Shamsi MohammadBagher, Mirzaei Maryam, Hopayian Kevork
Department of Physiotherapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Centre for Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
BMC Sports Sci Med Rehabil. 2024 Jan 10;16(1):12. doi: 10.1186/s13102-023-00802-4.
In deep gluteal syndrome (DGS), the piriformis muscle could impinge the sciatic nerve. The FAIR (flexion adduction internal rotation) test is a provocation test used to identify sciatic nerve irritation caused by this muscle. Compression and stretching exercises are usually prescribed to treat this syndrome. The aim of this study was to compare the effects of these two treatments on surface electromyography (sEMG) of the gastrocnemius and tibialis anterior in patients with low back pain (LBP) and DGS.
Forty-five participants were allocated to three groups of stretching exercise, compression or control. In addition to 15 min of heat and 15 min of electrical nerve stimulation for pain relief, participants in the compression exercise (CE) group received self-compression exercise, those in the stretching exercise (SE) group received self-stretching exercise and those in the control group received no extra interventions. For the two intervention groups, three sets of two minutes of exercise with two minutes of rest in between were applied. The sEMG amplitude values of the gastrocnemius and tibialis anterior muscles of the affected buttock side of any one group while performing the FAIR test were compared to the others. Pain and disability were assessed and the changes were compared between the two groups.
After the intervention period, no group demonstrated a change in the sEMG of the gastrocnemius or tibialis anterior muscles (p > 0.05). There was no difference in the change in this variable between groups (Mean difference (95% CI) of gastrocnemius was ranged over= -4.04 to 7.72 (-19.44 to 23.14); p = 0.603); (Mean difference (95% CI) of tibialis anterior muscles was ranged from - 2.44 to -6.43 (-18.28 to 9.31); p = 0.550).; Pain and disability also decreased significantly in all three study groups (p < 0.05). However, only the disability of patients who performed stretching exercises improved compared to the compression exercise group (Mean difference (95% CI) = -12.62 (-20.41 to -4.38); p = 0.009).
Neither stretching nor compression exercises altered the sEMG of the gastrocnemius and tibialis anterior muscles in patients with DGS. Furthermore, performing stretching exercises improved disability compared to the other interventions.
The trial was retrospectively registered in the Iranian Registry of Clinical Trials ( www.irct.ir ) on 10/01/2017 as IRCT201604178035N4. URL of the record: https://en.irct.ir/trial/8473 .
在深部臀肌综合征（DGS）中，梨状肌可能会压迫坐骨神经。FAIR（屈曲内收内旋）试验是一种激发试验，用于识别由该肌肉引起的坐骨神经刺激。通常会开出处方进行按压和伸展运动来治疗这种综合征。本研究的目的是比较这两种治疗方法对伴有下腰痛（LBP）和DGS患者的腓肠肌和胫骨前肌表面肌电图（sEMG）的影响。
45名参与者被分为三组，分别进行伸展运动、按压或对照。除了15分钟的热敷和15分钟的电神经刺激以缓解疼痛外，按压运动（CE）组的参与者接受自我按压运动，伸展运动（SE）组的参与者接受自我伸展运动，而对照组不接受额外干预。对于两个干预组，进行三组两分钟的运动，每组运动之间休息两分钟。将任何一组在进行FAIR试验时患侧臀部的腓肠肌和胫骨前肌的sEMG振幅值与其他组进行比较。评估疼痛和功能障碍情况，并比较两组之间的变化。
干预期后，没有一组的腓肠肌或胫骨前肌的sEMG显示出变化（p>0.05）。组间该变量的变化没有差异（腓肠肌的平均差异（95%CI）范围为=-4.04至7.72（-19.44至23.14）；p=0.603）；（胫骨前肌的平均差异（95%CI）范围为-2.44至-6.43（-18.28至9.31）；p=0.550）。所有三个研究组的疼痛和功能障碍也显著降低（p<0.05）。然而，与按压运动组相比，仅进行伸展运动的患者的功能障碍得到改善（平均差异（95%CI）=-12.62（-20.41至-4.38）；p=0.009）。
伸展运动和按压运动均未改变DGS患者腓肠肌和胫骨前肌的sEMG。此外，与其他干预措施相比，进行伸展运动改善了功能障碍。
该试验于2017年1月10日在伊朗临床试验注册中心（www.irct.ir）进行回顾性注册，注册号为IRCT201604178035N4。记录的网址：https://en.irct.ir/trial/8473 。
