Deep Gluteal SyndromeBowen+ESWTNCT07772661
Comparative Effects of the Bowen Technique With and Without Extracorporeal Shock Wave Therapy in Patients With Deep Gluteal Syndrome
A study testing Experimental : Group A = Bowen With ESWT in people with Deep Gluteal Syndrome, run by University of Management and Technology Sialkot Pakistan at 1 site in Pakistan.
Trial summary
A single-blinded, randomized controlled trial consisting of 46 participants with Deep Gluteal syndrome, calculated by the G power tool with an attrition rate of 5 % will be conducted. Participants will be recruited using non-probability convenience sampling based on pre-defined inclusion and exclusion criteria. Read more about this study
- Who is it for?
- Ages 25 to 45 years
- Conditions the study is for
- Deep Gluteal Syndrome
- What is being tested?
- Experimental : Group A = Bowen With ESWT
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 sitePakistan
- Study dates
- 1 May 2026to 1 Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 25 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 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
Who cannot join
- 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
Show all 9Show fewer
- 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
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
University of Management and technology Sialkot Campus
Sialkot, Punjab Province, 51070
About this study
Official title: Comparative Effects of the Bowen Technique With and Without Extracorporeal Shock Wave Therapy in Patients With Deep Gluteal Syndrome: A Randomized Clinical Trial
A single-blinded, randomized controlled trial consisting of 46 participants with Deep Gluteal syndrome, calculated by the G power tool with an attrition rate of 5 % will be conducted. Participants will be recruited using non-probability convenience sampling based on pre-defined inclusion and exclusion criteria. Participants will be randomly assigned into two groups with 23 participants each group. Group A will receive Bowen Technique with extracorporeal shockwave therapy. Group B will receive Bowen Technique without extracorporeal shockwave therapy in conjunction with conventional therapy. Primary outcomes like pain, functional level and ROM will be measured at baseline and post-intervention using the Lower extremity functional scale (LEFS), Numeric Pain Rating scale (NPRS), and Goniometer. Data will be analyzed by IBM SPSS 26.0 with the Shapiro-Wilk test to confirm the normality.
Read the detailed description
This randomized controlled trial investigates the effects of Bowen Technique with and without Extracorporeal Shockwave Therapy in patients with Deep Gluteal Syndrome. The study includes 46 participants, with 23 participants allocated to each group. Group A receives Bowen Technique combined with ESWT, while Group B receives Bowen Technique without ESWT, with both groups receiving standardized physiotherapy. The main outcomes assessed are pain intensity, lower-limb function, hip range of motion, and clinical provocation tests including the FAIR Test, Active Piriformis Test, and Seated Piriformis Stretch Test. NPRS, LEFS, universal goniometry, and the clinical special tests are used to evaluate changes from baseline to post-treatment. The study aims to determine whether adding ESWT to Bowen Technique provides greater clinical benefit than Bowen Technique alone in patients with Deep Gluteal Syndrom
- Conditions
- Deep Gluteal Syndrome
- Being tested
- Experimental : Group A = Bowen With ESWT, Control Group: Group B= Bowen Techniques only
- Keywords
- Bowen therapy, Deep gluteal syndrome, Extracorporeal Shockwave Therapy
- Medical subject headings
- Hip socket neuropathy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Experimental : Group A = Bowen With ESWTOther
Bowen Technique is a gentle manual fascial technique used to reduce muscle tension, pain, and soft-tissue restriction. ESWT is a non-invasive mechanical treatment that delivers shockwaves to promote analgesia, circulation, and tissue repair. In Deep Gluteal Syndrome, both can target the painful and restricted deep gluteal tissues, so my study compares Bowen alone with Bowen combined with ESWT to determine whether the addition of ESWT provides greater clinical benefit
Control Group: Group B= Bowen Techniques onlyOther
The Bowen Technique is a gentle manual soft-tissue technique developed by Thomas Bowen. It uses slow, precise, cross-fiber rolling movements over muscles, tendons, ligaments, and fascia, with short rest periods between sets of movements. In your study, the therapist applies gentle pressure to the deep gluteal muscles, holds the tissue briefly, then moves across it in a controlled manner.
| Study group | Role | What they receive |
|---|---|---|
| GROUP A (Bowen Technique with ESWT) | Experimental | Group A will receive Bowen Technqiue with ESWT along with conventional Physiotherapy Protocol. Receives: Other: Experimental : Group A = Bowen With ESWT |
| GROUP B (Bowen technique without ESWT) | Active comparator | Group B will receive Bowen Technqiue ONLY along with conventional Physiotherapy Protocol. Receives: Other: Control Group: Group B= Bowen Techniques only |
What is being measured
The primary outcome is the main question the study is designed to answer.
UNIVERSAL GONIOMETRY
A goniometer is a conventional clinical tool utilized to assess joint range of motion (ROM), offering objective and dependable measurements to assess mobility restrictions in musculoskeletal disorders72
. Goniometric measurement of passive hip ROM has good test-retest reliability, with
ICC ranging from 0.82 to 0.94 across different hip movements79
- For goniometric evaluation of hip internal rotation, the minimal detectable change (MDC) is 8.6°, and for hip external rotation, it is 6.1° 18
- According to anchor-based methodology, the minimal clinically significant difference (MCID) for hip range of motion is 5.81° 80
Measured: 6 Weeks
NUMERICAL PAIN RATING SCALE (NPRS)
The Numeric Pain Rating Scale (NPRS) is a self-reported metric utilized to evaluate pain severity in individuals with musculoskeletal conditions 70
- It is a simple 11-point scale that ranges from 0 (no pain) to 10 (worst pain imaginable) that can be administered verbally or in writing 74
- which shows multilevel likelihood ratios of 0.99 (scores 1-3), 2.67 (scores 4-6), and 5.60 (scores 7-10) for detecting pain-related functional interference, and an established sensitivity of 69 percent at ascore of 175 .Patients are asked to rate their current, best, and worst pain levels during the previous 24 hours, and the average of the three values is used to get the final pain intensity score 76 The NPRS minimal clinically significant difference (MCID) in this current study was set at two points 77 . The NPRS is widely used in research and clinical environments due to its ease of use, high reliability, validity, and responsiveness to clinically relevant changes in both acute and chronic
Measured: 6 Weeks
Secondary outcomes (1)
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 71
. There are twenty items in the LEFS, and the scores range from 0 (extreme difficulty/unable to perform activity) to 4 (no difficulty). By adding up the scores for each item, the overall score can be found. Extreme limitations are indicated by a score of 0, while a maximum score of 80 denotes no functional limitations82
- When compared to the SF-36, the LEFS's construct validity was confirmed, and its sensitivity to change was higher than the SF-36's.The subgroup of patients with more chronic conditions showed excellent test-retest reliability (r = 0.94; 95 percent lower limit CI = 0.89) 71
- When tested against the Timed Up and Go (TUG) test as an external criterion, the LEFS showed exceptional diagnostic accuracy with a sensitivity of 92% and specificity of 96% at a cut-off score of 53
Measured: 6 Weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Aug 2026
- Study start1 May 2026
- Primary completion25 Jun 2026
- Study completion1 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Deep Gluteal SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This study uses a randomized controlled trial model to compare two physiotherapy interventions for Deep Gluteal Syndrome. A total of 46 participants are divided equally into two groups of 23 participants each. Group A receives Bowen Technique with Extracorporeal Shockwave Therapy, while Group B receives Bowen Technique without ESWT. Pain, lower-limb function, hip range of motion, and relevant clinical special tests are assessed before and after treatment. The model is designed to determine whether adding ESWT to Bowen Technique provides greater clinical improvement than Bowen Technique alone.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 46 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Management and Technology Sialkot Pakistan
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Danyal Ahmad, University of Management and Technology Sialkot Pakistan
- Investigators
- Hamza Zahid, Principal investigator, University of Management and Technology Sialkot Pakistan
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07772661
- Sponsor's protocol ID
- kuhs/dpt/umt-skt-00261
- Acronym
- Bowen+ESWT
- Status last verified
- Aug 2026
- First submitted
- 10 Aug 2026
- Last updated
- 21 Aug 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Amjad F, Khalid A. Comparative effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome. J Orthop Surg Res. 2023 Nov 24;18(1):895. doi: 10.1186/s13018-023-04379-z.
PubMed 37996838De la Corte-Rodriguez H, Roman-Belmonte JM, Rodriguez-Damiani BA, Vazquez-Sasot A, Rodriguez-Merchan EC. Extracorporeal Shock Wave Therapy for the Treatment of Musculoskeletal Pain: A Narrative Review. Healthcare (Basel). 2023 Oct 26;11(21):2830. doi: 10.3390/healthcare11212830.
PubMed 37957975Kurkova S, Kyncl M, Ibrahim I, Lachman H, Sakmarova K, Machac S. Exploring non-invasive diagnostic tools for deep gluteal syndrome: a multimodal approach integrating clinical and imaging techniques. Quant Imaging Med Surg. 2025 Sep 1;15(9):8409-8422. doi: 10.21037/qims-2025-241. Epub 2025 Aug 13.
PubMed 40893505Carro LP, Hernando MF, Cerezal L, Navarro IS, Fernandez AA, Castillo AO. Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release. Muscles Ligaments Tendons J. 2016 Dec 21;6(3):384-396. doi: 10.11138/mltj/2016.6.3.384. eCollection 2016 Jul-Sep.
PubMed 28066745
Study at a glance
From the registry record, last updated by the sponsor on 21 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of the Bowen Technique With and Without Extracorporeal Shock Wave Therapy in Patients With Deep Gluteal Syndrome: A Randomized Clinical Trial
- ClinicalTrials.gov ID
- NCT07772661
- Acronym / sponsor ID
- Bowen+ESWT / kuhs/dpt/umt-skt-00261
- Conditions
- Deep Gluteal Syndrome
- Keywords
- Bowen therapy, Deep gluteal syndrome, Extracorporeal Shockwave Therapy
- Study type
- Interventional
- Recruitment status
- Enrolling by invitation
- Enrolment
- 46 participants (estimated)
- Lead sponsor
- University of Management and Technology Sialkot PakistanUniversity, hospital or other
- Study start
- 1 May 2026 (actual)
- Primary completion
- 25 Jun 2026 (actual)
- Study completion
- 1 Sep 2026 (estimated)
- First posted
- 19 Aug 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A single-blinded, randomized controlled trial consisting of 46 participants with Deep Gluteal syndrome, calculated by the G power tool with an attrition rate of 5 % will be conducted. Participants will be recruited using non-probability convenience sampling based on pre-defined inclusion and exclusion criteria. Participants will be randomly assigned into two groups with 23 participants each group. Group A will receive Bowen Technique with extracorporeal shockwave therapy. Group B will receive Bowen Technique without extracorporeal shockwave therapy in conjunction with conventional therapy. Primary outcomes like pain, functional level and ROM will be measured at baseline and post-intervention using the Lower extremity functional scale (LEFS), Numeric Pain Rating scale (NPRS), and Goniometer. Data will be analyzed by IBM SPSS 26.0 with the Shapiro-Wilk test to confirm the normality.
Detailed description
This randomized controlled trial investigates the effects of Bowen Technique with and without Extracorporeal Shockwave Therapy in patients with Deep Gluteal Syndrome. The study includes 46 participants, with 23 participants allocated to each group. Group A receives Bowen Technique combined with ESWT, while Group B receives Bowen Technique without ESWT, with both groups receiving standardized physiotherapy. The main outcomes assessed are pain intensity, lower-limb function, hip range of motion, and clinical provocation tests including the FAIR Test, Active Piriformis Test, and Seated Piriformis Stretch Test. NPRS, LEFS, universal goniometry, and the clinical special tests are used to evaluate changes from baseline to post-treatment. The study aims to determine whether adding ESWT to Bowen Technique provides greater clinical benefit than Bowen Technique alone in patients with Deep Gluteal Syndrom
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- This study uses a randomized controlled trial model to compare two physiotherapy interventions for Deep Gluteal Syndrome. A total of 46 participants are divided equally into two groups of 23 participants each. Group A receives Bowen Technique with Extracorporeal Shockwave Therapy, while Group B receives Bowen Technique without ESWT. Pain, lower-limb function, hip range of motion, and relevant clinical special tests are assessed before and after treatment. The model is designed to determine whether adding ESWT to Bowen Technique provides greater clinical improvement than Bowen Technique alone.
| Arm | Type | Receives |
|---|---|---|
| GROUP A (Bowen Technique with ESWT) | Experimental | Other: Experimental : Group A = Bowen With ESWTGroup A will receive Bowen Technqiue with ESWT along with conventional Physiotherapy Protocol. |
| GROUP B (Bowen technique without ESWT) | Active comparator | Other: Control Group: Group B= Bowen Techniques onlyGroup B will receive Bowen Technqiue ONLY along with conventional Physiotherapy Protocol. |
Who may qualify
- Ages
- 25 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- 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
Key exclusion criteria (9 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Experimental : Group A = Bowen With ESWTBowen Technique is a gentle manual fascial technique used to reduce muscle tension, pain, and soft-tissue restriction. ESWT is a non-invasive mechanical treatment that delivers shockwaves to promote analgesia, circulation, and tissue repair. In Deep Gluteal Syndrome, both can target the painful and restricted deep gluteal tissues, so my study compares Bowen alone with Bowen combined with ESWT to determine whether the addition of ESWT provides greater clinical benefit | Other | GROUP A (Bowen Technique with ESWT) |
| Control Group: Group B= Bowen Techniques onlyThe Bowen Technique is a gentle manual soft-tissue technique developed by Thomas Bowen. It uses slow, precise, cross-fiber rolling movements over muscles, tendons, ligaments, and fascia, with short rest periods between sets of movements. In your study, the therapist applies gentle pressure to the deep gluteal muscles, holds the tissue briefly, then moves across it in a controlled manner. | Other | GROUP B (Bowen technique without ESWT) |
Primary outcome
UNIVERSAL GONIOMETRY
Time frame: 6 Weeks
A goniometer is a conventional clinical tool utilized to assess joint range of motion (ROM), offering objective and dependable measurements to assess mobility restrictions in musculoskeletal disorders72 . Goniometric measurement of passive hip ROM has good test-retest reliability, with ICC ranging from 0.82 to 0.94 across different hip movements79 * For goniometric evaluation of hip internal rotation, the minimal detectable change (MDC) is 8.6°, and for hip external rotation, it is 6.1° 18 * According to anchor-based methodology, the minimal clinically significant difference (MCID) for hip range of motion is 5.81° 80
NUMERICAL PAIN RATING SCALE (NPRS)
Time frame: 6 Weeks
The Numeric Pain Rating Scale (NPRS) is a self-reported metric utilized to evaluate pain severity in individuals with musculoskeletal conditions 70 * It is a simple 11-point scale that ranges from 0 (no pain) to 10 (worst pain imaginable) that can be administered verbally or in writing 74 * which shows multilevel likelihood ratios of 0.99 (scores 1-3), 2.67 (scores 4-6), and 5.60 (scores 7-10) for detecting pain-related functional interference, and an established sensitivity of 69 percent at ascore of 175 .Patients are asked to rate their current, best, and worst pain levels during the previous 24 hours, and the average of the three values is used to get the final pain intensity score 76 The NPRS minimal clinically significant difference (MCID) in this current study was set at two points 77 . The NPRS is widely used in research and clinical environments due to its ease of use, high reliability, validity, and responsiveness to clinically relevant changes in both acute and chronic
1 secondary outcome
LEFS
Time frame: 6 Weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Aug 2026.
- Results publication: PubMed 37996838Amjad F, Khalid A. Comparative effects of Bowen therapy and tennis ball technique on pain and functional disability in patients with thoracic myofascial pain syndrome. J Orthop Surg Res. 2023 Nov 24;18(1):895. doi: 10.1186/s13018-023-04379-z.
- Results publication: PubMed 37957975De la Corte-Rodriguez H, Roman-Belmonte JM, Rodriguez-Damiani BA, Vazquez-Sasot A, Rodriguez-Merchan EC. Extracorporeal Shock Wave Therapy for the Treatment of Musculoskeletal Pain: A Narrative Review. Healthcare (Basel). 2023 Oct 26;11(21):2830. doi: 10.3390/healthcare11212830.
- Results publication: PubMed 40893505Kurkova S, Kyncl M, Ibrahim I, Lachman H, Sakmarova K, Machac S. Exploring non-invasive diagnostic tools for deep gluteal syndrome: a multimodal approach integrating clinical and imaging techniques. Quant Imaging Med Surg. 2025 Sep 1;15(9):8409-8422. doi: 10.21037/qims-2025-241. Epub 2025 Aug 13.
- Results publication: PubMed 28066745Carro LP, Hernando MF, Cerezal L, Navarro IS, Fernandez AA, Castillo AO. Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release. Muscles Ligaments Tendons J. 2016 Dec 21;6(3):384-396. doi: 10.11138/mltj/2016.6.3.384. eCollection 2016 Jul-Sep.
- Related InfoLink provided by the sponsor.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Hamza Zahid principal investigator
University of Management and Technology Sialkot Pakistan
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Experimental : Group A = Bowen With ESWT in people with Deep Gluteal Syndrome, run by University of Management and Technology Sialkot Pakistan at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: enrolling by invitation, as of the sponsor's last update on 21 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
UNIVERSAL GONIOMETRY (time frame: 6 Weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07772661, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Aug 2026.