Effects of Hip Abductor Strengthening Exercises in Patients With Piriformis Syndrome

Effects of Hip Abductor Strengthening Exercises on Pain, Range of Motion and Lower Extremity Function in Patients With Piriformis Syndrome

The study was conducted to determine the effects of hip abductor strengthening exercises on pain, range of motion, and lower extremity function in patients with piriformis syndrome.

Study Overview

• Status: Completed
• Conditions: Piriformis Syndrome
• Intervention / Treatment: Other: Progressive Hip Abductor Strengthening Exercises; Other: conventional physiotherapy treatment

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 40100
      • Hashir Ali clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Males and Females between 18 and 45 .
• Unilateral involvement, Onset of pain not > 2 weeks.
• Grade 1-3 Tenderness at piriformis muscle.
• Numeric pain rating scale>3and equal to, <6.
• Any three positive test among Piriformis Test, Beatty Test, Freiberg Test, FAIR Test, Sign of Pace & Nagel.

Exclusion Criteria:

Positive Leagues' sign.

• Any pathology or recent injury around hip, knee and SI joint .
• Fracture of femur & hip joint dislocation.
• Pain due to neurological, spinal or pelvic origin.
• Limb length discrepancy .
• Stenosis of spine and disc herniation .
• Any postural abnormality/ deformity .
• Tumors and facet joint pathology.
• Congenital or acquired abnormality in the spinal column .
• Pregnancy .
• Neurological conditions like, CVA, Parkinson's disease, non-cooperative & subjects with psychological impairment .

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm 1: Hip Abductor Strengthening Exercise Group + conventional physiotherapy	Other: Progressive Hip Abductor Strengthening Exercises; Experimental Group (Hip Abductor Strengthening + Baseline Physiotherapy) A structured hip abductor strengthening program divided into three progressive phases over four weeks, along with baseline physiotherapy treatment. Phase I (Week 1 - Non-weight bearing / Isolated activation) Exercises: Bridging, Side-lying clam exercises, Side-lying hip abduction, Towel squeeze Dosage: 3 × 15 repetitions Phase II (Week 2 - Weight-bearing strengthening) Exercises: Squats, Side-stepping, Single-limb sit-to-stand, Step-up/Step-down, Leg press Dosage: 3 × 15 repetitions Phase III (Weeks 3-4 - Dynamic/Functional training) Exercises: Forward lunges, Double-limb jump Dosage: Week 3 → 3 × 15 repetitions Week 4 → 5 × 20 repetitions; Other: conventional physiotherapy treatment; conventional Physiotherapy treatment; Hydro-collateral pack for 10 minutes over piriformis muscle (40°C); Pulsed ultrasound for 10 minutes at 2.25 W/cm²; Piriformis stretching maneuver (20-second hold × 10 repetitions)
Active Comparator: Arm 2: Conventional Physiotherapy Group	Other: conventional physiotherapy treatment; conventional Physiotherapy treatment; Hydro-collateral pack for 10 minutes over piriformis muscle (40°C); Pulsed ultrasound for 10 minutes at 2.25 W/cm²; Piriformis stretching maneuver (20-second hold × 10 repetitions)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Lower Extremity Functional Scale (LEFS)	The Lower Extremity Functional Scale (LEFS) is a self-reported questionnaire used to assess lower extremity functional status in individuals with musculoskeletal conditions. It consists of 20 items related to daily activities such as walking, climbing stairs, squatting, and running. Each item is scored on a 5-point Likert scale (0 = extreme difficulty/unable to perform, 4 = no difficulty), with a maximum total score of 80. Higher scores indicate better functional ability. The LEFS is widely used due to its high reliability, validity, and responsiveness in evaluating functional improvement over time.	From enrolment to the end of treatment at 4 weeks
Numeric Pain Rating Scale (NPRS)	The Numeric Pain Rating Scale (NPRS) is a subjective measure used to assess pain intensity. Patients are asked to rate their current pain level on a scale from 0 to 10, where 0 represents "no pain" and 10 represents "worst imaginable pain." It is simple, quick to administer, and clinically reliable for monitoring changes in pain over time. A reduction of 2 points or more is generally considered clinically meaningful improvement	from enrollment to the end of treatment at 4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hip Abduction range of motion	Changes in hip abduction range of motion at baseline and 4 weeks of intervention were measured using a universal goniometer.	from enrollment to the end of treatment.
Hip external roration ROM	Changes in hip external rotation range of motion at baseline and 4 weeks of intervention were measured using a universal goniomete	From enrollment to the end of treatment at 4 weeks.

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Humera Mubashar, Ms-OMPT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): January 13, 2025
• Primary Completion (Actual): May 31, 2025
• Study Completion (Actual): October 31, 2025

Study Registration Dates

• First Submitted: March 16, 2026
• First Submitted That Met QC Criteria: March 16, 2026
• First Posted (Actual): March 20, 2026

Study Record Updates

• Last Update Posted (Actual): March 20, 2026
• Last Update Submitted That Met QC Criteria: March 16, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Quality of life; Lower Extremity Functional Scale; Piriformis syndrome Pain; Hip abductor strengthening exercises
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Nervous System Diseases; Neuromuscular Diseases; Peripheral Nervous System Diseases; Neuralgia; Pelvic Pain; Mononeuropathies; Nerve Compression Syndromes; Sciatic Neuropathy; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Piriformis Muscle Syndrome
• Other Study ID Numbers: REC/RCR & AHS/24/01113

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