McGill Strengthening With and Without Integrated Neuromuscular Inhibition Technique in Piriformis Syndrome

February 4, 2026 updated by: Riphah International University

Effects of McGill Strengthening Exercises Program With and Without Integrated Neuromuscular Inhibition Technique on Pain, Range of Motion and Function in Patients With Piriformis Syndrome

The study was conducted to determine the effects of McGill strengthening exercises program with and without integrated neuromuscular inhibition technique on pain, range of motion and function in patients with piriformis syndrome.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

56

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 Province
      • Lahore, Punjab Province, Pakistan
        • Mumtaz Bakhtawar Memorial Trust Hospital, Mustafa Town

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 genders with age ranged from 25 and 45 years
  • Sedentary
  • Non-traumatic
  • Idiopathic
  • External tenderness near the greater sciatic notch
  • Pain for more than 1 month's duration
  • NPRS ranging from >3 to ≤ 6

  • Positive results on three of the following five tests:

    1. FAIR
    2. Beatty
    3. Laségue
    4. Pace
    5. Freiberg

Exclusion Criteria:

  • Acute low back pain and/or acute lumbar radiculopathy
  • History of Stroke or any other neurological disorders
  • Recent buttock trauma
  • Inflammatory, infectious or tumor diseases
  • Severe vascular disease
  • Osteoporosis
  • Pregnancy

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: McGill strengthening exercises program with integrated neuromuscular inhibition technique
Other: McGill strengthening exercises program
These exercises were divided into 3 phases, each lasting 2 weeks. Patients performed 4 repetitions of each exercise during 1st and 2nd week at each hospital visit. Then, increased by 4 repetitions every 2 weeks for up to 6 weeks. These exercises were performed with a maximum of 12 repetitions with a 1-minute of rest interval between each exercise. These exercises were performed by patients at each clinical visit, 3 days per week for total of 6 weeks.
Other: Integrated neuromuscular inhibition technique
This technique was applied at piriformis muscle. The procedure was repeated 3 times for up to 10 minutes at each clinical visit. This intervention was performed 3 days per week for total of 6 weeks.
Other: Standardized physiotherapy treatment

These exercises were performed by patients at the end of each hospital visit (3 days per week for total of 6 weeks) and also at home twice a week during the 2 months follow-up period after treatment ends.

  1. Continuous-mode ultrasound therapy was applied at a frequency of 1 MHz and an intensity of 1.0 W/cm² for 3 minutes to the tender or trigger points on the posterior aspect of the pelvis.
  2. A hydrocollator pack (40°C) was applied for 10 minutes at lumbopelvic region.

  3. Piriformis, hamstring/calf stretching was performed progressively in phases.

    • Phase 1 consists of weeks 1 and 2 with 1 set of 3 repetitions with 30 seconds hold per day.
    • Phase 2 consists of weeks 3 and 4 with 2 sets of 3 repetitions with 30 seconds hold per day.
    • Phase 3 consists of weeks 5 and 6 with 2 sets of 3 repetitions with 30 seconds hold twice per day.
    • Follow-up period consists of 2 sets of 3 repetitions with 30 seconds hold twice per day.
Active Comparator: McGill strengthening exercises program
Other: McGill strengthening exercises program
These exercises were divided into 3 phases, each lasting 2 weeks. Patients performed 4 repetitions of each exercise during 1st and 2nd week at each hospital visit. Then, increased by 4 repetitions every 2 weeks for up to 6 weeks. These exercises were performed with a maximum of 12 repetitions with a 1-minute of rest interval between each exercise. These exercises were performed by patients at each clinical visit, 3 days per week for total of 6 weeks.
Other: Standardized physiotherapy treatment

These exercises were performed by patients at the end of each hospital visit (3 days per week for total of 6 weeks) and also at home twice a week during the 2 months follow-up period after treatment ends.

  1. Continuous-mode ultrasound therapy was applied at a frequency of 1 MHz and an intensity of 1.0 W/cm² for 3 minutes to the tender or trigger points on the posterior aspect of the pelvis.
  2. A hydrocollator pack (40°C) was applied for 10 minutes at lumbopelvic region.

  3. Piriformis, hamstring/calf stretching was performed progressively in phases.

    • Phase 1 consists of weeks 1 and 2 with 1 set of 3 repetitions with 30 seconds hold per day.
    • Phase 2 consists of weeks 3 and 4 with 2 sets of 3 repetitions with 30 seconds hold per day.
    • Phase 3 consists of weeks 5 and 6 with 2 sets of 3 repetitions with 30 seconds hold twice per day.
    • Follow-up period consists of 2 sets of 3 repetitions with 30 seconds hold twice per day.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale
Time Frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Numeric Pain Rating Scale (NPRS) was used to assess the patient's pain intensity. This scale ranges from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst pain.
From enrollment to 6 weeks of intervention with follow-up at 14 weeks.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Range of Motion (Hip Abduction)
Time Frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
The universal goniometer was used to assess hip abduction range of motion.
From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Range of Motion (Hip Internal Rotation)
Time Frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
The universal goniometer was used to assess hip internal rotation range of motion.
From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Lower Extremity Functional Scale
Time Frame: From enrollment to 6 weeks of intervention with follow-up at 14 weeks.
Lower Extremity Functional Scale was used to assess the patient's functional status. Maximum score of this scale is 80. The greater the score, the lower the disability.
From enrollment to 6 weeks of intervention with follow-up at 14 weeks.

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Study Director: Syed Shakil ur Rehman, PhD, 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)

May 26, 2025

Primary Completion (Actual)

September 5, 2025

Study Completion (Actual)

November 5, 2025

Study Registration Dates

First Submitted

February 4, 2026

First Submitted That Met QC Criteria

February 4, 2026

First Posted (Actual)

February 11, 2026

Study Record Updates

Last Update Posted (Actual)

February 11, 2026

Last Update Submitted That Met QC Criteria

February 4, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/24/0176

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

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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