A Novel, Nonoperative Treatment Demonstrates Success for Stiff Total Knee Arthroplasty after Failure of Conventional Therapy

Chughtai, Morad; Mont, Michael A.; Cherian, Chris; Cherian, Jeffrey J.; Elmallah, Randa K.; Naziri, Qais; Harwin, Steven F.; Bhave, Anil

doi:10.1055/s-0035-1569482

Cited by 14 publications

(8 citation statements)

References 19 publications

(29 reference statements)

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“…7,9 Astym therapy has been shown to be effective in improving ROM in patients with stiff knee/athrofibrosis following total knee arthroplasty. 14 Studies have demonstrated significant improvements in symptoms within a notably shorter duration with the use of Astym treatment compared to an eccentric program alone in treating hamstring and Achilles tendinopathies. 7,9,10 The results of this case demonstrate the positive treatment effects of Astym therapy in a young patient with cerebral palsy.…”

Section: Discussionmentioning

confidence: 99%

“…7,9,11 Achieving these treatment goals then reduces subjective complaints of restrictions in motion and improves function. 13,14 Astym therapy has consistently demon strated safety and effectiveness in the soft tissue conditions studied and is also well tolerated by patients. [7][8][9][10] However, it is important to recognize that instrumentassisted soft tissue mobilization (IASTM) interventions are not showing similar results.…”

Section: Introductionmentioning

confidence: 96%

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Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report

Scheer

Alstat²,

Zant

2016

Clin Med Insights Case Rep

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PURPOSEThe purpose of this case report was to describe the use of Astym therapy to improve hamstring flexibility and Achilles tendinopathy in a child with cerebral palsy.CASE DESCRIPTIONAn eight-year-old female with cerebral palsy was referred to physical therapy for the treatment of bilateral hamstring inflexibility and Achilles tendinopathy. Treatment focused on an Astym therapy protocol of eccentric exercise, stretching, active and passive range of motion, gait training, and a home exercise program. The patient underwent a total of 11 physical therapy treatment sessions.OUTCOMESAt the conclusion of treatment, the patient demonstrated improved resting muscle tone in bilateral lower extremities with active 90/90 hamstring flexibility measured at 165° and ankle dorsiflexion active range of motion of 5° without pain at 0° and 90° knee flexion. The patient exhibited an improved gait pattern with even stride length and diminished genu recurvatum, decreased pain with standing and walking, discontinued use of ankle–foot orthoses, and improved activity tolerance and overall function for daily activities.DISCUSSIONThe results of this case report indicate that physical therapy rehabilitation utilizing an Astym therapy protocol can successfully achieve gains in flexibility and strength and allow for improved function of bilateral lower extremities in a patient with cerebral palsy.CONCLUSIONBased on the findings of this case report, clinicians should consider the use of Astym therapy in treating musculoskeletal soft tissue dysfunction in pediatric patients with cerebral palsy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report

Scheer

Alstat²,

Zant

2016

Clin Med Insights Case Rep

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“…3 Modern-day IASTM instruments vary in material (eg, stainless steel, plastic) and design 2 and are used to improve a variety of musculoskeletal conditions and associated outcomes. [4][5][6] As such, many IASTM instruments, companies, and proposed application protocols, including ASTYM (Performance Dynamics, Muncie, IN), 7 Fascial Abrasion Technique (FIT Institute, Niagara Falls, ON, Canada), 8 Graston Technique (Indianapolis, IN), 9 and HawkGrips (Conshohocken, PA), 10 to name a few, exist.…”

mentioning

confidence: 99%

Instrument-Assisted Soft Tissue Mobilization: A Systematic Review and Effect-Size Analysis

Seffrin

Cattano

Reed

et al. 2019

Journal of Athletic Training

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Objective To determine the overall effectiveness of instrument-assisted soft tissue mobilization (IASTM) in improving range of motion (ROM), pain, strength, and patient-reported function in order to provide recommendations for use. We also sought to examine the influence of IASTM on injured and healthy participants, body part treated, and product used. Data Sources We searched the Academic Search Premier, Alt Healthwatch, CINAHL Complete, Cochrane Library, MEDLINE with full text, NLM PubMed, Physical Education Index, Physiotherapy Evidence Database (PEDro), SPORTDiscus with full text, and Web of Science databases for articles published from 1997 through 2016. The Boolean string advantEDGE OR astym OR graston OR iastm OR “instrument assist* soft tissue mobil*” OR “augment* soft tissue mobil*” OR “myofascial release” OR “instrument assist* massage” OR “augment* massage” OR “instrument assist* cross fiber massage” was used. Study Selection Included articles were randomized controlled trials that measured ROM, pain, strength, or patient-reported function and compared IASTM treatment with at least 1 other group. Data Extraction Thirteen articles met the inclusion criteria. Four independent reviewers assessed study quality using the PEDro and Centre for Evidence-Based Medicine scales. Twelve articles were included in the effect-size analysis. Data Synthesis The average PEDro score for studies of uninjured participants was 5.83 (range = 5 to 7) and that for studies of injured participants was 5.86 (range = 3 to 7). Large effect sizes were found in outcomes for ROM (uninjured participants), pain (injured participants), and patient-reported function (injured participants). The different IASTM tools used in these studies revealed similar effect sizes in the various outcomes. Conclusions The current literature provides support for IASTM in improving ROM in uninjured individuals as well as pain and patient-reported function (or both) in injured patients. More high-quality research involving a larger variety of patients and products is needed to further substantiate and allow for generalization of these findings.

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“…The instrumentation is designed to assess the presence of dysfunctional tissue by amplifying the tactile sensation of the underlying texture of the soft tissues in order to provide the treating clinician with indications where rough or improperly organized tissue is located. Once an area of potential dysfunctional tissue is located, the clinician applies appropriate pressures and shear forces to that tissue to initiate a reparative cellular response in dysfunctional tissue (1,5,18,19). At the cellular level, Astym treatment has been shown to stimulate a regenerative response via stimulating the recruitment and activation of fibroblasts, which produce fibronectin, and thereby helps to facilitate soft tissue healing and remodeling (20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Astym® therapy: a systematic review

et al. 2019

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Soft tissue dysfunction can result from the degeneration of tissues as in the case of degenerative tendinopathy or from the build-up of problematic scar tissue, which can be the result of several aggravating factors, including overuse injuries, acute or chronic trauma, or as a result of surgery. This dysfunction often results in impaired movement, pain, and swelling of the affected area, which can lead to patient dissatisfaction and a lower quality of life. These soft tissue dysfunctions also have a marked economic impact. Although a number of traditional treatments attempt to address these issues, no optimal treatment choice has emerged. Traditional treatments are not always successful, can be invasive, and can consume many medical resources. A relatively new treatment approach, Astym therapy, is a potentially useful, non-invasive, more cost-effective option. This therapy was developed to address soft-tissue dysfunctions by stimulating the regeneration of soft tissues and the resorption of inappropriate scar tissue/fibrosis. It has been reported to help with the resorption and remodeling of abnormal tissue, thereby leading to improved motion, function and pain relief. The purpose of this analysis was to review the published literature related to Astym therapy on various musculoskeletal disorders. Specifically, we evaluated the effectiveness of this therapeutic method on disorders related to the: (I) knee; (II) upper extremity; (III) hamstring muscles; and (IV) ankle and Achilles tendon injuries.

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A Novel, Nonoperative Treatment Demonstrates Success for Stiff Total Knee Arthroplasty after Failure of Conventional Therapy

Abstract: Astym therapy is a novel, nonoperative treatment that may be an effective treatment option for post-TKA patients suffering from persistent knee stiffness. Further studies are needed to validate this intervention as a part of cost-effective, standard treatment after TKA.

Cited by 14 publications

References 19 publications

Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report

Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report

Instrument-Assisted Soft Tissue Mobilization: A Systematic Review and Effect-Size Analysis

Astym® therapy: a systematic review

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