Effects of PIR and PFS on Pain, ROM, and Disabilty in Tight Hamstring Syndrome

July 14, 2025 updated by: Riphah International University

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

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 Type

Interventional

Enrollment (Actual)

46

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 54810
        • Zafar Hospital lahore

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 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)

Exclusion Criteria:

  • 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)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Post Isometric Relaxation
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
Other: Post Isometric relaxation
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
Active Comparator: Post Facilitation Stretch
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
Other: Post Facilitation stretch
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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
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.
4th week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Active Knee Extension Test
Time Frame: 4th week
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.
4th week
Modified Oswestry Disability Index
Time Frame: 4th week
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.
4th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Hira Shaukat, TDPT, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 10, 2025

Primary Completion (Actual)

July 1, 2025

Study Completion (Actual)

July 13, 2025

Study Registration Dates

First Submitted

January 22, 2025

First Submitted That Met QC Criteria

January 22, 2025

First Posted (Actual)

January 28, 2025

Study Record Updates

Last Update Posted (Actual)

July 15, 2025

Last Update Submitted That Met QC Criteria

July 14, 2025

Last Verified

July 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • REC/RCR&AHS/24/0155

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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