Neural Gliders With and Without ESWT for Deep Gluteal Syndrome

N/AEnrolling By InvitationNCT07772674

University of Management and Technology Sialkot Pakistan46 enrolled

Overview

This study is a randomized controlled trial comparing Neural Gliders with and without Extracorporeal Shock Wave Therapy (ESWT) in patients with Deep Gluteal Syndrome. A total of 44 participants are divided equally into two groups: Group A receives neural gliders, ESWT, and conventional physiotherapy, while Group B receives neural gliders with conventional physiotherapy only. The study evaluates changes in pain, functional disability, and nerve mechano-sensitivity using NPRS, ODI, LEFS, Slump Test, FAIR Test, and SLR. Its aim is to determine whether adding ESWT provides greater clinical improvement than neural gliders alone.

This study is a randomized controlled trial designed to compare the effects of Neural Gliders with and without Extracorporeal Shock Wave Therapy (ESWT) in patients with Deep Gluteal Syndrome (DGS). A total of 44 participants will be randomly divided into two equal groups of 22. Group A will receive neural gliding exercises combined with ESWT and conventional physiotherapy, while Group B will receive neural gliding exercises with conventional physiotherapy only. The conventional treatment includes a hot pack and piriformis stretching. The main outcomes are pain intensity, functional disability, lower-limb function, and nerve mechano-sensitivity, assessed using the NPRS, ODI, LEFS, Slump Test, FAIR Test, and Straight Leg Raise (SLR). The intervention is planned for 3 sessions per week for 4 weeks, and the study aims to determine whether adding ESWT to neural gliders provides greater improvement in pain, function, and nerve mobility than neural gliders alone.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Interventions

Group A= Neural Gliders with ESWTOTHER

We use Neural Gliders in Deep Gluteal Syndrome because the sciatic nerve can become irritated or restricted as it passes through the deep gluteal region. Neural gliding produces gentle alternating movements that allow the nerve to slide within its pathway, helping improve nerve mobility, reduce mechano-sensitivity, improve circulation around the nerve, and decrease pain and functional limitation. We combine Neural Gliders with ESWT because the two interventions target different components of the problem. Neural gliders mainly address nerve mobility and sensitivity, while ESWT is intended to act on the surrounding deep gluteal/piriformis tissues by helping reduce pain, improve blood flow, decrease tissue tightness, and stimulate healing.

Group B= Neural Gliders without ESWTOTHER

We use neural gliders to improve sciatic nerve mobility and reduce nerve mechano-sensitivity. We add ESWT because it may reduce pain, improve circulation, and treat tight or restricted deep gluteal tissues. Therefore, the combination may address both the nerve and the surrounding soft tissues more effectively."

Eligibility

Sex: ALLMin age: 25 MonthsMax age: 45 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Individuals aged 25 to 45 years, including both genders 55 * Positive FAIR, Active Piriformis Test, Seated Piriformis Stretch Test 56,6,57 * NPRS pain score ≥ 3/10 55 * For a minimum of four weeks, there has been unilateral discomfort in the buttock, with or without accompanying posterior thigh pain, exacerbated by sitting 58 Exclusion Criteria: * Previous surgery involving the ipsilateral hip, pelvis, lumbar spine, or sacroiliac joint 34 * Women who were pregnant or nursing were excluded 59 * Medical conditions such as tumors or fractures 60 * Neuromuscular disorders that impair normal lumbopelvic morphology or progressive neurologic disease 60 * Disc pathologies identified through radiological imaging 17 * Pathologies of the hip joint and soft tissues 17 * Recent trauma history 17 * History of polyneuropathy, sciatic nerve injury, rheumatological disease, or malignancy 17 * Corticosteroid therapy or opioid-derived analgesia for pain during the previous month 17

Outcomes

Primary Outcomes

Universal Gonimeter

A Universal Goniometer is a simple clinical instrument used to measure joint range of motion in degrees. It consists of a central axis or fulcrum with one stationary arm and one movable arm, which are aligned with anatomical landmarks during measurement. In this study, the goniometer is used during the Straight Leg Raise (SLR) test to record the angle at which pain, tightness, or neural symptoms appear. A lower SLR angle indicates greater restriction or nerve mechano-sensitivity, while an increased angle after treatment suggests improved nerve mobility and functional recovery.

Time frame: 6 weeks

NPRS

The NPRS is simple 0-10 scale used to measure pain intensity. Patients rate their pain where 0=no pain and 10=worst possible pain. In your study, it helps track changes in buttock and leg caused by deep gluteal syndrome. A score reduction after treatment indicates improvement. Clinically, a change of ≥ 2 points is considered meaningful

Time frame: 6 weeks

Secondary Outcomes

LEFS

The Lower Extremity Functional Scale (LEFS) is a patient-reported outcome measure utilized to evaluate functional impairments in individuals with lower extremity musculoskeletal disorders .

Time frame: 6 WEEKS