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

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.

Role of physiotherapy in post-operative knee stiffness: A literature review

Objectives: Restricted motion range, also known as knee stiffness, is one of the significant complications after intra-articular or extra-articular injury. Postoperatively, it is primarily due to articular fibrosis (intra and extra) and scarring adhesions in the quadriceps-femoral apparatus after ligament reconstruction, patellar tendon repair, burn, and total knee arthroplasty. Knee stiffness is both preventable and treatable with physiotherapy treatment. Physiotherapy includes electrotherapy and exercises therapy playing an important role in reduction of knee stiffness. The aim of the present study to survey the existing literature related to exercise therapy and electrotherapy programs for the management of post-operative knee stiffness. Materials and Methods: A computerized search of the ELSEVIER, PubMed, and Medline database was conducted for year 2008 onward. The search was performed using English language. Results: Based on the literature survey undertaken, the best approach for efficient recovery is to plan and start treatment regime preoperatively that should be continued until achieving knee symmetry postoperatively. Conclusion: The findings of the current study support that both electrotherapy and exercise interventions play a significant role to overcome the consequences of post-operative knee stiffness. In addition to it, literature enlightens that advanced techniques such as unique sustained method and Graston technique are much more beneficial and advantageous over traditional and conventional methods of physiotherapy treatment to manage post-operative knee stiffness.

Comparison of Myofascial Release Techniques on Pectoralis Minor Length, Glenohumeral Total Arc of Motion, and Skin Temperature: A Pilot Study

Context: The pectoralis minor (PM) is an important postural muscle that may benefit from myofascial techniques, such as Graston Technique® (GT) and self-myofascial release (SMR). Objective: To examine the effects of GT and SMR on PM length, glenohumeral total arc of motion (TAM), and skin temperature. Design: Cohort. Setting: Laboratory. Participants: Twenty-six healthy participants (19 females and 7 males; age = 20.9 [2.24] y, height = 170.52 [8.66] cm, and weight = 72.45 [12.32] kg) with PM length restriction participated. Interventions: Participants were randomized to the intervention groups (GT = 12 and SMR = 14). GT and SMR interventions were both applied for a total of 5 minutes during each of the 3 treatment sessions. Main Outcome Measures: PM length, TAM, and skin temperature were collected before and after each intervention session (Pre1, Post1, Pre2, Post2, Pre3, and Post3) and at 1-week follow-up (follow-up). Separate intervention by time analyses of variance examined differences for each outcomes measure. Bonferroni post hoc analyses were completed when indicated. Significance was set a priori at P ≤ .05. Results: No significant intervention by time interactions were identified for PM length, TAM, or temperature (P > .05). No significant intervention main effects were identified for PM length (P > .05), TAM (P > .05), or temperature (P > .05) between the GT or SMR technique groups. Overall, time main effects were found for PM length (P = .02) and temperature (P < .001). Post hoc analysis showed a significant increase in PM length for both intervention groups at follow-up (P = .03) compared with Post2. Furthermore, there were significant increases in temperature at Post1 (P < .001), Post2 (P = .01), and Post3 (P < .001) compared with Pre1; Post2 was increased compared with Pre2 (P = .003), Pre3 (P < .001), and follow-up (P = .01); Post3 increased compared with Pre3 (P = .01) and follow-up (P = .01). Conclusion: Serial application of GT and SMR to the PM did not result in increases in PM length or TAM. Regardless of intervention, skin temperature increased following each intervention.

PENGARUH GRASTON TECHNIQUE DAN CLOSED KINETIC CHAIN EXERCISE PADA OSTEOARTHRITIS KNEE DEXTRA

Background : The prevalence of osteoarthritis in Indonesia increases with age. The highest prevalence is at age <75 years. The incidence of osteoarthritis in Indonesia from 1990 to 2010 has increased. Per 100,000 men and women reach their peak at the 80 years old. Women reached a peak at 1,327.4 compared to men who were only 907.7. Osteoarthritis of the knee has problems such as pain, decreased ROM, edema, and decreased muscle strength, to overcome the problems in the case of knee osteoarthritis can be given physiotherapy treatment such as Graston Technique and Closed Kinetic Chain Exercise. Objective : The purpose of this study was to determine the effect of graston technique and closed kinetic chain exercise on knee dextra osteoarthritis to overcome body and function. Results : After being given physiotherapy management with a combination of graston technique and closed kinetic chain exercise in patients with knee osteoarthritis, there was a decrease in pain so that the increase in functional ability is known from the reduction of the diagram from the results of filling the WOMAC index form pre treatment with the score being post treatment in six meetings. Conclusion : The combination of graston technique and closed kinetic chain exercise has effect on reducing pain so that it can improve the functional abilities of patients with knee osteoarthritis.

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

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.