EFFECTIVENESS OF ADDING MUSCLE ENERGY TECHNIQUE TO ROUTINE PHYSICAL THERAPY FOR PAIN MANAGEMENT, RANGE OF MOTION, AND FUNCTIONAL DISABILITY IN PIRIFORMIS SYNDROME
Keywords:
Muscle energy technique, functional disability, range of motion, piriformis syndrome, pain, routine physical therapy.Abstract
Background of the study: Piriformis syndrome is a neuromuscular disorder. Muscle energy technique (MET), when combined with routine physical therapy, is proposed to improve outcomes by enhancing muscle flexibility, and reducing pain,
Methodology: A randomized controlled trial was conducted in the University of Lahore Teaching Hospital. In the routine physical therapy, 19 females and 12 males were allocated, while 20 females and 11 males were recruited in the other group. The control group received transcutaneous electric nerve stimulation (TENS), heat therapy, range of motion, stretching exercise and core strengthening exercise. At the same time, the experimental group was treated with the isometric relaxation muscle energy technique
Results: The muscle energy technique (MET) combined with routine physical therapy was more effective than routine physical therapy. Experimental group: After one-month follow-up, the value NPRS had a mean of 1.34±0.48, internal rotation ROM was 38.93± 4.78, abduction ROM was 39.83±5.84 and lower extremity functional scale was 67.38+12.31 while in control group, NPRS had value 2.3+0.31 ROM of internal rotation and abduction was 38.93±4.78 and 39.83±5.84, the mean value of lower extremity functional scale was 56.66±17.04.
Conclusion: Muscle energy technique and routine physical therapy are more effective in treating pain, range of motion, and functional disability.
References
Hicks BL, Lam JC, Varacallo M. Piriformis Syndrome. StatPearls. Treasure Island (FL); 2021.
Nambi G, Dusad G. Effect of reciprocal inhibition and post isometric relaxation; types of muscle energy technique in Piriformis syndrome? A comparative study. Eur J Pharm Med Res. 2018; 5:160-4.
Sharma S, Kaur H, Verma N, Adhya B. Looking beyond Piriformis Syndrome: Is It Really the Piriformis? Hip Pelvis. 2023 Mar;35(1):1-5.
Velappanchavadi C. Effectiveness of muscle energy technique versus stretching in subjects with Piriformis syndrome. Int J Physiother Res. 2019;7(5):3252-6.
Jawade S, Chitale N Jr, Phansopkar P. The Effect of Reciprocal Inhibition Techniques on Pain, Range of Motion, and Functional Activities in Patients With Upper Trapezitis. Cureus. 2023 Feb 1;15(2):e34487.
Lo JK, Robinson LR. Piriformis syndrome. Handb Clin Neurol. 2024;201:203-226.
Manske RC, Wolfe C, Page P, Voight M, Bardowski B. Use of Diagnostic Musculoskeletal Ultrasound in the Evaluation of Piriformis Syndrome: A Review for Rehabilitation Providers. Int J Sports Phys Ther. 2024 Jun 1;19(6):768-772.
Vij N, Kiernan H, Bisht R, Singleton I, Cornett EM, Kaye AD, et al. Surgical and non-surgical treatment options for Piriformis syndrome: a literature review. Anesth Pain Med. 2021;11(1)
Othman IK, Mohamad N, Sidek S, Bhaskar RN, Kuan CS. Risk factors associated with piriformis syndrome: a systematic review. Sci Eng Health Stud. 2020:215-33.
Haleem F, Khan FM, Kashif M, Jamshed M, Jaffar M. Evaluation of Piriformis syndrome in patients with low back pain reporting to public medical teaching institutes in Peshawar. Found Univ J Rehabil Sci. 2021;1(1):11-4.
Yürük D, Can E, Genç Perdecioglu GR, Yıldız G, Akkaya ÖT. Prevalence of priformis syndrome in sciatica patients: Predictability of specific tests and radiological findings for diagnosis. Br J Pain. 2024 Oct;18(5):418-424.
Warner S, Munawar A, Ahmad A, Fatima M, Waqas M. Prevalence of piriformis syndrome among University of Lahore male students. Rawal Med J. 2018;43(2):306-8.
Astarini NMWT, Wahyuni N, Wibawa A, Indrayani AW, Widyadharma IPE. Prevalence and risk factors of piriformis syndrome among online motorcycle taxis in Denpasar, Bali. Bali Anat J. 2020;3(1):24-7.
Desai VS, Anand S. Prevalence of piriformis tightness with the relevance of sitting duration in bankers. Indian J Forensic Med Toxicol. 2020;14(3).
Kirch N, Rana MV. Piriformis syndrome. In: Practical Chronic Pain Management. Springer; 2020. p. 293-9.
Popoola IS. A case study: Combination of physiotherapy and osteopathic manual therapy technique in managing piriformis syndrome. National University of Medical Sciences; 2020.
Probst D, Stout A, Hunt D. Piriformis syndrome: A narrative review of the anatomy, diagnosis, and treatment. PM R. 2019;11
Sarkar M, Goyal M, Samuel AJ. Comparing the effectiveness of the muscle energy technique and kinesiotaping in mechanical sacroiliac joint dysfunction: A non-blinded, two-group, pretest-posttest randomized clinical trial protocol. Asian Spine J. 2021;15(1):54.
Khakneshin A, Javaherian M, Attarbashi Moghadam B. The efficacy of physiotherapy interventions for recovery of patients suffering from piriformis syndrome: A literature review. J Rafsanjan Univ Med Sci. 2021;19(12):1304.
Alcock GK, Stratford PW. Validation of the Lower Extremity Functional Scale on athletic subjects with ankle sprains. Physiother Can. 2002; 54:233-40.
Velappanchavadi C. Effectiveness of muscle energy technique versus stretching in subjects with piriformis syndrome. Int J Physiother Res. 2019;7(5):3252-6.
Ilyas N, Jamil A, Akram S, Ilyas R, Afzal Z, Akram A. Comparative effects of hold relax with agonist contraction and active release therapy on pain, functional disability and sleep quality in piriformis syndrome.
Rajendran S, Sundaram SS. The effectiveness of myofascial release over stretching on pain and range of motion among female college students with piriformis syndrome. Malaysian J Mov Health Exerc. 2020;9(2).
Young IA, Dunning J, Butts R, Mourad F, Cleland JA. Reliability, construct validity, and responsiveness of the neck disability index and numeric pain rating scale in patients with mechanical neck pain without upper extremity symptoms. Physiother Theory Pract. 2019;35(12):1328-35.
Ratter J, Pellekooren S, Wiertsema S, van Dongen JM, Geleijn E, de Groot V, et al. Content validity and measurement properties of the Lower Extremity Functional Scale in patients with fractures of the lower extremities: A systematic review. J Patient Rep Outcomes. 2022;6(1):1-4.
Anjali S. A study to assess the effectiveness of deep friction massage and muscle energy technique among piriformis syndrome patients with pain, disability, and limitations in the hip joint's internal rotation range of motion. [Doctoral dissertation]. Coimbatore: PPG College of Physiotherapy; 2020.
Brochado JF, Pereira J. Behind the Pain: Understanding and Treating Piriformis Syndrome. Cureus. 2024 Oct 3;16(10):e70750.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Rehabilitation
This work is licensed under a Creative Commons Attribution 4.0 International License.
