Comparison of the Graston Technique® With Instrument-Assisted Soft Tissue Mobilization for Increasing Dorsiflexion Range of Motion

2020 ◽  
pp. 1-8
Author(s):  
Holly M. Bush ◽  
Justin M. Stanek ◽  
Joshua D. Wooldridge ◽  
Stephanie L. Stephens ◽  
Jessica S. Barrack

Context: Limited dorsiflexion (DF) range of motion (ROM) is commonly observed in both the athletic and general populations and is a predisposing factor for lower extremity injury. Graston Technique® (GT) is a form of instrument-assisted soft tissue mobilization (IASTM), used commonly to increase ROM. Evidence of the long-term effects of GT on ROM is lacking, particularly comparing the full GT protocol versus IASTM alone. Objective: To evaluate the effectiveness of 6 sessions of the GT or IASTM compared with a control (CON) group for increasing closed-chain DF ROM. Design: Cohort design with randomization. Setting: Athletic training clinic. Patients or Other Participants: A total of 23 physically active participants (37 limbs) with <34° of DF. Participants’ limbs were randomly allocated to the GT, IASTM, or CON group. Intervention: Participants’ closed-chain DF ROM (standing and kneeling) were assessed at baseline and 24–48 hours following their sixth treatment. Participants in the CON group were measured at baseline and 3 weeks later. The intervention groups received 6 treatments during a 3-week period, whereas the CON group received no treatment. The GT group received a warm-up, instrument application, stretching, and strengthening of the triceps surae. The IASTM group received a warm-up and instrument application. Main Outcome Measures: Closed-chain DF was assessed with a digital inclinometer in standing and kneeling. Results: A significant difference between groups was found in the standing position (P = .03) but not in kneeling (P = .15). Post hoc testing showed significant improvements in DF in standing following the GT compared with the control (P = .02). Conclusions: The GT significantly increases ankle DF following 6 treatments in participants with DF ROM deficits; however, no differences were found between GT and IASTM. The GT may be an effective intervention for clinicians to consider when treating patients with DF deficits.

Author(s):  
Shibili Nuhmani

AbstractObjectivesObjective of the study is to investigate whether Soft tissue mobilization (STM) can assist with static stretching to improve hamstring flexibly.MethodsThe design of the study was repeated measure design. The study was conducted at the physical therapy laboratory of Jamia Hamdard University, New Delhi. Participants included 78 healthy males with hamstring tightness, randomly assigned to either the control group (static stretching) or the experimental group (STM and static stretching). The experimental group received five sets of four different STM techniques, followed by two sets of 30-s static stretches 3 days per week over the course of 12 weeks. The control group received 5 min of sham ultrasound with an inactive probe prior to static stretching. Active knee extension test (AKE) was the outcome measure.ResultsBoth groups showed significant improvement in AKE compared with the baseline measurements. With ingroup analysis showed a significant difference in AKE across all measured time periods (weeks 4, 8, and 12) with pre-test in both groups (p<0.05). No significant difference in AKE improvement was found between groups (p>0.05).ConclusionThe results of this study show that STM prior to static stretching does not significantly improve hamstring flexibility among healthy individuals. Although this study cannot be generalized, the results may be useful for evidence-based practice in the management of hamstring tightness.


2019 ◽  
Vol 3 (2) ◽  
pp. 9-23
Author(s):  
Wijianto . ◽  
Nizar Wazdi

Latar Belakang:  Instrumen Assisted Soft Tissue Mobilization (IASTM) merupakan prosedur terapi yang mana menggunakan instrumen untuk secara mekanik menstimulus struktur jaringan lunak untuk mengurangi nyeri otot, ketidaknyamanan, dan meningkatkan secara keseluruhan mobilitas dan fungsi Self Myofascial Release (SMFR) merupakan salah satu teknik manual terapi dengan cara memberikan tekanan pada otot dan fascia yang bertujuan untuk menambah Range of Motion (ROM), mengurangi nyeri, dan meningkatkan fungsi. Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui efek akut perubahan fleksibilitas otot hamstring setelah diberikan IASTM dan SMFR, juga mengetahui adanya perbedaan efek akut antara pemberian IASTM dan SMFR pada perubahan fleksibilitas otot hamtring. Metode: Penelitian eksperimen dengan membandingan pre dan post tes dari dua kelompok yang berbeda perlakuan. Kelompok pertama diberikan perlakuan teknik IASTM, kelompok kedua diberikan perlakuan SMFR.  Data yang dikumpulkan dianalisa menggunakan paired t-test dan mann-whitney test. Hasil: Hasil penelitian menunjukkan efek akut IASTM terhadap fleksibilitas otot hamstring (p = 0,001), efek akut SMFR terhadap fleksibilitas otot hamstring  (p = 0,000), Perbedaan pengaruh antara passive dan active MFR terhadap ketegangan otot (p = 0,134). Kesimpulan: Terdapat peningkatan fleksibilitas otot hamstring pada grup 1 dan grup 2. Tidak ada beda pengaruh yang signifikan antara pemberian IASTM atau SMFR terhadap fleksibilitas otot hamstring.  Kata Kunci: Hamstring, instrumen assisted soft tissue mobilization, fleksibilitas, self  myofascial release.


2021 ◽  
Vol 34 ◽  
Author(s):  
Jessica Marques da Silva ◽  
Josiele Folletto Bianchin ◽  
Emanuelle Francine Detogni Schmit ◽  
Cláudia Tarragô Candotti ◽  
Adriane Vieira

Abstract Introduction: There are no studies that investigate whether different workout endings of the Pilates method (PM), either prioritizing the activation of powerhouse muscles or the relaxation of muscles trained during the session, affects spinal curvature. Objective: Identify the immediate effect of a PM session that ends with soft tissue mobilization or wall exercises on the kyphotic and lumbar lordotic angles. Methods: A crossover clinical trial with 19 female Pilates practitioners that used a Flexicurve ruler to evaluate thoracic and lumbar spine curvature before and after a PM exercise protocol, and after endings that involved soft tissue mobilization using massage balls or wall exercises. The order of the different endings was chosen by random draw and the study volunteers participated in two interventions, with intervals of seven to ten days between them. Two two-way ANOVAs were performed (one for each postural variable), using the factors “assessment time” (pre-session; post-PE; post-ending) and “type of ending” (soft tissue or wall exercises). Results: There was no significant difference between the assessment times or endings for the kyphotic (p = 0.972; p = 0.747) and lumbar lordotic angles (p = 0.574; p = 0.627), respectively. Conclusion: Pilates instructors can opt for more relaxing or more active endings without affecting the kyphotic and lumbar lordotic angles.


Author(s):  
Ahmed M. Alotaibi ◽  
Sohel Anwar ◽  
M. Terry Loghmani ◽  
Stanley Chien

Instrument assisted soft tissue mobilization (IASTM) is a form of massage using rigid manufactured or cast devices. The delivered force, which is a critical parameter in massage during IASTM, has not been measured or standardized for most clinical practices. In addition to the force, the angle of treatment and frequency play an important role during IASTM. As a result, there is a strong need to characterize the delivered force to a patient, angle of treatment, and stroke frequency. This paper proposes a novel mechatronic design for a specific instrument from Graston Technique® (Model GT-3), which is a frequently used tool to clinically deliver localize pressure to the soft tissue. The design uses a 3D load cell, which can measure all three force components force simultaneously. The overall design is implemented with an IMUduino microcontroller chip which can also measure tool orientation angles and provide computed stroke frequency. The prototype of the mechatronic IASTM tool was validated for force measurements using an electronic plate scale that provided the baseline force values to compare with the applied force magnitudes measured by the device. The load cell measurements and the scale readings were found to be in agreement within the expected degree of accuracy. The stroke frequency was computed using the force data and determining the peaks during force application. The orientation angles were obtained from the built-in sensors in the microchip.


2018 ◽  
Vol 27 (4) ◽  
pp. 385-389 ◽  
Author(s):  
Matthew J. Hussey ◽  
Alex E. Boron-Magulick ◽  
Tamara C. Valovich McLeod ◽  
Cailee E. Welch Bacon

Clinical Scenario: Shoulder range of motion (ROM) in throwing athletes relies on a balance of mobility and stability to maintain proper function and health that, if disrupted, can lead to shoulder injury. There have been several studies that address the relationship between ROM deficits and overhead injuries; however, it may be unclear to clinicians which interventions are most effective for increasing ROM in the glenohumeral joints of overhead athletes. Clinical Question: In overhead athletes who have deficient shoulder ROM, is instrument-assisted soft tissue mobilization (IASTM) more effective at acutely increasing ROM over the course of a patient’s treatment when compared with self-stretching? Summary of Key Findings: A thorough literature review yielded 3 studies relevant to the clinical question, and all 3 studies were included. Two articles found a significant increase in acute ROM when compared with a self-stretch measure. All 3 articles showed increases in internal rotation and horizontal adduction, and 1 study reported an increase in total arc of shoulder ROM. Clinical Bottom Line: There is moderate evidence to support the use of IASTM to acutely increase ROM in the glenohumeral joint of overhead athletes. Clinicians should be aware of the variability with recommended treatment times; however, positive results have been seen with treatments lasting 5 to 6 minutes per treatment region. There is no consensus for treatment intensity, and certain IASTM tools require certification. Strength of Recommendation: Grade B evidence exists that IASTM is more effective at increasing shoulder ROM (ie, internal rotation, horizontal adduction, external rotation, total arc of motion) in overhead athletes than self-stretching measures.


2015 ◽  
Vol 95 (11) ◽  
pp. 1467-1477 ◽  
Author(s):  
Paul A. van den Dolder ◽  
Paulo H. Ferreira ◽  
Kathryn M. Refshauge

Background Soft tissue massage and exercise are commonly used to treat episodes of shoulder pain. Objective The study objective was to compare the effects of soft tissue massage and exercise with those of exercise alone on pain, disability, and range of motion in people with nonspecific shoulder pain. Design This was a randomized controlled trial. Setting The study was conducted in public hospital physical therapy clinics in Sydney, New South Wales, Australia. Participants The study participants were 80 people with an average age of 62.6 years (SD=12.2) who were referred to physical therapists for treatment of nonspecific shoulder pain. Intervention Participants were randomly assigned to either a group that received soft tissue massage around the shoulder and exercises (n=40) or a group that received exercise only (n=40) for 4 weeks. Measurements The primary outcome was improvement in pain, as measured on a 100-mm visual analog scale, 1 week after the cessation of treatment. Secondary outcomes were disability and active flexion, abduction, and hand-behind-back range of motion. Measurements were obtained at baseline, 1 week after the cessation of treatment, and 12 weeks after the cessation of treatment. Results The between-group difference in pain scores from the baseline to 12 weeks after the cessation of treatment demonstrated a small significant difference in favor of the group receiving exercise only (mean difference=14.7 mm). There were no significant differences between groups in any other variable. Limitations It was not possible to mask therapists or participants to group allocation. Diagnostic tests were not used on participants to determine specific shoulder pathology. Conclusions The addition of soft tissue massage to an exercise program for the shoulder conferred no additional benefit for improving pain, disability, or range of motion in people with nonspecific shoulder pain.


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