scholarly journals Descriptive Analysis of Forces Applied by Trained Clinicians During Two-Handed Instrument-Assisted Soft Tissue Mobilization

2021 ◽  
Author(s):  
Taylor C. Stevenson ◽  
James A. Whitlock ◽  
Nickolai Martonick ◽  
Scott W. Cheatham ◽  
Ashley Reeves ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Physical Therapist ◽  
Descriptive Analysis ◽  
Force Plate ◽  
Athletic Trainer ◽  
Graston Technique ◽  
Normal Forces ◽  
Soft Tissue Mobilization ◽  
Common Intervention

Abstract Instrument-assisted soft tissue mobilization (IASTM) is a common intervention among clinicians. Despite the popularity, little is known about the forces applied by the clinician with the instruments during treatment. The purpose of this investigation was to examine the forces applied by trained clinicians using IASTM instruments during a simulated treatment. Eleven IASTM trained (Graston Technique, Técnica Gavilán, or RockBlades) clinicians (Physical Therapist = 2, Chiropractor = 2, Athletic Trainer = 7) participated in the study. Each clinician performed 75 two-handed strokes distributed evenly across five different IASTM instruments on a skin simulant attached to a force plate. IASTM stroke application was analyzed for peak normal forces (Fpeak) and mean normal forces (Fmean) by stroke. We observed an average Fpeak of 8.9N and Fmean of 6.0N across all clinicians and instruments. Clinicians and researchers may use the descriptive values as a reference for application of IASTM in practice and research.

Instrument-Assisted Soft Tissue Mobilization Forces Applied by Trained Clinicians During a Simulated Treatment

2021 ◽  
pp. 1-5
Author(s):  
Nickolai J.P. Martonick ◽  
Ashley J. Reeves ◽  
James A. Whitlock ◽  
Taylor C. Stevenson ◽  
Scott W. Cheatham ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Patient Outcomes ◽  
Muscle Soreness ◽  
Physical Therapist ◽  
Force Plate ◽  
Treatment Scenario ◽  
Hypothetical Treatment ◽  
Data Points ◽  
Soft Tissue Mobilization ◽  
Force Data

Context: Instrument-assisted Soft Tissue Mobilization (IASTM) is a therapeutic intervention used by clinicians to identify and treat myofascial dysfunction or pathology. However, little is known about the amount of force used by clinicians during an IASTM treatment and how it compares to reports of force in the current literature. Objective: To quantify the range of force applied by trained clinicians during a simulated IASTM treatment scenario. Design: Experimental. Setting: University research laboratory. Participants: Eleven licensed clinicians (physical therapist = 2, chiropractor = 2, and athletic trainer = 7) with professional IASTM training participated in the study. The participants reported a range of credentialed experience from 1 to 15 years (mean = 7 [4.7] y; median = 6 y). Intervention: Participants performed 15 one-handed unidirectional sweeping strokes with each of the 5 instruments for a total of 75 data points each. Force data were collected from a force plate with an attached skin simulant during a hypothetical treatment scenario. Main Outcome Measures: Peak force and average forces for individual strokes across all instruments were identified. Averages for these forces were calculated for all participants combined, as well as for individual participants. Results: The average of peak forces produced by our sample of trained clinicians was 6.7 N and the average mean forces was 4.5 N. Across individual clinicians, average peak forces ranged from 2.6 to 14.0 N, and average mean forces ranged from 1.6 to 10.0 N. Conclusions: The clinicians in our study produced a broad range of IASTM forces. The observed forces in our study were similar to those reported in prior research examining an IASTM treatment to the gastrocnemius of healthy individuals and greater than what has been reported as effective in treating delayed onset muscle soreness. Our data can be used by researchers examining clinically relevant IASTM treatment force on patient outcomes.

Development of a Force Sensing Instrument Assisted Soft Tissue Mobilization Device

2016 ◽  
Author(s):  
Ahmed M. Alotaibi ◽  
Sohel Anwar ◽  
M. Terry Loghmani ◽  
Stanley Chien
Keyword(s):  
Soft Tissue ◽  
Load Cell ◽  
Force Measurements ◽  
Clinical Practices ◽  
Stroke Frequency ◽  
Graston Technique ◽  
Overall Design ◽  
Force Components ◽  
Soft Tissue Mobilization ◽  
Force Data

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.

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
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Athletic Training ◽  
Triceps Surae ◽  
Lower Extremity Injury ◽  
Warm Up ◽  
Graston Technique ◽  
Closed Chain ◽  
Significant Difference ◽  
Soft Tissue Mobilization

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.

Instrument-Assisted Soft-Tissue Mobilization for the Management of Chronic Plantar Heel Pain: A Pilot Study

2019 ◽  
Vol 109 (3) ◽  
pp. 193-200
Author(s):  
Edward R. Jones ◽  
Margaret A. Finley ◽  
Stacie J. Fruth ◽  
Thomas G. McPoil
Keyword(s):  
Pilot Study ◽  
Soft Tissue ◽  
Sample Size ◽  
Heel Pain ◽  
Effect Sizes ◽  
Graston Technique ◽  
Plantar Heel Pain ◽  
Final Treatment ◽  
And Function ◽  
Soft Tissue Mobilization

Background: The purpose of this study was to determine feasibility of further investigation of treatment with instrument-assisted soft-tissue mobilization (IASTM), using the Graston technique, compared with conservative care for treatment of chronic plantar heel pain (CPHP). Methods: Eleven participants with plantar heel pain lasting 6 weeks to 1 year were randomly assigned to one of two groups, with each group receiving up to eight physical therapy visits. Both groups received the same stretching, exercise, and home program, but the experimental group also received IASTM using the Graston technique. Outcome measures of pain and function were recorded at baseline, after final treatment, and 90 days later. Feasibility of a larger study was determined considering recruitment and retention rates, compliance, successful application of the protocol and estimates of the treatment effect. Results: Both groups demonstrated improvements in current pain (pain at time of survey), pain with the first step in the morning, and function after final treatment and at 90-day follow up. Medium-to-large effect sizes between groups were noted, and sample size estimates demonstrated a need for at least 42 participants to realize a group difference. A larger-scale study was determined to be feasible with modifications including a larger sample size and higher recruitment rate. Conclusions: This pilot study demonstrates that inclusion of IASTM using the Graston technique for CPHP lasting longer than 6 weeks is a feasible intervention warranting further study. Clinically important changes in the IASTM group and moderate-to-large between-group effect sizes suggest that further research is warranted to determine whether these trends are meaningful.

Does soft tissue mobilization assist static stretching to improve hamstring flexibility? A randomized controlled trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Shibili Nuhmani
Keyword(s):  
Soft Tissue ◽  
Controlled Trial ◽  
Knee Extension ◽  
Repeated Measure ◽  
Control Group ◽  
Static Stretching ◽  
Significant Difference ◽  
Hamstring Flexibility ◽  
Soft Tissue Mobilization ◽  
Experimental Group

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.

scholarly journals Soft Tissue Mobilization and Stretching for Shoulder in CrossFitters: A Randomized Pilot Study

2021 ◽  
Vol 18 (2) ◽  
pp. 575
Author(s):  
Marcos Jusdado-García ◽  
Rubén Cuesta-Barriuso
Keyword(s):  
Soft Tissue ◽  
Internal Rotation ◽  
Repeated Measures ◽  
Control Group ◽  
Average Weight ◽  
Average Height ◽  
Shoulder Injury ◽  
Glenohumeral Internal Rotation Deficit ◽  
Posterior Shoulder ◽  
Soft Tissue Mobilization

Background. The shoulder in CrossFit should have a balance between mobility and stability. Glenohumeral internal rotation deficit and posterior shoulder stiffness are risk factors for overhead shoulder injury. Objective. To determine the effectiveness of instrument-assisted soft tissue mobilization and horizontal adduction stretch in CrossFit practitioners’ shoulders. Methods: Twenty-one regular CrossFitters were allocated to experimental (stretching with isometric contraction and instrument-assisted soft tissue mobilization) or control groups (instrument-assisted soft tissue mobilization). Each session lasted 5 min, 2 days a week, over a period of 4 weeks. Shoulder internal rotation and horizontal adduction (digital inclinometer), as well as posterior shoulder stretch perception (Park scale), were evaluated. Shapiro–Wilk test was used to analyze the distribution of the sample. Parametric Student’s t-test was used to obtain the intragroup differences. The inter- and intra-rater differences were calculated using a repeated measures analysis of variance (ANOVA). Results. Average age was 30.81 years (SD: 5.35), with an average height of 178 (SD: 7.93) cm and average weight of 82.69 (SD: 10.82) kg. Changes were found in the experimental group following intervention (p < 0.05), and when comparing baseline and follow-up assessments (p < 0.05) in all variables. Significant differences were found in the control group following intervention (p < 0.05), in right horizontal adduction and left internal rotation. When comparing the perception of internal rotation and horizontal adduction in both groups, significant differences were found. Conclusions. Instrument-assisted soft tissue mobilization can improve shoulder horizontal adduction and internal rotation. An instrument-assisted soft tissue mobilization technique yields the same results alone as those achieved in combination with post-isometric stretch with shoulder adduction.

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