facilitation Stretching (PFS) | Experimental | Procedure: Post Facilitation Stretching (PFS)Patient position: Supine, affected leg slightly adducted and externally rotated, hip flexed >60° Therapist hand placement: Inferior hand on table for support, superior hand guides leg movement Muscle positioning: Piriformis placed in intermediate range (between full stretch and rest) Isometric contraction: Patient externally rotates leg against resistance for 10 seconds Pause / Rest phase: 30-second relaxation after contraction; therapist applies deeper stretch into adduction and external rotation Next barrier: Leg gently moved to new barrier Repetitions: 3 times per session |
Who may qualify
- Ages
- 35 to 55 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- Participants aged 35-55 years Both genders Positive findings on three or more of the following tests: Piriformis, Beatty, Freiberg, FAIR, Sign of Pace, Nagel tonic external rotation of hip Bilateral buttock pain caused by compression of the sciatic nerve or piriformis muscle spasm NPRS pain score between 3 and 7 Tenderness to palpation over the sciatic foramen Diagnosed sub-acute or chronic Piriformis Syndrome Willing to participate
Key exclusion criteria (1 listed)
- Any pathology or recent injury around the hip, knee, or SI joint, or radiating pain from the spine, SI joint, or hip History of spinal surgery or vertebral fracture History of systemic disease, stroke, leprosy, or amputation Leg pain not related to Piriformis Syndrome (e.g., disc herniation, sacroiliac joint dysfunction, degenerative joint disease) History of spinal injury, joint disease, or congenital abnormalities Limb length difference SI joint dysfunction Hip joint dislocation or femoral fracture Any postural deformity or anomaly (e.g., scoliosis) Psychologically diagnosed condition
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 Relaxation (PIR)Also: Muscle Energy Technique (MET)Participants received PIR exercises targeting the piriformis muscle three days per week for 4 weeks. The technique involved pain-free isometric contractions followed by gentle stretching to improve hip abduction and internal rotation | Procedure or surgery | Post Isometric Relaxation (PIR) |
| Post Facilitation Stretching (PFS)Also: Muscle Energy Technique (MET)Participants received PFS exercises targeting the piriformis muscle three days per week for 4 weeks. The technique combined isometric contractions with controlled stretching to enhance hip mobility and reduce pain. | Procedure or surgery | Post Facilitation Stretching (PFS) |
Primary outcome
Pain intensity in patients with Piriformis Syndrome
Time frame: Baseline and 4 weeks after intervention completion
Pain was measured using the Numeric Pain Rating Scale (NPRS), a 0-10 scale where 0 indicates no pain and 10 indicates worst possible pain.
2 secondary outcomes
Hip Abduction and Internal Rotation Range of Motion
Time frame: Baseline and 4 weeks after intervention completion
Functional Disability
Time frame: Baseline and at 4 weeks after intervention completion
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 28 Nov 2025.
- Individual participant dataSharing planned: Yes. De-identified individual participant data from this study, including pain scores (NPRS), hip range of motion (internal rotation and abduction), and functional scores (LEFS), will be shared with qualified researchers upon reasonable request. The shared data will be used for secondary analyses, meta-analyses, and reproducibility studies related to Piriformis Syndrome interventions.
Related trials for Piriformis Syndrome
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Comparative Effects of Post-Isometric Relaxation and Reciprocal Inhibition Techniques inPiriformis Syndrome
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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.
The record lists no contact. Use the official record to reach the sponsor.
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 (PIR) and Post Facilitation Stretching (PFS) in people with Piriformis Syndrome, run by University of Faisalabad 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 1 inclusion and 1 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 28 Nov 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?
Pain intensity in patients with Piriformis Syndrome (time frame: Baseline and 4 weeks after intervention completion). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 28 Nov 2025.