Outcome of Specific Piriformis Stretching Technique in Females with Piriformis Syndrome

• Main Authors: Quratulain Saeed, Arshad Nawaz Malik, Samina Ghulam
• Format: Article
• Language: English
• Published: Journal of Pioneering Medical Sciences 2017-10-01
• Series: Journal of Pioneering Medical Sciences
• Subjects: Flexion; Adduction and Internal Rotation test; Stretching Techniques; Piriformis Syndrome;
• Online Access: http://www.jpmsonline.com/wp-content/uploads/2017/09/JPMS-VOL7-ISSUE4-PAGES55-58-OA.pdf

BACKGROUND: Pain and functional limitation affect the quality of life in piriformis syndrome. Stretching of piriformis is essential in the treatment protocols in physiotherapy, however, which sequence of stretching provides optimal improvement is only determined by trial and error. The purpose of this study was to compare the effects of specific stretching technique in terms of functional outcome in female with piriformis syndrome and to determine the normative length of piriformis at different reference points in females. METHODS: This study was a randomized controlled trial that was conducted in the Physiotherapy Department of the Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, Pakistan between July to December, 2015. This study enrolled 30 patients with piriformis syndrome at outpatient department between the ages of 20 and 50 years. These patients were randomly assigned into two groups. In one group, external rotator sequence of self-stretching (ERS) was practiced while in the second group, adductor sequence of passive stretching (APS) was performed. Each group was treated for two weeks. Pre and post intervention, the assessment was made on Numerical Pain Rating Scale (NPRS), Functional Performance of Lower Extremity Scale (FPLES) and by measured length at three reference positions. Independent T-test was used for statistical analysis. RESULTS: Both groups showed improvement in outcome in term of a decrease in pain score on NRPS, FPLES and measured reference lengths at all three positions (p-value < 0.05). Adductor pattern of stretching was as effective as external rotator pattern of stretching (p-value> 0.05) when results of pain score and measured reference length at three different positions were compared. However, on the FPLES, external rotator stretching technique was more effective than adductor stretching technique (p value < 0.05). CONCLUSION: The two studied sequence of piriformis stretching exercises have the same effect on outcomes in terms of clinically measured referenced length and decrease in pain score. Future studies will highlight which subgroups patients are more likely to get greater benefit for a given technique.