COMPARATIVE EFFECTS OF THE POST-FACILITATION STRETCHING TECHNIQUE VERSUS THE ACTIVE RELEASE TECHNIQUE ON PAIN AND LOWER-EXTREMITY FUNCTION IN ADULTS WITH PIRIFORMIS SYNDROME

Abstract

Background: Piriformis syndrome (PS) is characterized by pain resulting from the compression of the sciatic nerve by the piriformis muscle. The aim of this study is to compare the effectiveness of the post-facilitation stretching technique (PFST) and active release technique (ART) in the management of patients with PS.

Methods: A comparative study involving two groups was conducted at Dr. M.G.R. Educational and Research Institute, Chennai. Thirty adults aged between 20 and 30 years with a clinical diagnosis of PS were recruited through simple random sampling into two groups (n = 15 per group). The treatment groups received PFST and ART, respectively, along with conventional physical therapy (moist heat and manual therapy). The participants underwent 24 sessions of treatment delivered three times a week over an eight-week period. Pain was measured on a 0-10 Numerical Pain Rating Scale (NPRS) and lower extremity function on the Lower Extremity Functional Scale (LEFS) before and after the treatment period. The data were analyzed using SPSS version 24; t-tests were used to compare the means within and between groups, and p < 0.05 was considered statistically significant.

Results: The PS pain and functional assessment scales were comparable between the groups prior to treatment (p > 0.05). Both groups exhibited a significant reduction in the NPRS and an increase in the LEFS scores following treatment (p ≤ 0.001). The changes in scores within the PFST and ART groups were as follows: the NPRS scores reduced from 5.00 to 2.80 and from 5.06 to 2.13, respectively, while the LEFS scores increased from 45.00 to 59.86 and from 44.73 to 63.40, respectively. The ART intervention was significantly better than the PFST intervention in the reduction of PS pain (p ≤ 0.001) and improvement of lower extremity function (p ≤ 0.001).

Conclusion: Both PFST and ART lead to a significant reduction in PS pain and improvement in lower extremity function. However, ART exhibits significantly greater effectiveness compared with PFST in PS patients; thus, ART may be incorporated into the rehabilitation protocols for PS patients to relieve their symptoms.

Keywords: Piriformis syndrome; Active release technique; Post-facilitation stretching; Numerical Pain Rating Scale; Lower Extremity Functional Scale; Manual therapy