Clinician Reliability of One-Handed Instrument-Assisted Soft Tissue Mobilization Forces During a Simulated Treatment

Abstract

Clinicians utilize instrument-assisted soft tissue mobilization (IASTM) to identify and treat myofascial dysfunction or pathology. Currently, little is known regarding the ability of clinicians to provide similar IASTM forces across treatment sessions. The authors’ purpose was to quantify clinician reliability of force application during a simulated IASTM treatment scenario. Five licensed athletic trainers with previous IASTM training (mean credential experience = 5.2 [4.3] y; median = 5 y) performed 15 one-handed unidirectional sweeping strokes with each of the 3 instruments on 2 consecutive days for a total of 90 data points each. The IASTM stroke application was analyzed for peak normal forces (Fpeak) and mean normal forces (Fmean) by stroke across 2 sessions. The authors’ findings indicate IASTM trained clinicians demonstrated sufficient Fpeak and Fmean reliability across a treatment range during a one-handed IASTM treatment. Future research should examine if IASTM applied at different force ranges influences patient outcomes.

Implementing A Flexible Sensor to Identify Forces during Instrument-Assisted Soft Tissue Mobilization

“…Initial efforts to quantify IASTM forces used by trained clinicians have been conducted on simulated tissue attached to a force plate: one-handed IASTM strokes resulted in 2.6 to 14.0 N for peak forces and 1.6 to 10.0 N for average force across clinicians [13], while two-handed IASTM stroke forces ranged from 1.1 to 21.3 N for average peak force and 0.9 to 15.3 N for average mean force across clinicians [14]. Simulated treatment scenarios have also found that trained clinicians can be reliable when applying forces across days when using instruments of different sizes, shapes, and weights [15]. Interestingly, findings from simulated treatment studies have also indicated the potential for different instruments and grip types (i.e., one versus two-handed grips) to impact the amount of force being applied over a single simulated treatment session [14].…”

Effect of instrument type and one-handed versus two-handed grips on force application during simulated instrument-assisted soft tissue mobilisation

“…Simulated one-handed treatment scenarios on a force plate resulted in applied IASTM forces ranging from 2.6 to 14.0 N for average peak force and 1.6 to 10.0 N for average mean force across clinicians during one-handed IASTM grips 13. Additionally, there is evidence for intraclinician reliability of applied IASTM forces for one-handed IASTM grips with the TG, FAT and RB 14. While IASTM force reliability data for a two-handed grip was not identified in the literature, two-handed force data from a simulated treatment on a force plate was found: IASTM forces ranged from 1.1 to 21.3 N for average peak force and 0.9 to 15.3 N for average mean force across clinicians using the EM, RB, FAT, TG and GT instruments 15.…”

“… 13 Additionally, there is evidence for intraclinician reliability of applied IASTM forces for one-handed IASTM grips with the TG, FAT and RB. 14 While IASTM force reliability data for a two-handed grip was not identified in the literature, two-handed force data from a simulated treatment on a force plate was found: IASTM forces ranged from 1.1 to 21.3 N for average peak force and 0.9 to 15.3 N for average mean force across clinicians using the EM, RB, FAT, TG and GT instruments. 15 The variations in the range of forces reported by these studies across the aforementioned instruments requires further investigation into whether grip or instrument influenced force application.…”

“…The recent studies13–15 on clinician applied IASTM forces during simulated treatment scenarios did not examine if IASTM forces vary across different IASTM instruments or whether one-handed or two-handed grips influence force application. The potential for force variation across IASTM instruments and one-handed or two-handed stroke type would be valuable for informing clinical practice, literature interpretation and future research.…”

The Use of Instrument-Assisted Soft-Tissue Mobilization for Manual Medicine: Aiding Hand Health in Clinical Practice

“…The approach to improve the patient's musculoskeletal dysfunctions, with the help of one or more IASTM, not only improves some functional parameters for the patient but can protect the joints of the operator's/clinician's hand. Recent studies have shown that clinicians who treat myofascial disorders can apply sufficient force to reach the desired tissue depth through the use of IASTM [45,46]. This allows the operator to save the use of the joints of the hand [47].…”