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J. Sawdon-Bea1, J. McOmber2
1California State University, Fresno, Physical Therapy, Fresno, United States, 2Summit Physical Therapy, Physical Therapy, Clovis, United States
Background: Optimal musculoskeletal function requires adequate joint range of motion (ROM) which may be restricted by muscle tightness. Instrument Assisted Soft Tissue Mobilization (IASTM) is a type of soft tissue mobilization in which designed instruments are used to apply longitudinal pressure along the course of muscle fibers. The instruments are theorized to provide a mechanical advantage which allows the clinician to achieve greater depth of mechanical force transmission to that which can be produced with the hands. Research has demonstrated benefits of IASTM including improved soft tissue physiology, decreased pain, and increased ROM, however limited research exists exploring the effects of trunk flexion ROM in individuals with limited active lumbar flexion.
Purpose: The purpose of this study was to examine the effectiveness of a one-time application of IASTM to the lumbar erector spinae on lumbar and trunk flexion ROM in individuals with limited active lumbar flexion.
Methods: Sixteen participants (7 females and 9 males) with a mean age 33 years (±39) volunteered from clients at an outpatient orthopedic physical therapy clinic. Participants were randomly assigned to IASTM treatment or control groups. Active trunk flexion ROM was measured from the knuckle of the third digit to the floor, before and immediately after intervention. Active lumbar ROM was measured with an inclinometer, with the superior edge placed 15 cm superior to the midline of bilateral posterior superior iliac spines (PSIS.) Inclusion criteria included inability to touch the floor with extended knees, and trunk flexion less than 90 degrees via inclinometer (Average baseline trunk flexion ROM measured with an inclinometer was 75.25°). IASTM was performed with HawkGrips™ tools of varying sizes, shapes, and styles of treatment edges. The differences in the tools allow for the treatment of various anatomical structures with varying intensities. Participants in the treatment group were lying prone on flexed hips and knees (child’s pose) for IASTM, with a total of 4 minutes of treatment directed to the erector spinae musculature from T10-L5. Participants in the control group maintained the same prone position with hip and knee flexion (child’s pose) for 4 minutes without IASTM treatment.
Results: A statistically significant improvement for trunk flexion ROM (6.5cm, p<.001) and lumbar flexion ROM (6.0°, p<.001) was found in the IASTM treatment group immediately after intervention. The control group change in trunk flexion ROM (.44cm, p<.132) and lumbar flexion ROM (.63°, p<.180) was not statistically significant.
Conclusion(s): Based on the results of this study, a one-time treatment of IASTM to the lumbar erector spinae is effective at improving trunk and lumbar flexion ROM.
Implications: IASTM may be considered as an alternative treatment to static stretching for improving trunk and lumbar ROM. Future research incorporating a larger sample size with multiple treatment sessions may further improve clinical implications.
Funding, acknowledgements: No funding.
Keywords: instrument assisted soft tissue mobilization (IASTM), Lumbar range of motion (ROM), Lumbar erector spinae
Topic: Musculoskeletal: spine
Did this work require ethics approval? Yes
Institution: Hands on Physical Therapy
Committee: IRB Committee
Ethics number: 3
All authors, affiliations and abstracts have been published as submitted.
