Volume 25, Issue 2 (June & July 2022)                   J Arak Uni Med Sci 2022, 25(2): 310-323 | Back to browse issues page

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Doosti Irani R, Golpayegani M, Faraji F. The Effect of Core Stability Exercises on Pain and Inflammation of Patients With Piriformis Syndrome. J Arak Uni Med Sci 2022; 25 (2) :310-323
URL: http://jams.arakmu.ac.ir/article-1-7209-en.html
1- Department of Sport Pathology and Physiology, Faculty of Sports Sciences, Arak University, Arak, Iran. , rashiddoostiirani@gmail.com
2- Department of Sport Pathology and Physiology, Faculty of Sports Sciences, Arak University, Arak, Iran.
3- Department of Neurology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
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Piriformis syndrome is one of the causes of sciatica. This syndrome occurs due to piriformis muscle pressure or stimulation on the sciatic nerve [2]. The clinical manifestations of piriformis syndrome are similar to intervertebral disc herniation, including pain in butt or hip without a specific reason, or neurological symptoms such as foot drop [4, 5]. Stretching the area that has muscle spasm can usually help improve or prevent its occurrence [3]. Considering the number of new cases of low back pain and sciatica (40 million cases per year), the incidence of piriformis syndrome is approximately 2.4 million people per year [9]. The present study aims to investigate the effect of core stability exercises on pain and inflammation in patients with piriformis syndrome.
Materials and Methods
This is a randomized clinical trial with a pre-test/post-test design. The study population consists of all patients with piriformis syndrome referred to medical centers in Arak, Iran. Using the G*Power software, and considering a test power of 0.84 and the effect size was 1.4, the sample size was determined 20. Participants were randomly divided into two groups of control (n=10) and exercise (n=10), after examination and clinical examinations by a specialist and performing the FAIR test to diagnose piriformis syndrome. Using the McGill pain questionnaire, the pain level of the subjects was examined, and their inflammation was evaluated by a specialist using MRI images. The exercise group performed core stability exercises for 6 weeks, while the control group continued their normal life during this period. T-test, Chi-square test, and McNemar’s test were used to examine the differences between groups. The significance level was set at 0.05.
The mean pain score in the control group decreased from 95.2 to 90.7 after the exercise, which was not statistically significant (P=0.562). In the exercise group, the mean pain score decreased from 91.7 to 33.4, and this decrease was statistically significant (P=0.0); Therefore, at 95% confidence interval, we can say that core stability exercises had a significant effect on the pain of patients with piriformis syndrome (P<0.05; Table 1).

The number of patients with inflamed nerve in the control group decreased from 10 in the pre-test phase to 8 in the post-test phase, but this decrease was not statistically significant (P=0.5). In the exercise group, it was reduced from 10 to 2, and this decrease was statistically significant (P=0.008); Therefore, we can say that core stability exercises had a significant effect on the inflammation of patients with piriformis syndrome (P<0.05, Table 2).

Due to the fact that the piriformis muscle is located near the sciatic nerve, its spasm causes pressure on the nerve, leading to sciatica pain and piriformis syndrome [2021]. The sciatic nerve may become inflamed due to the pressure caused by the abnormal piriformis muscle [1, 4]. Since the piriformis muscle is one of the muscles in the central region of the body [22], in this study, core stability stretching exercises were used which showed a significant effect on pain and inflammation in patients with piriformis syndrome. Therefore, it can be concluded that core stability exercises can reduce pain and inflammation in patients with piriformis syndrome. These exercises can be used in treatment of these patients.

Ethical Considerations
Compliance with ethical guidelines

All ethical principles were according to the guidelines of the ethics committee of Arak University of Medical Sciences (Ethical Code: IR.ARAKMU.REC.1400.157) and was registered by Iranian Registry of Clinical Trials (ID: IRCT20211003052662N1).

This study was extracted from the master thesis of the first author. It was not funded by any organizations.

Authors' contributions
Conceptualization, supervision, editing & review: Masoud Golpayegani; methodology: Rashid Doosti Irani and Fardin Faraji; data analysis: Rashid Doosti Irani.

Conflicts of interest
The authors declare no conflict of interest.

The authors would like to thank all patients participated in this research for their cooperation.

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Type of Study: Original Atricle | Subject: General
Received: 2022/03/1 | Accepted: 2022/04/24

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