Graston vs Manual Myofascial Release Technique in Piriformis Syndrome.

Comparison of Graston and Manual Myofacial Release Technique in Patients With Piriformis Syndrome.

The objective of our study is to compare the effects of Graston and manual myofascial release technique on pain, muscle length and functional status in patients with Piriformis syndrome.

Study Overview

• Status: Completed
• Conditions: Piriformis Syndrome
• Intervention / Treatment: Other: Graston; Other: Manual myofascial release

Detailed Description

In 2019, a study was conducted to conclude the effectiveness of Passive stretching v/s Myofascial release in improving Piriformis flexibility in females. They reported that myofascial release was more valuable than passive stretching exercises in enhancing piriformis flexibility in patients with piriformis tightness.

According to another study in 2018, after a single treatment, compressive myofascial release showed more improvement in ankle dorsiflexion than Graston technique, in participants with decrease dorsiflexion range.

In 2016, a study reported the effects of the Graston technique and general exercise in patients with chronic low back pain. Graston group showed greater improvement in pain and range of motion in patients with chronic low back pain.

According to a study conducted in 2014, self-myofascial release was more effective than Graston technique in improving knee joint flexibility, hamstring, and quadriceps strength.

In 2011, a study evaluated the effectiveness of deep soft tissue mobilization techniques and stretching exercises in piriformis syndrome and found that the deep soft tissue mobilization techniques along with stretching exercises significantly improved the piriformis syndrome.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Fedral
    • Islamabad, Fedral, Pakistan, 46000
      • Federal Government Polyclinic Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 25 years to 60 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:•

• Pain more than 1 month.
• Piriformis syndrome diagnosed through screening test (FAIR test, Beatty test, Freiberg test, Sign of Pace)

Exclusion Criteria:

• Leg pain due to causes other than piriformis syndrome.
• Congenital spinal deformity.
• History of fracture.
• History of back or hip surgery.
• Any systemic illness like metastatic or infective disorders.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Graston; Ultrasound, Graston technique, piriformis stretching, home plan (hip abductor and extensor strengthening)	Other: Graston; Ultrasound for 10 mins/1 set/ (3 sessions/week), Graston for 5 mins/1 set/ (3 sessions/week), Piriformis stretching exercises/ 10 reps with 30 sec hold/ 1 set/(3 sessions/week), Hip abductor strengthening/10 reps/1 set/(3 weeks), Hip extensor strengthening/10 reps/1 set/(3 weeks), A total of 9 sessions for 3 weeks (3 sessions/week) were given each consisting of 20 mins.
Active Comparator: Manual myofascial release; Ultrasound, Manual myofascial release, piriformis stretching, home plan (hip abductor and extensor strengthening)	Other: Manual myofascial release; Ultrasound for 10 mins/1 set/ (3 sessions/week), Manual myofascial release for 5 mins/1 set/ (3 sessions/week), Piriformis stretching exercises/ 10 reps with 30 sec hold/ 1 set/(3 sessions/week), Hip abductor strengthening/10 reps/1 set/(3 weeks), Hip extensor strengthening/10 reps/1 set/(3 weeks), A total of 9 sessions for 3 weeks (3 sessions/week) were given each consisting of 20 mins.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric Pain Rating Scale	Changes from baseline and after 1st session, Numeric pain rating scale is a scale from 0 to 10. 0 indicating no pain and 10 indicating worse pain.	9th day
Piriformis muscle length	Changes from baseline and after 1st session, in prone lying range of internal rotation is measured for piriformis muscle length	9th day
Lower extremity functional scale	Changes from baseline and after 1st session, lower extremity functional scale is used to measure the functional status of patients with piriformis syndrome.	9th day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Straight leg raise	Changes from baseline and after 1st session, goniometer is used to measure the straight leg raise range.	9th day

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Asghar Khan, PhD, Riphah International University

Publications and helpful links

General Publications

• Kukadia HA, Malshikare A, Palekar TJ. Effect of Passive Stretching v/s Myofascial Release in Improving Piriformis Flexibility in Females-A Comparative Study. Indian Journal of Physiotherapy and Occupational Therapy-An International Journal. 2019;13(4):57-61.
• Stanek J, Sullivan T, Davis S. Comparison of Compressive Myofascial Release and the Graston Technique for Improving Ankle-Dorsiflexion Range of Motion. J Athl Train. 2018 Feb;53(2):160-167. doi: 10.4085/1062-6050-386-16. Epub 2018 Jan 26.
• Lee JH, Lee DK, Oh JS. The effect of Graston technique on the pain and range of motion in patients with chronic low back pain. J Phys Ther Sci. 2016 Jun;28(6):1852-5. doi: 10.1589/jpts.28.1852. Epub 2016 Jun 28.
• Kim D-H, Ms T-HK, Jung D-Y, Weon J-H. Effects of the graston technique and self-myofascial release on the range of motion of a knee joint. Journal of Korean Society of Physical Medicine. 2014;9(4):455-63.
• Awan WA, Babur MN. EFFECTIVENESS OF DEEP FRICTION MASSAGE & STRETCHING EXERCISES IN PIRIFORMIS SYNDROME. IJCRB. 2011:378.

Study record dates

Study Major Dates

• Study Start (Actual): January 11, 2020
• Primary Completion (Actual): September 17, 2020
• Study Completion (Actual): September 24, 2020

Study Registration Dates

• First Submitted: October 9, 2020
• First Submitted That Met QC Criteria: October 9, 2020
• First Posted (Actual): October 19, 2020

Study Record Updates

• Last Update Posted (Actual): October 19, 2020
• Last Update Submitted That Met QC Criteria: October 9, 2020
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Keywords: Piriformis syndrome; Graston technique; Myofascial release; Lower extremity functional scale
• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Pain; Neurologic Manifestations; Disease; Neuromuscular Diseases; Sciatic Neuropathy; Mononeuropathies; Peripheral Nervous System Diseases; Neuralgia; Nerve Compression Syndromes; Pelvic Pain; Syndrome; Piriformis Muscle Syndrome
• Other Study ID Numbers: REC/00689 Sonia Wali

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No