INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION IN MANAGEMENT OF ATHLETIC AND MUSCULOSKELETAL CONDITIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Year 2024,
Volume: 35 Issue: 3, 402 - 413, 23.12.2024
Amandeep Singh
,
Shabnam Joshi
Rekha Chaturvedi
Abstract
Purpose: Instrument assisted soft tissue mobilization (IASTM) is a therapeutic intervention that involves the use of specialized tools to manipulate the muscles, tendons, myofascia and skin in a variety of soft tissue problems. Nonetheless, there is a divergence of opinions when it comes to the efficacy of IASTM in the treatment of athletic and musculoskeletal conditions. This systematic review was conducted to evaluate the effectiveness of IASTM in management of athletic and musculoskeletal conditions.
Methods: An investigation of the literature was carried out from inception to April 2023 using the databases PubMed, PEDro, and the Cochrane Library.
Results: Eighteen studies were included for qualitative synthesis, and six were selected for further quantitative synthesis. The effectiveness of IASTM in the management of athletic and musculoskeletal conditions was found to be either better or equal in comparison to other control interventions. The meta-analysis results showed that the reduction in pain was statistically significant in the experimental group (IASTM) compared to the control group (MD -1.33, 95% CI [-1.59, -1.06], p < 0.0001).
Conclusion: It can be stated that IASTM is an effective tool in the management of athletic and musculoskeletal conditions. Further studies should concentrate on investigating the efficiency of EASTM on particular participants with various specific athletic and musculoskeletal conditions.
Project Number
This review was also registered in PROSPERO as CRD 42023410985 on 04 April 2023.
References
- Cheatham SW, Lee M, Cain M, Baker R. The efficacy of instrument-assisted soft tissue mobilization: a systematic review. J Can Chiropr Assoc. 2016;3:200-211.
- Baker RT, Hansberger BL, Warren L. A novel approach for the reversal of chronic apparent hamstring tightness: a case report. Int J Sports Phys Ther. 2015;10(5):723-733.
- Howitt S, Wong J, Zabukovec S. The conservative treatment of Trigger thumb using Graston Techniques and Active Release Techniques. J Can Chiropr Assoc. 2006;50(4):249-54.
- Sevier TL, Gehlsen GM, Wilson JK, Stover. Traditional Physical Therapy Vs. Graston Augmented Soft Tissue Mobilization in Treatment of Lateral Epicondylitis. Med Sci Sports Exerc. 1995;27:299.
- Baker RT, Nasypany A, Seegmiller JG, Baker JG. Instrument-Assisted Soft Tissue Mobilization Treatment for Tissue Extensibility Dysfunction. Int J Athl Ther Train. 2013;18:16-21.
- Loghmani MT, Warden SJ. Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments. BMC Complement Altern Med. 2013;13:240.
- Hammer WI. The effect of mechanical load on degenerated soft tissue. J Bodyw Mov Ther. 2008;12(3):246-256.
- Lee JJ, Lee JJ, Kim do H. Inhibitory effects of instrument-assisted neuromobilization on hyperactive gastrocnemius in a hemiparetic stroke patient. Biomed Mater Eng. 2014;24(6):2389-2394.
- Howitt S, Jung S, Hammonds N. Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report. J Can Chiropr Assoc. 2009;53(1):23-31.
- Strunk RG, Pfefer MT, Dube D. Multimodal chiropractic care of pain and disability for a patient diagnosed with benign joint hypermobility syndrome: a case report. J Chiropr Med. 2014;13(1):35-42.
- Papa JA. Conservative management of De Quervain’s stenosing tenosynovitis: a case report. J Can Chiropr Assoc. 2012;56(2):112-120.
- Davidson CJ, Ganion LR, Gehlsen GM. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc. 1997;29(3):313-319.
- Gehlsen GM, Ganion LR, Helfst R. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exerc. 1999;31(4):531-535.
- Loghmani MT, Warden SJ. Instrument-assisted crossfiber massage accelerates knee ligament healing. J Orthop Sports Phys Ther. 2009;39(7):506-514.
- Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche P.C, Ioannidis J.P, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339, b2700.
- Gulick, D. T. Instrument-assisted soft tissue mobilization increases myofascial trigger point pain threshold. J Bodyw Mov Ther. 2017;22(2):341–345.
- Stanek J, Sullivan T, Davis S. Comparison of compressive myofascial release and the Graston Technique for improving ankle-dorsiflexion range of motion. J Athl Train. 2018;53(2):160–167.
- Stroiney D, Mokris A, Hanna RL, Ranney JD. Examination of Self-Myofascial Release vs. Instrument-Assisted Soft-Tissue Mobilization Techniques on Vertical and Horizontal Power in Recreational Athletes. J Strength Cond Res. 2020;34(1):79–88.
- Gunn LJ, Stewart JC, Morgan B, Metts ST, Magnuson JM, Iglowski JM, et al. Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial. J Man Manip Ther. 2019;27(1):15–23.
- Schaefer JL, Sandrey MA. Effects of a 4-week dynamic-balance-training program supplemented with Graston instrument-assisted soft-tissue mobilization for chronic ankle instability. J Sport Rehabil. 2012;21(4):313–26.
- Jones ER, Finley MA, Fruth SJ, McPoil TG. Instrument-assisted soft-tissue mobilization for the management of chronic plantar heel pain: a pilot study. J Am Podiatr Med Assoc. 2019;109(3):193–200.
- Launder, K., Compton, B.D., McLoda, T.A., & Walters, C.M. Acute effects of instrument-assisted soft tissue mobilization for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. 2014;9(1):1–7.
- Macdonald N, Baker R, & Cheatham, S. W. The effects of instrument-assisted soft tissue mobilization on lower extremity muscle performance: a randomized controlled trial. Int J Sports Phys Ther. 2016;11(7):1040–1047.
- Kim, J., & Yim, J. Instrument-assisted Soft Tissue Mobilization Improves Physical Performance of Young Male Soccer Players. Int J Sports Med. 2018;39(12):936–943.
- Kim, Y. K., Cho, S. Y., & Lee, K. H. Effects of transcutaneous electrical nerve stimulation and instrument-assisted soft tissue mobilization combined treatment on chronic low back pain: A randomized controlled trial. J Back Musculoskelet Rehabil. 2021;34(5):895–902.
- Kim, J., & Lee, J. Effect of instrument-assisted soft tissue mobilization on exercise-induced muscle damage and fibrotic factor: a randomized controlled trial. J Men’s Health. 2019;15(4):18–27.
- Serag El-Dein M, Mostafa M, Serag M, Mahgoub Mostafa E, Abdelraouf NA, Salah Z, et al. Effect of instrument-assisted soft tissue mobilization on mechanical neck pain: a randomized controlled trial. Turk J Physiother Rehabil. 2022;32:3.
- Jusdado-García, M., & Cuesta-Barriuso, R. Soft tissue mobilization and stretching for shoulder in crossfitters: A randomized pilot study. Int J Environ Res Public Health. 2021;18(2):1–10.
- Ikeda, N., Otsuka, S., Kawanishi, Y., & Kawakami, Y. Effects of Instrument-assisted Soft Tissue Mobilization on Musculoskeletal Properties. Med Sci Sports Exerc. 2019;51(10):2166–2172.
- Venkata & Saini, Seema & Palekar, Tushar & Chandra. Effect of Sub Occipital Release, Myofascial Release with IASTM Tool on Cervicogenic Headache. Indian J Physiother Occup Ther. 2020;14:204-210.
- Osailan, A., Jamaan, A., Talha, K., & Alhndi, M. Instrument-assisted soft tissue mobilization versus stretching: A comparison in effectiveness on hip active range of motion, muscle torque, and power in people with hamstring tightness. J Bodyw Mov Ther. 2021;27:200–206.
- 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 Musculoskelet Disord. 2021;22(1):212.
- Mahmood, T., Afzal, W., Ahmad, U., Arif, M. A., & Ahmad. Comparative effectiveness of routine physical therapy with and without instrument-assisted soft tissue mobilization in patients with neck pain due to upper crossed syndrome. J Pak Med Assoc. 2021;71(10):2304–2308
- Zainuddin, Z., Newton, M., Sacco, P., & Nosaka, K. Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train. 2005;40(3):174–180.
- Loghmani, M. T., & Warden, S. J. Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments. BMC Complement Altern Med. 2013;13,240.
- Markovic G. Acute effects of instrument-assisted soft tissue mobilization vs. foam rolling on knee and hip range of motion in soccer players. J Bodyw Mov Ther. 2015;19(4):690-696.
- Kim, J., Sung, D. J., & Lee, J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. J Exerc Rehabil. 2017;13(1),12–22.
- Seffrin CB, Cattano NM, Reed MA, Gardiner-Shires AM. Instrument-Assisted Soft Tissue Mobilization: A Systematic Review and Effect-Size Analysis. J Athl Train. 2019;54(7):808–821.
- Nazari G, Bobos P, Lu SZ, Reischl S, Sharma S, Le CY, Vader K, Held N, MacDermid JC. Effectiveness of instrument-assisted soft tissue mobilization for the management of upper body, lower body, and spinal conditions. An updated systematic review with meta-analyses. Disabil Rehabil. 2023;45(10):1608–1618.
- Lambert M, Hitchcock R, Lavallee K, Hayford E, Morazzini R, Wallace A, et al. The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review. Phys Ther Rev. 2017;22(1-2):76-85.
- Ge W, Roth E, Sansone A. A quasi-experimental study on the effects of instrument assisted soft tissue mobilization on mechanosensitive neurons. J Phys Ther Sci. 2017;29(4):654-657.
- Snodgrass SJ, Rivett DA. Thumb pain in physiotherapists: potential risk factors and proposed prevention strategies. J Man Manip Ther. 2002;10(4):206-217.
ATLETİK VE MUSKULOSKELETAL DURUMLARIN YÖNETİMİNDE ALET DESTEKLİ YUMUŞAK DOKU MOBİLİZASYONU: SİSTEMATİK DERLEME VE META-ANALİZ
Year 2024,
Volume: 35 Issue: 3, 402 - 413, 23.12.2024
Amandeep Singh
,
Shabnam Joshi
Rekha Chaturvedi
Abstract
Amaç: Alet destekli yumuşak doku mobilizasyonu (IASTM), çeşitli yumuşak doku problemlerinde kasları, tendonları, miyofasyayı ve cildi manipüle etmek için özel aletlerin kullanılmasını içeren terapötik bir müdahaledir. Bununla birlikte, atletik ve kas-iskelet sistemi rahatsızlıklarının tedavisinde IASTM'nin etkinliği söz konusu olduğunda görüş ayrılığı vardır. Bu sistematik derleme, atletik ve kas-iskelet sistemi rahatsızlıklarının yönetiminde IASTM'nin etkinliğini değerlendirmek amacıyla yapılmıştır.
Yöntem: Bu çalışma, kuruluşlarından Nisan2023 tarihine kadar PubMed, PEDro ve Cochrane Library veritabanlarında yayımlanmış olan literatür incelenerek gerçekleştirildi.
Sonuçlar: Nitel senteze 18 çalışma dahil edildi ve bunların altısı daha ileri nicel sentez için seçildi. IASTM'nin atletik ve kas-iskelet sistemi durumlarının yönetimindeki etkinliği, diğer kontrol girişimlerininkine benzer veya daha iyi bulundu. Meta-analiz sonuçları, deney grubunda (IASTM) ağrının kontrol grubuna kıyasla istatistiksel olarak anlamlı şekilde daha fazla azaldığını gösterdi (MD -1.33,% 95 CI [-1.59, -1.06], p < 0.0001).
Tartışma: IASTM'nin atletik ve kas-iskelet sistemi rahatsızlıklarının yönetiminde etkili bir araç olduğu söylenebilir. İleriki çalışmalar, EASTM'nin çeşitli spesifik atletik ve kas-iskelet sistemi rahatsızlıkları olan belirli katılımcılar üzerindeki etkinliğini araştırmaya yoğunlaşmalıdır.
Supporting Institution
Guru Jambheshwar University of Science and Technology University in Hisar, Haryana
Project Number
This review was also registered in PROSPERO as CRD 42023410985 on 04 April 2023.
Thanks
please review my manuscripts
References
- Cheatham SW, Lee M, Cain M, Baker R. The efficacy of instrument-assisted soft tissue mobilization: a systematic review. J Can Chiropr Assoc. 2016;3:200-211.
- Baker RT, Hansberger BL, Warren L. A novel approach for the reversal of chronic apparent hamstring tightness: a case report. Int J Sports Phys Ther. 2015;10(5):723-733.
- Howitt S, Wong J, Zabukovec S. The conservative treatment of Trigger thumb using Graston Techniques and Active Release Techniques. J Can Chiropr Assoc. 2006;50(4):249-54.
- Sevier TL, Gehlsen GM, Wilson JK, Stover. Traditional Physical Therapy Vs. Graston Augmented Soft Tissue Mobilization in Treatment of Lateral Epicondylitis. Med Sci Sports Exerc. 1995;27:299.
- Baker RT, Nasypany A, Seegmiller JG, Baker JG. Instrument-Assisted Soft Tissue Mobilization Treatment for Tissue Extensibility Dysfunction. Int J Athl Ther Train. 2013;18:16-21.
- Loghmani MT, Warden SJ. Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments. BMC Complement Altern Med. 2013;13:240.
- Hammer WI. The effect of mechanical load on degenerated soft tissue. J Bodyw Mov Ther. 2008;12(3):246-256.
- Lee JJ, Lee JJ, Kim do H. Inhibitory effects of instrument-assisted neuromobilization on hyperactive gastrocnemius in a hemiparetic stroke patient. Biomed Mater Eng. 2014;24(6):2389-2394.
- Howitt S, Jung S, Hammonds N. Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report. J Can Chiropr Assoc. 2009;53(1):23-31.
- Strunk RG, Pfefer MT, Dube D. Multimodal chiropractic care of pain and disability for a patient diagnosed with benign joint hypermobility syndrome: a case report. J Chiropr Med. 2014;13(1):35-42.
- Papa JA. Conservative management of De Quervain’s stenosing tenosynovitis: a case report. J Can Chiropr Assoc. 2012;56(2):112-120.
- Davidson CJ, Ganion LR, Gehlsen GM. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc. 1997;29(3):313-319.
- Gehlsen GM, Ganion LR, Helfst R. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exerc. 1999;31(4):531-535.
- Loghmani MT, Warden SJ. Instrument-assisted crossfiber massage accelerates knee ligament healing. J Orthop Sports Phys Ther. 2009;39(7):506-514.
- Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche P.C, Ioannidis J.P, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339, b2700.
- Gulick, D. T. Instrument-assisted soft tissue mobilization increases myofascial trigger point pain threshold. J Bodyw Mov Ther. 2017;22(2):341–345.
- Stanek J, Sullivan T, Davis S. Comparison of compressive myofascial release and the Graston Technique for improving ankle-dorsiflexion range of motion. J Athl Train. 2018;53(2):160–167.
- Stroiney D, Mokris A, Hanna RL, Ranney JD. Examination of Self-Myofascial Release vs. Instrument-Assisted Soft-Tissue Mobilization Techniques on Vertical and Horizontal Power in Recreational Athletes. J Strength Cond Res. 2020;34(1):79–88.
- Gunn LJ, Stewart JC, Morgan B, Metts ST, Magnuson JM, Iglowski JM, et al. Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial. J Man Manip Ther. 2019;27(1):15–23.
- Schaefer JL, Sandrey MA. Effects of a 4-week dynamic-balance-training program supplemented with Graston instrument-assisted soft-tissue mobilization for chronic ankle instability. J Sport Rehabil. 2012;21(4):313–26.
- Jones ER, Finley MA, Fruth SJ, McPoil TG. Instrument-assisted soft-tissue mobilization for the management of chronic plantar heel pain: a pilot study. J Am Podiatr Med Assoc. 2019;109(3):193–200.
- Launder, K., Compton, B.D., McLoda, T.A., & Walters, C.M. Acute effects of instrument-assisted soft tissue mobilization for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. 2014;9(1):1–7.
- Macdonald N, Baker R, & Cheatham, S. W. The effects of instrument-assisted soft tissue mobilization on lower extremity muscle performance: a randomized controlled trial. Int J Sports Phys Ther. 2016;11(7):1040–1047.
- Kim, J., & Yim, J. Instrument-assisted Soft Tissue Mobilization Improves Physical Performance of Young Male Soccer Players. Int J Sports Med. 2018;39(12):936–943.
- Kim, Y. K., Cho, S. Y., & Lee, K. H. Effects of transcutaneous electrical nerve stimulation and instrument-assisted soft tissue mobilization combined treatment on chronic low back pain: A randomized controlled trial. J Back Musculoskelet Rehabil. 2021;34(5):895–902.
- Kim, J., & Lee, J. Effect of instrument-assisted soft tissue mobilization on exercise-induced muscle damage and fibrotic factor: a randomized controlled trial. J Men’s Health. 2019;15(4):18–27.
- Serag El-Dein M, Mostafa M, Serag M, Mahgoub Mostafa E, Abdelraouf NA, Salah Z, et al. Effect of instrument-assisted soft tissue mobilization on mechanical neck pain: a randomized controlled trial. Turk J Physiother Rehabil. 2022;32:3.
- Jusdado-García, M., & Cuesta-Barriuso, R. Soft tissue mobilization and stretching for shoulder in crossfitters: A randomized pilot study. Int J Environ Res Public Health. 2021;18(2):1–10.
- Ikeda, N., Otsuka, S., Kawanishi, Y., & Kawakami, Y. Effects of Instrument-assisted Soft Tissue Mobilization on Musculoskeletal Properties. Med Sci Sports Exerc. 2019;51(10):2166–2172.
- Venkata & Saini, Seema & Palekar, Tushar & Chandra. Effect of Sub Occipital Release, Myofascial Release with IASTM Tool on Cervicogenic Headache. Indian J Physiother Occup Ther. 2020;14:204-210.
- Osailan, A., Jamaan, A., Talha, K., & Alhndi, M. Instrument-assisted soft tissue mobilization versus stretching: A comparison in effectiveness on hip active range of motion, muscle torque, and power in people with hamstring tightness. J Bodyw Mov Ther. 2021;27:200–206.
- 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 Musculoskelet Disord. 2021;22(1):212.
- Mahmood, T., Afzal, W., Ahmad, U., Arif, M. A., & Ahmad. Comparative effectiveness of routine physical therapy with and without instrument-assisted soft tissue mobilization in patients with neck pain due to upper crossed syndrome. J Pak Med Assoc. 2021;71(10):2304–2308
- Zainuddin, Z., Newton, M., Sacco, P., & Nosaka, K. Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train. 2005;40(3):174–180.
- Loghmani, M. T., & Warden, S. J. Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments. BMC Complement Altern Med. 2013;13,240.
- Markovic G. Acute effects of instrument-assisted soft tissue mobilization vs. foam rolling on knee and hip range of motion in soccer players. J Bodyw Mov Ther. 2015;19(4):690-696.
- Kim, J., Sung, D. J., & Lee, J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. J Exerc Rehabil. 2017;13(1),12–22.
- Seffrin CB, Cattano NM, Reed MA, Gardiner-Shires AM. Instrument-Assisted Soft Tissue Mobilization: A Systematic Review and Effect-Size Analysis. J Athl Train. 2019;54(7):808–821.
- Nazari G, Bobos P, Lu SZ, Reischl S, Sharma S, Le CY, Vader K, Held N, MacDermid JC. Effectiveness of instrument-assisted soft tissue mobilization for the management of upper body, lower body, and spinal conditions. An updated systematic review with meta-analyses. Disabil Rehabil. 2023;45(10):1608–1618.
- Lambert M, Hitchcock R, Lavallee K, Hayford E, Morazzini R, Wallace A, et al. The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review. Phys Ther Rev. 2017;22(1-2):76-85.
- Ge W, Roth E, Sansone A. A quasi-experimental study on the effects of instrument assisted soft tissue mobilization on mechanosensitive neurons. J Phys Ther Sci. 2017;29(4):654-657.
- Snodgrass SJ, Rivett DA. Thumb pain in physiotherapists: potential risk factors and proposed prevention strategies. J Man Manip Ther. 2002;10(4):206-217.