Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

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Effect of Muscle Energy Technique with Deep Friction Massage on Pain, Disability and Internal Rotation Range of Motion of Hip Joint in Individuals with Piriformis Syndrome


Affiliations
1 Cooperative Institute of Health Sciences, Thalassery, Kannur, Kerala, India
2 Burjeel Hospital for Advanced Surgeries, Dubai, United Arab Emirates
3 Hamilton Physio and Rehab, Canada
4 (Dept. of Medical Biochemistry) Cooperative Institute of Health Sciences, Thalassery, Kannur, Kerala, India
     

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Background: Piriformis Syndrome (pseudo sciatica) is caused by pressure of an injured or irritated piriformis muscle which leads to neuritis of branches of the sciatic nerve; mimics the signs and symptoms of low back pain. Due to high incidence of low back pain in our society, P.S frequently goes unrecognized or misdiagnosed in clinical settings.

Method: Patients with piriformis syndrome were screened for inclusion and exclusion criteria after detailed assessment. 30 patients who meet the inclusion criteria were grouped into 2groups (15 patients in each group). Control group received UST and piriformis muscle stretching and experimental group received MET with DFM. Treatment period was about 30-40min each session in regular period of 6 days for a week for both groups.

Outcome Measures: Oswestry Disability Index, Visual Analogue Scale, Standard Goniometer

Results: Statistical analysis of intergroup significance by Mann Whitney U-test for IR ROM (sig.0.000 < p = 0.05) and independent sample t-test for VAS (t = 2.895 > table value, t = 2.048) and ODI (t = 4.842 > table value, t = 2.048) reveals that experimental group shows significant difference between pre test and post test values of IR ROM, VAS and ODI than that in the control group.

Conclusion: experimental group who received MET along with DFM shows greater improvement on pain, disability and IR ROM in individuals with piriformis syndrome than those in the control group who received U.S.T and piriformis muscle stretching.


Keywords

Piriformis Syndrome, MET, DFM.
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  • S.BrentBrotzman,MD.Low Back injuries,chapter 9,P.588;Clinical orthopaedic Rehabilitation

  • Kraus H. “pseudodisc”.South Med J.1967; 60(4):416-418.

  • Corwin J.piriformis syndrome in the atlet.ACA journal of chiriopractic.jan 1987,22.

  • Fishman LM, Dombi GW, Michaelsen C, Ringel S, Rozbruch J, Rosner B, Weber C. Piriformis syndrome: diagnosis, treatment, and outcome—a 10-year study. Archives of physical medicine and rehabilitation. 2002 Mar 1;83(3):295-301.

  • Boyajian-O’Neill LA, McClain RL, Coleman MK, Thomas PP. Diagnosis and management of piriformis syndrome: an osteopathic approach. The Journal of the American Osteopathic Association. 2008 Nov 1;108(11):657-64.

  • KlevinMJ. Piriformissyndrome. e Medicine Specialities: physical Medicine and Rehabilitation: Lowerlimb Musculoskeletal conditions 2010,article/308798.

  • Pace J.B, Nagle D.Piriformis Syndrome. West.J.Med.1976; 124:435-439.Medicine.

  • Papadopoulos EC, Khan SN. Piriformis syndrome and low back pain: a new classification and review of the literature. The Orthopedic Clinics of North America. 2004 Jan;35(1):65-71

  • Shah.S, Wang TW.PiriformisSyndrome.eMedicine Specialties: Sports and medicine: hip 2009 article/87545-overview.

  • Yeoman w. The relation of arthritis of the sacroiliac joint to sciatica, with an analysis of 100 cases. The lancet. 1928 dec 1;212(5492):1119-23.

  • Steiner C, Staubs C, Ganon M, Buhlinger C. Piriformis syndrome: pathogenesis, diagnosis, and treatment. The Journal of the American Osteopathic Association. 1987 Apr;87(4):318-23.

  • Saeed Q, Malik AN, Ghulam S. Outcome of Specific Piriformis Stretching Technique in Females with Piriformis Syndrome. Journal of Pioneering Medical Sciences. 2017 Oct 1;7(4):55.

  • Beatty RA. The piriformis muscle syndrome: a simple diagnostic maneuver. Neurosurgery. 1994 Mar 1;34(3):512-4.

  • Leon Chaotow and Judith Walker Delany. Clinical Application of Neuromuscular techniques.vol2 lower body Churchill Livingstone Publication, China, P. 429-431.

  • Lewit K, Simons DG. Myofascial pain: relief by post-isometric relaxation. Archives of Physical medicine and rehabilitation. 1984 Aug;65(8): 452-6.

  • Chamberlain GJ. Cyriax’s friction massage: a review. Journal of Orthopaedic & Sports Physical Therapy. 1982 Jul 1;4(1):16-22.

  • D Bruce Fligg.piriformistechnique.the journal of CCA.june 1986. vol 30 no.2

  • PeggiHonig.A Case Report of the Treatment of Piriformis Syndrome Applying Modalities of Therapeutic Bodywork. Massage Today. January, 2007, Vol. 07, Issue 0

  • KevorkHopavian, FugianSong, Ricardo Riera and SidhaSambandan.Eur Spine J 2010 December 19(12):2095-2109.

  • Vallejo MC, Mariano DJ, Kaul B, Sah N, Ramanathan S. Piriformis syndrome in a patient after cesarean section under spinal anesthesia.

  • Chen WS, Wan YL. Sciatica caused by piriformis muscle syndrome: report of two cases. Journal of the Formosan Medical Association= Taiwan yi zhi. 1992 Jun;91(6):647-50.

  • Barton PM. Piriformis syndrome: a rational approach to management. Pain. 1991 Dec 1;47(3):345-52

  • Beaton LE, Anson BJ. The sciatic nerve and the piriformis muscle: their interrelation a possible cause of coccygodynia. JBJS. 1938 Jul 1;20(3):686-8.

  • Freiberg AH, Vinke TH. Sciatica and the sacroiliac joint. J Bone Joint Surg (Am) 1934; 16: 126-36

  • Davidson M, Keating JL. A comparison of five low back disability questionnaires: reliability and responsiveness. Physical therapy. 2002 Jan 1;82(1):8-24.

  • Fairbank JC, Couper J, Davies JB, O’brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980 Aug;66(8):271-3

  • BoonstraAm,SchiphorstPreuperHR,Reneman M F,Stewart R E.Int J Rehabil Res.2008 Jun 31(2):165-9.

  • Childers MK, Wilson DJ, Gnatz SM, Conway RR, Sherman AK. Botulinum toxin type A use in piriformis muscle syndrome: a pilot study. American journal of physical medicine & rehabilitation. 2002 Oct 1;81(10):751-9.

  • Silvio Nussbaumer,MichaelLeunig,Julia F Glalthron,HansGerber.BMC Musculoskeletal Disord.2010;11:194.

  • Holm I,BokstadB.LutkenT,ErvikA.Physiother Res Int.2000;5(4)241-8.

  • Lori A. Boyajian-O’Neill, DO; Rance L. McClain, DO; Michele K. Coleman, DO; and Pamela P. Thomas, PhD. Diagnosis and Management of Piriformis Syndrome: An Osteopathic Approach. JAOA. November 2008; 108:657-664.

  • Meg Russell. Massage therapy and restless legs syndrome. Journal of Bodywork and Movement Therapies. 2007; 11: 146-150.

  • Jada Bell. Massage therapy helps to increase range of motion, decrease pain and assist in healing a client with low back pain and sciatica symptoms. Journal of Bodywork and Movement Therapies. 2008; 12: 281-289.

  • Frey Law LA, Evans S, Knudtson J, et al. Massage reduces pain perception and hyperalgesia in experimental muscle pain: a randomized, controlled trial, J Pain 2008 Aug; 9(8):714-21.

  • . Kristal Swafford. Anatomical considerations for stretching the piriformis muscle: A pilot study. JHMI. 2006. 21.

  • Fishman LM, Konnoth C, Rozner B. Botulinum neurotoxin type B and physical therapy in the treatment of piriformis syndrome: a dose-finding study. Am J Phys Med Rehabil. 2004; 83: 42-50.

  • F. Guyomarc’h, C. Labanere, et al. Syndrome du muscle piriformis: un diagnostic differential de sciatalgie chez le sportif? : A propos de 3 cas et revue de la literature. Journal de Traumatologie du Sport, September 2004; 21: 133-145.

  • Loren M. Fishman, MD, George W. Dombi, PhD, Christopher Michaelsen, MD, Stephen Ringel, MD, Jacob Rozbruch, MD, et al. Arch Phys Med Rehabil 2002; 83: 295-301.

  • Br J Sports Med. 1999 Aug;33(4):259-63

  • Keskula DR, Tamburello M. Conservative management of piriformis syndrome. Journal of athletic training. 1992;27(2):102.

  • Barton PM. Piriformis syndrome: a rational approach to management. Pain. 1991 Dec 1;47(3):345-52.

  • Justard ME. Piriformis Syndrome. A rational approach to management of pain. 1991;9:345-52.

  • Lewit K, Simons DG. Myofascial pain: relief by post-isometric relaxation. Archives of Physical medicine and rehabilitation. 1984 Aug;65(8): 452-6.


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  • Effect of Muscle Energy Technique with Deep Friction Massage on Pain, Disability and Internal Rotation Range of Motion of Hip Joint in Individuals with Piriformis Syndrome

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Authors

Nithya Narayanan Kutty
Cooperative Institute of Health Sciences, Thalassery, Kannur, Kerala, India
Saad Siddeeque
Burjeel Hospital for Advanced Surgeries, Dubai, United Arab Emirates
Heiskrujam Tamphaibema
Burjeel Hospital for Advanced Surgeries, Dubai, United Arab Emirates
Azharuddin
Burjeel Hospital for Advanced Surgeries, Dubai, United Arab Emirates
Nishanth Othayoth
Hamilton Physio and Rehab, Canada
C. P. Bineesh
(Dept. of Medical Biochemistry) Cooperative Institute of Health Sciences, Thalassery, Kannur, Kerala, India

Abstract


Background: Piriformis Syndrome (pseudo sciatica) is caused by pressure of an injured or irritated piriformis muscle which leads to neuritis of branches of the sciatic nerve; mimics the signs and symptoms of low back pain. Due to high incidence of low back pain in our society, P.S frequently goes unrecognized or misdiagnosed in clinical settings.

Method: Patients with piriformis syndrome were screened for inclusion and exclusion criteria after detailed assessment. 30 patients who meet the inclusion criteria were grouped into 2groups (15 patients in each group). Control group received UST and piriformis muscle stretching and experimental group received MET with DFM. Treatment period was about 30-40min each session in regular period of 6 days for a week for both groups.

Outcome Measures: Oswestry Disability Index, Visual Analogue Scale, Standard Goniometer

Results: Statistical analysis of intergroup significance by Mann Whitney U-test for IR ROM (sig.0.000 < p = 0.05) and independent sample t-test for VAS (t = 2.895 > table value, t = 2.048) and ODI (t = 4.842 > table value, t = 2.048) reveals that experimental group shows significant difference between pre test and post test values of IR ROM, VAS and ODI than that in the control group.

Conclusion: experimental group who received MET along with DFM shows greater improvement on pain, disability and IR ROM in individuals with piriformis syndrome than those in the control group who received U.S.T and piriformis muscle stretching.


Keywords


Piriformis Syndrome, MET, DFM.

References