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Ge W1, Sfara S1, Parpart J1
1Youngstown State University, Physical Therapy, Youngstown, United States
Background: Instrument Assisted Soft Tissue Mobilization (IASTM) is a form of manual therapy that uses instruments of various shapes and materials to identify and treat soft tissue dysfunction and pain. The therapeutic mechanisms of the action of IASTM are not fully understood. The prevailing theory is limited primarily to the mechanical effects of IASTM in the release and breakdown of scar tissue, adhesions, and fascial restrictions. This theory does not consider the neural response to IASTM. Soft tissue is embedded with peripheral neurons that respond to mechanical stimuli and provide somatosensory inputs to the central nervous system. Since the quantity of soft tissue deformation during IASTM should alter the activities of the local mechanosensitive neurons, physiotherapists should ascertain the impact of IASTM on the neurologic system. Mechanosensitive neurons provide neural inputs to proprioception, which is very important for normal movements. In addition, joint injuries may cause proprioception deficits. We previously found that IASTM altered the neural activities in 2-point discrimination but not in pain threshold. However, the effect of IASTM on proprioception is largely unknown.
Purpose: The purpose of this research project was to determine the effect of IASTM on proprioception at the knee joint.
Methods: Subjects were recruited through convenience sampling in the University community. The inclusion criteria were healthy adults, males and females, aged 18 to 65. The exclusion criteria were sensory impairments and conditions considered contraindications to IASTM. The study design was a single group pretest-posttest design. Each subject received IASTM in a supine position to the region of the right anterior thigh for 10 minutes using Graston GT1 instrument (Graston Technique, Indianapolis, IN, USA) and sweep technique. Proprioception was quantified by measuring the reposition error of the right knee joint in supine. The subject was instructed to position the knee joint to a position previously set by the investigator at 30 degrees of knee flexion. The reposition error was measured before and after the application of IASTM. One familiarization trial was performed for each subject to minimize the threat to research validity. Data were analyzed with a paired t-test with a pre-set alpha of .05.
Results: The sample contained 30 subjects, mean age 24.6 (SD 6.3) years old, 11 males and 19 females. The knee reposition error changed from 2.39 (SD 2.36) degrees before IASTM to 2.43 (SD 1.90) degrees after IASTM. However, no statistical significance was found (p=0.46).
Conclusion(s): In this study, IASTM did not alter proprioception at the knee joint as measured by the reposition error. It is possible that our sample size might be too small to detect any statistically significant differences and cause type II error. Most of the subjects in our sample were young, healthy students, so the therapeutic effect and impact of IASTM may differ when compared to patients with musculoskeletal conditions. Future research with a larger sample size from physical therapy clients is necessary.
Implications: Although no significant difference was found, the results provide insights for elucidating the therapeutic mechanisms of IASTM and future clinical research on the effects of IASTM on musculoskeletal conditions.
Keywords: instrument assisted soft tissue mobilization, knee, proprioception
Funding acknowledgements: None.
Purpose: The purpose of this research project was to determine the effect of IASTM on proprioception at the knee joint.
Methods: Subjects were recruited through convenience sampling in the University community. The inclusion criteria were healthy adults, males and females, aged 18 to 65. The exclusion criteria were sensory impairments and conditions considered contraindications to IASTM. The study design was a single group pretest-posttest design. Each subject received IASTM in a supine position to the region of the right anterior thigh for 10 minutes using Graston GT1 instrument (Graston Technique, Indianapolis, IN, USA) and sweep technique. Proprioception was quantified by measuring the reposition error of the right knee joint in supine. The subject was instructed to position the knee joint to a position previously set by the investigator at 30 degrees of knee flexion. The reposition error was measured before and after the application of IASTM. One familiarization trial was performed for each subject to minimize the threat to research validity. Data were analyzed with a paired t-test with a pre-set alpha of .05.
Results: The sample contained 30 subjects, mean age 24.6 (SD 6.3) years old, 11 males and 19 females. The knee reposition error changed from 2.39 (SD 2.36) degrees before IASTM to 2.43 (SD 1.90) degrees after IASTM. However, no statistical significance was found (p=0.46).
Conclusion(s): In this study, IASTM did not alter proprioception at the knee joint as measured by the reposition error. It is possible that our sample size might be too small to detect any statistically significant differences and cause type II error. Most of the subjects in our sample were young, healthy students, so the therapeutic effect and impact of IASTM may differ when compared to patients with musculoskeletal conditions. Future research with a larger sample size from physical therapy clients is necessary.
Implications: Although no significant difference was found, the results provide insights for elucidating the therapeutic mechanisms of IASTM and future clinical research on the effects of IASTM on musculoskeletal conditions.
Keywords: instrument assisted soft tissue mobilization, knee, proprioception
Funding acknowledgements: None.
Topic: Musculoskeletal: lower limb; Neurology; Pain & pain management
Ethics approval required: Yes
Institution: Youngstown State University
Ethics committee: Institutional Review Board
Ethics number: 072-17
All authors, affiliations and abstracts have been published as submitted.
