Comparison of Gluteal Muscle Activation and Core Strengthening in Dead Butt Syndrome Syndrome

• Group A: Gluteal Muscle Activation (Other): Gluteal Activation focuses on "waking up" and isolating the gluteus maximus, medius, and minimus to ensure they fire properly, often using low-load, high-control movements.
• Group B: Gluteal Muscle Activation and Core stregthening exercises (Other): Gluteal Activation focuses on "waking up" and isolating the gluteus maximus, medius, and minimus to ensure they fire properly, often using low-load, high-control movements.Core Strengthening focuses on stabilizing the spine and pelvis by targeting the abdominals, back, and deep pelvic muscles.

Primary outcomes

• Tampa Scale of Kinesiophobia (TSK-11) [4 weeks]: The Tampa Scale for Kinesiophobia (TSK-11) is a shortened, 11-item version of the original 17-item TSK questionnaire used to assess fear of movement, or kinesiophobia, in individuals with chronic pain or other conditions involving movement limitations
• Lower Extremity Functional Scale (LEFS) [4 weeks]: The Lower Extremity Functional Scale (LEFS) is used to assess "patients' initial function, ongoing progress, and outcome" for a variety of disorders affecting the lower extremities. LEFS is a self-reported survey. The LEFS total score ranges from 0 to 80, with higher scores indicating better functional ability.
• Numeric Pain Rating Scale [4 Weeks]: The Numeric Pain Rating Scale (NPRS) is a tool used to measure the intensity of pain. It's a unidimensional scale, typically an 11-point scale ranging from 0 to 10, where 0 represents no pain and 10 represents the worst pain imaginable. Patients verbally or numerically indicate the level of pain they are experiencing.
• The Trendelenburg test [4 Weeks]: The Trendelenburg test is a physical examination used to assess the strength of hip abductor muscles, specifically the gluteus medius and gluteus minimus, or to check for the competency of venous valves in the legs. A positive Trendelenburg sign, indicated by a drop of the pelvis on the unsupported side during a single-leg stance, suggests weakness in the hip abductors.

Sex: All, ages: 18 Years to 55 Years

Inclusion Criteria:

* Symptoms persisting for more than 6 weeks (subacute or chronic cases).
* Sedentary to moderately active individuals (i.e., not involved in heavy gluteal-strengthening or core training for at least 3 months prior to the study). vParticipants will be diagnosed with Dead Butt Syndrome based on the presence of at least two out of three of the following criteria:
* Self-reported dull ache, discomfort, or tightness in the gluteal region worsened with prolonged sitting or walking.
* Positive Trendelenburg Test
* ≤ 4/5 on the standard MRC grading scale

Exclusion Criteria:

* Pregnancy or plans to become pregnant during the study period.
* Diagnosed hip labral tears, piriformis syndrome, or sciatica unrelated to gluteal amnesia.
* Degenerative or neurological conditions such as osteoarthritis, multiple sclerosis, stroke, or spinal cord injury.
* History of significant spinal trauma or surgery in the past 12 months.
* Engagement in regular physical exercise or participation in rehabilitation programs within the last 6 months.

• Attiq Ur Rehman, MS, Principal investigator, Riphah International University