Instrument-Assisted Soft Tissue Mobilization Forces Applied by Trained Clinicians During a Simulated Treatment

Abstract

Context: Instrument-assisted Soft Tissue Mobilization (IASTM) is a therapeutic intervention used by clinicians to identify and treat myofascial dysfunction or pathology. However, little is known about the amount of force used by clinicians during an IASTM treatment and how it compares to reports of force in the current literature. Objective: To quantify the range of force applied by trained clinicians during a simulated IASTM treatment scenario. Design: Experimental. Setting: University research laboratory. Participants: Eleven licensed clinicians (physical therapist = 2, chiropractor = 2, and athletic trainer = 7) with professional IASTM training participated in the study. The participants reported a range of credentialed experience from 1 to 15 years (mean = 7 [4.7] y; median = 6 y). Intervention: Participants performed 15 one-handed unidirectional sweeping strokes with each of the 5 instruments for a total of 75 data points each. Force data were collected from a force plate with an attached skin simulant during a hypothetical treatment scenario. Main Outcome Measures: Peak force and average forces for individual strokes across all instruments were identified. Averages for these forces were calculated for all participants combined, as well as for individual participants. Results: The average of peak forces produced by our sample of trained clinicians was 6.7 N and the average mean forces was 4.5 N. Across individual clinicians, average peak forces ranged from 2.6 to 14.0 N, and average mean forces ranged from 1.6 to 10.0 N. Conclusions: The clinicians in our study produced a broad range of IASTM forces. The observed forces in our study were similar to those reported in prior research examining an IASTM treatment to the gastrocnemius of healthy individuals and greater than what has been reported as effective in treating delayed onset muscle soreness. Our data can be used by researchers examining clinically relevant IASTM treatment force on patient outcomes.

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

“…Prior reports have indicated that clinicians may not consider or be able to calculate the amount of force being applied during IASTM. 5,6 Clinicians may also not accurately predict the amount of force being produced during IASTM, 17 and optimal force application for IASTM has not been established across pathologies or treatment locations. 11 Our results, however, inform the efforts in this area by providing evidence that IASTM trained clinicians still provide consistent F peak and F mean within a therapeutic range across treatment sessions despite these limitations.…”

“…A convenience sample of 5 licensed athletic trainers who were a subset of a previous study 17 was utilized for this study. Participants were included if they had previously completed at least one professional IASTM training course (Técnica Gávilan ® = 5 and RockBlades ® = 1).…”

“…However, wide ranges in average peak force (265.13-1427.60 g and 2.6-14.0 N) and average mean force (163.15-1019.73 and 1.6-10.0 N) were also found across clinicians, and the reliability of these forces was not established across instruments or treatment sessions. 17 Variations in the amount, duration, or reliability of the applied forces within or between clinicians or across instruments might help explain inconsistent outcomes in the IASTM literature. 11 Failure to establish clinician ability to replicate similar forces across treatment sessions limits our ability to examine IASTM effectiveness in clinical and laboratory settings.…”

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].…”

Exploring Force Production Reliability across Different Levels of Clinical Experience during a Simulated One-handed Instrument-Assisted Soft Tissue Mobilization Treatment: A Pilot Study

“…The Técnica Gavilán® instrument Ala has also been used in prior studies. 1,2,7,16 The weight of the instrument is 196g. The Técnica Gavilán® instrument is a stainless-steel tool with a single beveled edge which allows unilateral strokes by the clinician (Figure 2).…”