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

Abstract

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.

The effectiveness of diacutaneous fibrolysis on pain, range of motion and functionality in musculoskeletal disorders: A systematic review and meta-analysis

“…A systematic review focused on instrument-assisted soft tissue mobilization showed improvements on functionality in subjects with tendinopathy. 25 However, differing from our results, no significant differences were found for function improvement in patients with chronic lateral epicondylalgia in Nazari et al 23 systematic review. These differences suggest that diacutaneous fibrolysis could be more effective than other instrument-assisted soft tissue mobilization techniques in order to improve function, in patients with musculoskeletal disorders.…”

“…This issue agree with other systematic reviews, where manual or instrumental therapy techniques are applied. 25,33 However, unlike another systematic review involving instrument-assisted soft tissue mobilization, in all the studies included in this review the participants and the assessor were blinded, as well as the subjects allocation processes. 23,25 There are some limitations to this review, which might limit the translations of our results.…”

Soft Tissue Mobilization and Stretching for Shoulder in CrossFitters: A Randomized Pilot Study

“…The current literature provides support for instrument-assisted soft tissue mobilization (IASTM) in improving the range of motion (ROM) in uninjured individuals as well as pain and patient-reported function (or both) in injured patients [ 15 ]. Horizontal adduction shoulder stretch or post-isometric cross-body stretch can improve the range of motion in horizontal adduction and the glenohumeral internal rotation [ 16 ], by decreasing the posterior stiffness of the shoulder [ 17 ].…”

The effects of instrument-assisted soft tissue mobilization rehabilitation exercise on range of motion, isokinetic strength, and balance in chronic ankle instability taekwondo players

“…Additionally, IASTM can alleviate pain associated with the muscle and ligament, promote regular ROM, and structurally and functionally treat the damaged area ( Cheatham et al, 2016 ). Overall, IASTM has a positive effect on the nervous system and body function of the specific area ( Seffrin et al, 2019 ). However, in the current state of scientific research, inadequate research has been done on the use of IASTM.…”