Effect of Instrument Assisted Soft Tissue Mobilization in Patients with Cervical Disc Herniation: A Randomized Controlled Trial

Year 2024, Volume: 8 Issue: 2, 327 - 335, 31.05.2024

Yasin Alğantekin Mehmet Özkeskin Adem Aktürk Emre Şenocak

https://doi.org/10.30621/jbachs.1283363

Abstract

Purpose: The effects of Instrument Assisted Soft Tissue Mobilization (IASTM) on cervical disc herniation (CDH) have not been extensively studied. The study aimed to investigate the effect of the IASTM technique on pain, functionality and psychology in CDH.
Methods: A two-armed randomized controlled trial was carried out with 24 patients with CDH. Participants were randomized into two groups: conventional physiotherapy (n=12) and IASTM plus conventional physiotherapy (n=12). A conventional rehabilitation consists of a hot pack, electrotherapy, and exercises five days a week for four weeks. IASTM technique has been used for two sessions per week for four weeks. Patients were assessed with Visual Analogue Scale (VAS), Neck Disability Index (NDI), Copenhagen Neck Functional Disability Scale (CNFDS), Hospital Anxiety and Depression Scale (HADS).
Results: Both groups had improvements in VAS scores (p<0.05). IASTM group yielded more reduction in resting and activity pains (presting=0.001, pactivity=0.001). Disability scores of both groups improved (p<0.05). However, no difference was encountered between the groups regarding function and disability (p>0.05). Both the intervention and control groups showed a decrease in anxiety and depression symptoms (p<0.05). The anxiety and depression score of the intervention group yielded better results than the control group (p<0.05).
Conclusion: IASTM improved patients' rest and activity pain, anxiety and depression symptoms. On the other hand, IASTM provided advancement on function and disability scores simply as effective as conventional physiotherapy.

Keywords

Anxiety, cervical pain, disability, instrument-assisted soft tissue mobilization

Project Number

Yok

Effect of Instrument Assisted Soft Tissue Mobilization in Patients with Cervical Disc Herniation: A Randomized Controlled Trial

Abstract

Supporting Institution

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Project Number

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Thanks

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References

• Vassilaki M, Hurwitz EL. Insights in public health: perspectives on pain in the low back and neck: global burden, epidemiology, and management. Hawai'i Journal of Medicine & Public Health. 2014;73(4):122.
• Fejer R, Kyvik KO, Hartvigsen J. The prevalence of neck pain in the world population: a systematic critical review of the literature. European spine journal. 2006;15(6):834-48.
• Peng B, DePalma MJ. Cervical disc degeneration and neck pain. Journal of pain research. 2018;11:2853.
• Whiting WC, Zernicke RF. Biomechanics of musculoskeletal injury: Human Kinetics; 2008.
• Papadakis M, Sapkas G, Papadopoulos EC, Katonis P. Pathophysiology and biomechanics of the aging spine. The open orthopaedics journal. 2011;5:335.
• Frost BA, Camarero-Espinosa S, Foster EJ. Materials for the spine: anatomy, problems, and solutions. Materials. 2019;12(2):253.
• Choi W-H. The Effects of the Cervical Deep Muscle Flexion Exercises on Pain and Cervical Function in Patients with Chronic Cervical Pain. Journal of Korean Society for Neurotherapy. 2019;23(1):55-9.
• Yang L, Yang C, Pang X, Li D, Yang H, Zhang X, et al. Mechanoreceptors in diseased cervical intervertebral disc and vertigo. Spine. 2017;42(8):540-6.
• Pampati K, is an Interventional IDM, Manchikanti L. A randomized, double-blind, active control trial of fluoroscopic cervical interlaminar epidural injections in chronic pain of cervical disc herniation: results of a 2-year follow-up. Pain Physician. 2013;16:465-78. 10. Amiri-Arimi S, Bandpei MAM, Rezasoltani A, Javanshir K, Biglarian A. Asymmetry of cervical multifidus and longus colli muscles size in participants with and without cervical radicular pain. Journal of Manipulative and Physiological Therapeutics. 2020;43(3):206-11.
• Bible JE, Biswas D, Miller CP, Whang PG, Grauer JN. Normal functional range of motion of the cervical spine during 15 activities of daily living. Clinical Spine Surgery. 2010;23(1):15-21.
• Liu F, Fang T, Zhou F, Zhao M, Chen M, You J, et al. Association of depression/anxiety symptoms with neck pain: a systematic review and meta-analysis of literature in China. Pain Research and Management. 2018;2018.
• Cohen SP, editor Epidemiology, diagnosis, and treatment of neck pain. Mayo Clinic Proceedings; 2015: Elsevier.
• Gebremariam L, Koes BW, Peul WC, Huisstede BM. Evaluation of treatment effectiveness for the herniated cervical disc: a systematic review. Spine. 2012;37(2):E109-E18.
• El-Hafez HM, Hamdy HA, Takla MK, Ahmed SEB, Genedy AF, Al Shaymaa S. Instrument-assisted soft tissue mobilisation versus stripping massage for upper trapezius myofascial trigger points. Journal of Taibah University Medical Sciences. 2020;15(2):87-93.
• Crothers AL, French SD, Hebert JJ, Walker BF. Spinal manipulative therapy, Graston technique® and placebo for non-specific thoracic spine pain: a randomised controlled trial. Chiropractic & manual therapies. 2016;24(1):1-9.
• Abdel-Aal NM, Elsayyad MM, Megahed AA. Short-term effect of adding Graston technique to exercise program in treatment of patients with cervicogenic headache: a single-blinded, randomized controlled trial. European Journal of Physical and Rehabilitation Medicine. 2021;57(5):758-66.
• Kim D-H, Lee B-H. The effects of mechanical stimulation using graston on changing trigger point pressure pain threshold and muscle tone of the same spinal segment in neck disk patient. The Journal of the Korea Contents Association. 2019;19(10):198-205.
• Davies CC, Brockopp DY. Use of ASTYM® treatment on scar tissue following surgical treatment for breast cancer: a pilot study. Rehabilitation Oncology. 2010;28(3):3.
• Liu X, Faes L, Calvert MJ, Denniston AK. Extension of the CONSORT and SPIRIT statements. The Lancet. 2019;394(10205):1225.
• Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 2007;39(2):175-91.
• Noori SA, Rasheed A, Aiyer R, Jung B, Bansal N, Chang K-V, et al. Therapeutic ultrasound for pain management in chronic low back pain and chronic neck pain: a systematic review. Pain Medicine. 2020;21(7):1482-93.
• Nitsure P, Welling A. Effect of gross myofascial release of upper limb and neck on pain and function in subjects with mechanical neck pain with upper limb radiculopathy: A clinical trial. Int J Dental Med Res. 2014;1(3):8-16.
• Kane RL, Bershadsky B, Rockwood T, Saleh K, Islam NC. Visual Analog Scale pain reporting was standardized. Journal of clinical epidemiology. 2005;58(6):618-23.
• Aslan E, Karaduman A, Yakut Y, Aras B, Simsek IE, Yaglý N. The cultural adaptation, reliability and validity of neck disability index in patients with neck pain: a Turkish version study. Spine. 2008;33(11):E362-E5.
• Yapali G, Günel MK, Karahan S. The cross-cultural adaptation, reliability, and validity of the Copenhagen Neck Functional Disability Scale in patients with chronic neck pain: Turkish version study. Spine. 2012;37(11):E678-E82.
• Misterska E, Jankowski R, Glowacki M. Cross-cultural adaptation of the Neck Disability Index and Copenhagen Neck Functional Disability Scale for patients with neck pain due to degenerative and discopathic disorders. Psychometric properties of the Polish versions. BMC musculoskeletal disorders. 2011;12(1):1-8.
• Aydemir Ö, Güvenir T, Küey L, Kultur S. Hospital Anxiety and Depression Scale Turkish form: validation and reliability study. Türk Psikiyatri Der. 1997;8(4):280e7.
• Youssef EF MN, Mohamed MM, Ahmad HA. Trigger Point Release versus Instrument Assisted Soft Tissue Mobilization on Upper Trapezius Trigger Points in Mechanical Neck Pain: A Randomized Clinical Trial. The Medical Journal of Cairo University. 2020;88(December):2073-9.
• Ramadan SM, El Gharieb HA, Labib AM, Embaby EA. Short-term effects of instrument-assisted soft tissue mobilization compared to algometry pressure release in tension-type headache: a randomized placebo-controlled trial. Journal of Manual & Manipulative Therapy. 2022:1-10.
• Mylonas K, Angelopoulos P, Billis E, Tsepis E, Fousekis K. Combining targeted instrument-assisted soft tissue mobilization applications and neuromuscular exercises can correct forward head posture and improve the functionality of patients with mechanical neck pain: a randomized control study. BMC musculoskeletal disorders. 2021;22(1):1-9.
• Smith SR, Little JA, Nowinski LA, Walker SJ. The comprehensive psychological assessment. Handbook of clinical rating scales and assessment in psychiatry and mental health: Springer; 2009. p. 287-301.
• Zlatkov Y, Zlatkova K. Monitoring the effect of the ERGON IASTM technique in patients with lumbar disc herniation. Journal of Physical Education and Sport. 2021;21(5):2706-11.
• Lauche R, Wübbeling K, Lüdtke R, Cramer H, Choi K-E, Rampp T, et al. Randomized controlled pilot study: pain intensity and pressure pain thresholds in patients with neck and low back pain before and after traditional East Asian" gua sha" therapy. The American Journal of Chinese Medicine. 2012;40(05):905-17.
• Crombez G, Eccleston C, Van Damme S, Vlaeyen JW, Karoly P. Fear-avoidance model of chronic pain: the next generation. The Clinical journal of pain. 2012;28(6):475-83.
• Emshi ZA, Okhovatian F, Kojidi MM, Baghban AA, Azimi H. Comparison of the effects of instrument assisted soft tissue mobilization and dry needling on active myofascial trigger points of upper trapezius muscle. Medical Journal of the Islamic Republic of Iran. 2021;35:59.
• Erden A, Şenocak E, Kalaycıoğlu A, Aktürk A. Effectiveness of instrument assisted soft tissue mobilization in myofascial pain syndrome: preliminary results of a randomized controlled trial. Sports Medicine Journal/Medicina Sportivâ. 2020;16(1).
• Melham TJ, Sevier TL, Malnofski MJ, Wilson JK, Helfst Jr RH. Chronic ankle pain and fibrosis successfully treated with a new noninvasive augmented soft tissue mobilization technique (ASTM): a case report. Medicine and science in sports and exercise. 1998;30(6):801-4.
• Gross MT. Chronic tendinitis: pathomechanics of injury, factors affecting the healing response, and treatment. Journal of Orthopaedic & Sports Physical Therapy. 1992;16(6):248-61.
• Hammer WI. The effect of mechanical load on degenerated soft tissue. Journal of Bodywork and Movement Therapies. 2008;12(3):246-56.
• Yip CHT, Chiu TTW, Poon ATK. The relationship between head posture and severity and disability of patients with neck pain. Manual therapy. 2008;13(2):148-54.
• Hermann KM, Reese CS. Relationships among selected measures of impairment, functional limitation, and disability in patients with cervical spine disorders. Physical therapy. 2001;81(3):903-12.
• Moon JH, Jung J-H, Won YS, Cho H-Y. Immediate effects of Graston Technique on hamstring muscle extensibility and pain intensity in patients with nonspecific low back pain. Journal of physical therapy science. 2017;29(2):224-7.
• Dunn AL, Trivedi MH, O'Neal HA. Physical activity dose-response effects on outcomes of depression and anxiety. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. 2001.
• Chiu TT, Hui-Chan CW, Cheing G. A randomized clinical trial of TENS and exercise for patients with chronic neck pain. Clinical rehabilitation. 2005;19(8):850-60.