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Journal of Physical Therapy and Sports Medicine
Volume 1, Issue 1 Euro Physiotherapy 2017
Notes:
Page 56
December 07-08, 2017 Rome, Italy
4th Euro-Global Physiotherapy Congress 2017
Self-exercise for piriformis syndrome
Kyung-Hoon Kim
Pusan National University, Korea
Introduction: Piriformis syndrome (PS) is defined as
excessive and prolonged contraction of the piriformis
muscle (PM), which produces low back and lower leg
pain. Diagnosis of PS is confirmed by conversion from
a positive to negative flexion-adduction-internal rotation
(FAIR) test after a diagnostic injection into the PM, while
both the straight leg raise and the Lasègue tests are
negative. Intractable PS is treated by an injection of 50-
100mg of botulinum toxin into the affected muscle under
the fluoroscope or ultrasound, and a perform-at-home
self-exercise program for piriformis muscle stretching. The
action of injected botulinum begins slowly and reaches
the tolerable pain level after 2-3 months, and ends the
relaxation effect at around 6 months. This study was
performed to evaluate the efficacy of piriformis exercise
in patients who received botulinum toxin into the affected
muscle.
Methods: 500 patients who received botulinum toxin
into the affected muscle divided into 2 groups, piriformis
exercise group and control group. The piriformis exercise
begins with a push-up position using hands and toes (A),
followed by placing the affected leg across and underneath
the body trunk so that, if possible, the affected knee is
outside the trunk (B). The unaffected leg is extended
straight back behind the trunk, keeping the pelvis straight
(C). The hips are moved backward toward the floor; the
body is leaned forward with the forearms toward the floor;
the affected leg is kept in place, until a deep stretch is felt
(D). The stretch is held for 30 s, and then the patient slowly
returns to starting position. The self-exercise program
requires the patient to assume a certain position 20 times
a day. This study was excluded the patients who could
not perform self-exercise due to old age and previous
lower leg operation. Re-injection rate after recurrence of
piriformis syndrome was compared between 2 groups.
Results: PS was more frequent in male (M/F=370/130).
Mean age was 58.5±10.3 years. Re-injection rate within 1
year after the first injection was significantly reduced in the
piriformis exercise group (P group/C group=15%/35%).
Conclusions: A self-exercise program reduces and
prevents the recurrence of PS within the 1-year-study
period.
Biography
Kyung-Hoon Kim is currently work in pain clinic. He is from Pusan
National University Yangsan Hospital, Bumeuri, Mulgeumup, Yangsan,
Kyungsangnamdo, Korea.
Kyung-Hoon Kim, J Phys Ther Sports Med 2017