Mechanical Percussion Devices: A Survey of Practice Patterns Among Healthcare Professionals

Abstract

BackgroundMechanical percussion devices have become popular among sports medicine professionals. These devices provide a similar effect as manual percussion or tapotement used in therapeutic massage. To date, there are few published studies or evidence-based guidelines for these devices. There is a need to understand what professionals believe about this technology and how they use these devices in clinical practice. PurposeTo survey and document the knowledge, clinical application methods, and use of mechanical percussion devices among healthcare professionals in the United States. DesignCross-sectional survey study. MethodsA 25 question online survey was emailed to members of the National Athletic Trainers Association, Academy of Orthopedic Physical Therapy, and American Academy of Sports Physical Therapy. ResultsFour hundred twenty-five professionals completed the survey. Most professionals (92%, n=391) used devices from two manufacturers: Hyperice® and Theragun®. Seventy-seven percent directed clients to manufacturer and generic websites (n=329) to purchase devices. Most respondents used a medium and low device speed setting for pre-and post-exercise (62%, n=185), pain modulation (59%, n=253), and myofascial mobility (52%, n=222). A large proportion of respondents preferred a total treatment time between 30 seconds and three minutes (36-48%, n=153-204) or three to five minutes (18-22%, n=76-93). Most respondents (54-69%, n=229-293) believed that mechanical percussion increases local blood flow, modulates pain, enhances myofascial mobility, and reduces myofascial restrictions. Most respondents (72%, n=305) were influenced by other colleagues to use these devices. Sixty-six percent used patient reported outcomes (n=280) to document treatment efficacy. Live instruction was the most common mode of education (79%, n=334). ConclusionThese results are a starting point for future research and provide insight into how professionals use mechanical percussion devices. This survey also highlights the existing gap between research and practice. Future research should examine the efficacy of this technology and determine consensus-based guidelines.

Acute Effects of Percussive Massage Treatment on Drop Jump Performance and Achilles Tendon Stiffness

“…Findings from the current study may indicate that 60 s of mechanical PM is insufficient to reduce the Achilles tendon’s stiffness significantly. However, it should be noted that there are no precise guidelines for the optimal duration of mechanical PM, and recent reports indicate that healthcare professionals prefer a total treatment time between 30 s to 3 min [ 1 ]. This points to the need for future empirical studies to assess the effect of different durations of mechanical PM and to establish how long post-PM effects are maintained in terms of stiffness and physical performance.…”

“…The device was set up to percussion frequency at 20 Hz, with a round tip of a 5.5 cm diameter. This PM duration and frequency were selected since health professionals match these values most frequently used [ 1 ]. Moreover, low frequencies of PM with a short duration were reported to improve muscular performance [ 17 , 18 ].…”

“…Percussion massage (PM) is a massage technique that combines elements of traditional massage and the vibration method [ 1 ]. Manual PM relies on applying a rapid, high-frequency, compressive striking with the tips of fingers or the edge of the hands to induce vibration throughout the selected part of the body [ 2 , 3 ].…”

“…However, it can also be applied by portable, easy-to-use, and inexpensive mechanical percussion devices which look similar to a gun. They allow us to set a chosen frequency, amplitude, and striking force and thus reduce the stress placed on the therapist during long-lasting manual PM or even allow us to perform it ourselves [ 1 ].…”

“…Despite high and growing mechanical PM popularity in amateur and professional sports, there is a paucity of studies investigating the underlying mechanism and post-treatment response and thus its acute and long-term impact on athletic performance [ 1 ]. The most frequently mentioned benefits of using PM include reducing pain and muscle spasms, increasing blood and lymphatic flow, increasing range of motion, and accelerating recovery [ 4 , 5 , 6 ].…”