Tissue Mobilization Techniques Research Articles

FISIOTERAPIA APLICADA NO PROCESSO CICATRICIAL DE CESÁREAS: REVISÃO DA LITERATURA

Physiotherapy plays an important role in the recovery process after a cesarean sec tion, where it works by promoting an adequate healing process, reducing all discomfort, aiming at elasticity, preventing a hypertrophic scar and mainly, improving the physical function of patients. It is important that physiotherapy is personalized according to individual needs and carried out as soon as possible, as early initiation of physiotherapy and adherence to the guidelines provided are essential for a successful recovery after a cesarean section. In this process, we can use massage and tissue mobilization techniques, where the application of gentle mas sages and mobilization techniques will help reduce tension in scar tissues, promoting blood circulation and helping to break down adhesions that may form during the process. of healing. In conjunction with manual therapies, we can use physical therapeutic resources, where the physiotherapist will work, for example, with low-intensity laser therapy, which can accelerate the healing process, reduce inflammation and alleviate discomfort in the area. of the incision. Other physical modalities, such as therapeutic ultrasound and electrotherapy, can also be applied to promote healing and reduce pain.

Effect of Pediatric Physical Therapy Interventions on Congenital Muscular Torticollis: A Systematic Review.

This review explores the current pediatric physiotherapy approaches for treating infants with congenital muscular torticollis (CMT). CMT is a common musculoskeletal condition characterized by an unequal position of the neck due to unilateral shortening of the sternocleidomastoid muscle. Our comprehensive literature search assessed articles published between 2014 and March 2024. The review emphasizes various pediatric physical therapy interventions, such as manual therapy, stretching, soft tissue mobilization techniques, kinesio taping, and microcurrent therapy, along with parental education. The effectiveness of these interventions was assessed in terms of improving the cervical range of motion, reducing muscle tightness, correcting head posture, and improving functional outcomes in infants with CMT. The review underlines the need for early diagnosis and prompt initiation of physiotherapy interventions in order to improve treatment outcomes and reduce long-term musculoskeletal complications associated with CMT. Future research directions are also highlighted to improve our understanding and treatment of this common pediatric condition.

The effect of instrument-assisted soft tissue mobilization in lumbar disc herniation: A randomized controlled trial

AimTo investigate the effect of instrument-assisted soft tissue mobilization technique on pain, joint range of motion, functionality and quality of life in patients with lumbar disc herniation. MethodsThis is a double blinded, randomized controlled trial. A total of 60 patients were randomly allocated to either an experimental group [n = 30, age = 46.33 ± 12.96 years] or a control group [n = 30, age = 57.03 ± 9.64 years]. The experimental group received instrument-assisted soft tissue mobilization [3 consecutive days a week for 4 weeks] in addition to conventional physiotherapy [five days a week for 4 weeks]. The control group only received the conventional physiotherapy [five days a week for 4 weeks]. Pain intensity, range of motion of the lumbar spine (flexion, extension, lateral flexion), functional disability related to low back pain and quality of life were assessed at the beginning and end of the study. ResultsThe experimental group showed statistically significant improvements in the range of motion in lumbar area (flexion, extension and lateral flexion values) compared to that shown in the control group (p < 0.05). The mean differences in Oswestry disability index were significantly better in experimental group than in the control group (p < 0.05). There were no significant differences between the two groups in terms of pain and quality of life (p > 0.05). ConclusionsInstrument-assisted soft tissue mobilization, in addition to conservative treatment, can improve range of motion in lumbar area and reduce functional disability in patients with Lumbar Region Disc Herniations.

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

Instrument-assisted soft tissue mobilization (IASTM) techniques use specialized hand-held instruments for applying controlled mechanical forces to the body with the goal of facilitating healing, improving range of motion, and reducing pain. Nevertheless, an optimal range of forces for achieving clinical outcomes has yet to be established. A barrier to advancing research on IASTM force optimization is the lack of commercially available instruments that quantify treatment forces. The aim of the current study was to assess the feasibility of attaching a flexible force sensor to a commercially available IASTM instrument to obtain valid force measurements. The validity of this novel approach was assessed by comparing data between the flexible force sensor and a force plate during a simulated treatment. Intraclass correlation coefficients, linear regression models, and Bland Altman plots all indicated excellent agreement between the force plate and flexible sensor when the instrument was used at 45°, 65°, and 90° treatment angles. Agreement between measures decreased when the instrument was held at 30°. Thus, commercially available instruments with attached sensors could make force measurement more accessible and feasible for a wider range of research settings, facilitating the advancement of IASTM research and ultimately informing clinical decision-making to improve patient care.

Effect of the Myofascial Release Technique on the Paraspinal Muscles Stiffness of Lumbar Region: A Case Study

Muscle stiffness refers to a sensation of muscle tightness makes it challenging to move.Muscle stiffness may occur after overuse of a particular muscle.Multifidus to be 1.5 times stiffer than Erector spinae in the Lumbar region the accurate modulation of lumbar erector spinae muscle stiffness is unclear but while adopted the different sitting and upright standing posture.The main purpose of this case study is to explore physiotherapy interventions for a subject with Lumbar region stiffness.Myofascial Release and Cryotherapy (supplimentry)for the improvement of the Range of motion and to increase flexibility which are restricted by stiffness.A38 years old woman had whole Lumbar region limited ROM and had difficulty to perform ADLs .She is unable to do forward bending and standing position.Investigations and Special test of Lumbar confirms the diagnose of stiffness of Paraspinal muscles of Lumbar region . Total 21days Physiotherapy session with precautions given to the subject in which we provide the Soft tissue mobilization and Myofascial Release Technique for relieving the stiffness.we also include supplimentry that is Cryotherapy for reducing the soreness comes after the MFR.The following 21days Physiotherapy management protocol improved the Range of motion of the subject and relieve in the stiffness in the Lumbar region, subject was able to perform the ADLs with minimal discomfort.we gave some instructions to subject to perform home exercise independently.This case report is consistent with recent studies and on the base of the result that demonstrate Myofascial Release Technique with supplimentry Cryotherapy are singnificant effective for people with stiffness in Lumbar region.After completing the management protocol, their marked improvement in the ROM and Flexibility.

Investigation of the functional and biomechanical effect of instrument-assisted soft tissue mobilization technique in individuals with asymptomatic dynamic knee valgus - Randomized controlled trial

Although there are studies showing that myofascial release will increase muscle force production, the contribution of its application alone to muscle force production has not been examined. Aim of the study is to investigate the effect of instrument-assisted soft tissue mobilization (IASTM) on eccentric strength, frontal plane projection angle (FPPA), dynamic (DPS), and static postural stability (SPS), femoral internal rotation (FIR) angle in females with dynamic knee valgus (DKV).A total of 44 recreationally active females with asymptomatic DKV (age: 21,39 ± 1,79, body mass index: 20,09 ± 2,45) participated and were randomly assigned to either control group (CG) or IASTM group (IASTMG).Participants' eccentric contraction strength, FPPA, DPS, SPS, and FIR on the involved leg were measured pre- and post. IASTM application was applied to IASTMG for 6 weeks, twice a week, for 5 min, using Graston Technique® instruments on gluteus medius. CG received no intervention. In comparison of ECS difference values, change in IASTMG was found to be statistically significantly higher than CG (p = .004; p < .01). There was no statistical difference in comparison of FIR and FPPA values (respectively p = .213, p = .360; p < .05). In SPS and DPS evaluation, a statistically significant improvement was observed in favor of IASTMG in comparison of both intergroup and difference values (p < .05 for all). Strength gain without exercise can increase postural stability, but it isn't sufficient to correct faulty movement patterns. We recommend adding IASTM to injury prevention programs, but there is a need to investigate the effect of IASTM with technique correction feedback.

Effects of adding electro-massage to manual therapy for the treatment of individuals with myofascial temporomandibular pain: a randomized controlled trial.

To evaluate the effect of the addition of dynamic cervical electrical stimulation (electro-massage, ES) to manual therapy (MT), compared to MT by itself, in individuals with myofascial temporomandibular pain. A total of 46 participants with bilateral myofascial temporomandibular pain for at least three months were distributed into two groups. Group 1 (n=21) received local MT consisting of soft tissue mobilization and release techniques over the neck and temporomandibular regions. Group 2 (n=25) received an ES procedure in the cervical region combined with the same intervention as group 1. All participants underwent a 2-week protocol. The primary outcomes were pain intensity (Visual Analogue Scale), pressure pain threshold (PPT) at the masseter and upper trapezius muscles (algometer), and pain-free vertical mouth opening (manual gauge). The secondary outcome was active cervical range-of-movement. Measurements were taken at baseline, immediately after intervention, and at a 4-week follow-up. The ANOVA revealed significant changes over group*time, with better results for group 2 (large effect sizes) regarding pain intensity (p< 0.001; η2>0.14), pressure pain sensitivity and mouth opening (p<0.001; η2>0.14). Similar findings were observed for active cervical range-of-movement in all directions (p<0.001; η2>0.14), except rotation (p≥0.05). Electrical stimulation therapy over the cervical region combined with a MT protocol over the neck and temporomandibular joint shows better clinical benefits than MT by itself in subjects with myofascial temporomandibular pain. Registration code: NCT04098952.

Effect of Self Neural Mobilization in Low Back Pain with Radiculopathy on Pain, ROM and Functional Disability - An Interventional Study

BACKGROUND: Leg pain extending below the knee into the foot and toes is lumbar radiculopathy, often accompanied by sensory, reflex or motor neurological problems along the lumbosacral nerves or nerve roots. Neural tissue mobilization techniques involve assessing and relieving neural tension through movements, restoring the nervous system's capacity to handle daily forces. These manual methods aid movement within neural structures and have been found, in research on both humans and animals, to reduce edema, enhance fluid dispersion, alleviate pain sensitivity, and reverse heightened immune responses resulting from nerve injuries. Nerve gliding exercises aim to improve nerve mobility and reduce irritation. They involve stretching and releasing a nerve in a controlled manner to potentially reduce swelling and alleviate symptoms. These exercises should be performed with caution and under the guidance of a healthcare professional. OBJECTIVES: To study the effect of self-neural mobilization on pain by NPRS. To study the effect of self-neural mobilization in ROM by Goniometry. To study the effect of self-neural mobilization on functional disability by ODI. METHODOLOGY: 36 patients were screened according to inclusion and exclusion criteria and divided into two groups; each consist of 18 patients. Group A received nerve mobilization and conventional treatment and Group B received conventional treatment. Post outcome measures such as NPRS, ODI and SLR ROM were taken after 6 weeks of treatment. RESULTS: After six-week data analysis was done suggest both group’s p value is &lt; 0.05 but interventional group has significant better improvement compared to control group. CONCLUSION: From the current study it has been concluded that nerve mobilization technique is effective in reducing pain, reduce functional disability and improves SLR ROM. Keywords: Low back pain, Radiculopathy, Nerve mobilization

A comparative study of the efficacy of instrument-assisted soft tissue mobilization and massage techniques in patients with patellofemoral joint pain.

The aim of this study was to compare the clinical efficacy of instrument-assisted soft tissue mobilization (IASTM) and manipulative therapy Tui-na techniques in the treatment of patients with patellofemoral joint pain syndrome, and to evaluate their impact on pain relief, functional improvement, and joint range of motion. In this study, 25 patients with patellofemoral pain syndrome were enrolled, comprising of an intervention group of 13 patients who received IASTM treatment and a control group of 12 patients who received Tui-na manipulation therapy. The treatment cycle lasted for 4 weeks, featuring two interventions per week. Before treatment, the visual analog pain scale (VAS) of the knee, Lysholm score of the knee, modified Thomas test (MTT), and maximum isometric strength of the extensor muscles of the lower limbs were measured and recorded for both groups. After the first and last treatments, the aforementioned indexes were reassessed, and the maximum isometric muscle strength of the lower extremity extensors was measured only after 4 weeks of treatment had been completed. There was no significant difference in the basic information of the two intervention groups (p > 0. 05). After the first treatment and 4 weeks of treatment, the Lysholm score in both groups significantly improved (p < 0. 05), indicating that both interventions can improve the function of patients' lower limbs. However, the Lysholm score in the IASTM group significantly increased compared with that of the massage group after 4 weeks of treatment, indicating that its improvement in functional performance is superior. Both groups showed significant improvement in knee joint pain after the first treatment and 4 weeks of treatment (p < 0. 05), with the IASTM group having a lower VAS score and better pain improvement after 4 weeks of treatment. The strength of the two intervention groups significantly increased after the maximum isometric muscle strength test of the lower limb extensor muscles before and after 4 weeks of treatment (p < 0. 05). After the MTT test, the extension angle, deviation angle, and hip abduction angle of the tested legs in the two intervention groups were significantly reduced (p < 0. 001), indicating an improvement in lower limb joint mobility. Instrument-assisted soft tissue mobilization treatment and Tui-na manipulation therapy significantly reduced pain, improved knee flexibility, and increased range of motion of the lower extremity in patients with PFPS. However, IASTM treatment significantly improved pain and function and sustained pain in the short to medium-term post-trial period. www.isrctn.com, ISRCTN88098928.

Effects of instrument-assisted soft tissue mobilization and myofascial release techniques in individuals with chronic neck pain: A Pilot Study

Effects of instrument-assisted soft tissue mobilization and myofascial release techniques in individuals with chronic neck pain: A Pilot Study

The Effect of Instrument Assisted Soft Tissue Mobilization on Improving Joint Range of Motion in Active Individuals: A Critically Appraised Topic

In all activities that require physical movement, whether in athletics or in other daily tasks, it is important for joints to have adequate range of motion and flexibility. Soft tissue restrictions are very common pathologies in healthcare. Although a decrease in myofascial range of motion can arise from a variety of reasons such as biomechanical deformities, autoimmune diseases, or age, it is often caused by overtraining or musculoskeletal injuries in active populations. Instrument assisted soft tissue mobilization techniques are gaining popularity to assist in treating various soft tissue injuries and musculoskeletal pathologies. The belief is that by applying a stimulus to the soft tissue around a joint, it will increase the number of fibroblasts, through localized inflammation, and result in a realignment of collagen fibers2. While some studies have shown positive outcomes of instrument assisted soft tissue mobilization (IASTM), there has been limited evidence to determine the efficacy of this modality in improving joint range of motion (ROM).

Instrument-Assisted Soft Tissue Mobilization Technique versus Static Stretching in Patients with Pronated Dominant Foot: A Comparison in Effectiveness on Flexibility, Foot Posture, Foot Function Index, and Dynamic Balance

Pronated foot is a deformity with various degrees of physical impact. Patients with a pronated foot experience issues such as foot pain, ankle pain, heel pain, shin splints, impaired balance, plantar fasciitis, etc. Objective: The study intended to compare the effectiveness of IASTM (instrument-assisted soft tissue mobilization) and static stretching on ankle flexibility, foot posture, foot function, and balance in patients with a flexible pronated foot. Seventy-two participants between the ages of 18-25 years with a flexible pronated foot were included and allocated into three groups: Control, stretching, and IASTM group using single-blinded randomization. Range of motion (ROM) measuring ankle flexibility, foot posture index (FPI), foot function index (FFI), and dynamic balance was measured at baseline and after 4 weeks of intervention. Soft tissue mobilization was applied on to the IASTM group, while the stretching group was directed in static stretching of the gastrocnemius-soleus complex, tibialis anterior, and Achilles tendon in addition to the foot exercises. The control group received only foot exercises for 4 weeks. The result shows the significant improvement of the right dominant foot in ROM plantar flexion, (F = 3.94, p = 0.03), dorsiflexion (F = 3.15, p = 0.05), inversion (F = 8.54, p = 0.001) and eversion (F = 5.93, p = 0.005), FFI (control vs. IASTM, mean difference (MD) = 5.9, p < 0.001), FPI (right foot, control vs. IASTM MD = 0.88, p = 0.004), and in dynamic balance of the right-leg stance (anterior, pre vs. post = 88.55 ± 2.28 vs. 94.65 ± 2.28; anteromedial, pre vs. post = 80.65 ± 2.3 vs. 85.55 ± 2.93; posterior, pre vs. post = 83 ± 3.52 vs. 87 ± 2.99 and lateral, pre vs. post = 73.2 ± 5.02 vs. 78.05 ± 4.29) in the IASTM group. The FFI was increased remarkably in the stretching group as compared to the control group. Myofascial release technique, i.e., IASTM with foot exercises, significantly improves flexibility, foot posture, foot function, and dynamic balance as compared to stretching, making it a choice of treatment for patients with a flexible pronated foot.

Effects of Bowen Technique in Postural Neck Pain among Dentists

Background: Prolonged forward neck posture is one of the common sources for neck pain among Dentists. Conventional physical therapy and Bowen technique are effective in treating the postural neck pain. Bowen technique is another form of soft tissue mobilization technique. Aim: To determine the effects of Bowen technique in postural neck pain among dentists. Methodology: A quasi study was conducted at Ibn e Siena Hospital Multan, 04 November 2020 to 03 April 2021. It consisted of 58 participants with postural neck pain, randomly allocated into experimental and control groups. The experimental group received Bowen technique and control group received conventional therapy. Assessments were taken at baseline and post treatment using study tools: Numeric pain rating scale (NPRS), Neck disability index (NDI) and goniometer. Results: The mean age of all the participants in experimental and control groups were 36.86± 8.91, 41.44±8.75 respectively. Pre treatment values of NPRS mean rank for experimental and control groups were 28.64, 30.36 respectively. Post treatment NPRS mean rank for experimental and control groups were 26.02 and 32.98 respectively with non-significant p value. Pre treatment values for NDI mean rank experimental and control groups 29.84 29.16. Post treatment NDI mean rank for experimental and control groups were 28.52 30.48 respectively with non-significant p value. Conclusion: Bowen technique is equally effective as conventional therapy for improving postural neck pain. Keywords: Bowen technique (BT), Conventional therapy (CT), Dentists, Neck Pain, Posture.

Acute effects of instrument assisted soft tissue mobilization technique on pain and joint position error in individuals with chronic neck pain: a double-blind, randomized controlled trial

Purpose/Aim The aim of this study was to determine the acute effects of IASTM on cervical joint position error and pain in individuals with chronic neck pain. Methods A total of 39 individuals with chronic neck pain were included in this study. Participants were randomized into three groups: Instrument-assisted soft-tissue mobilization(IASTM (n = 13), sham (n = 13), and control (n = 13). In the IASTM group, intervention was applied to the sternocleidomastoid and trapezius muscles with an application time of 45 s and a frequency of 60 beats/min. In the sham group, IASTM was applied at a 90° angle without pressure. The control group did not receive any intervention. The pain severity and joint position error(JPE) were evaluated before and after the intervention, by using the visual analogue scale and a cervical range of motion device. Results The effects of time and treatment group on visual analogue scale(VAS) score were statistically significant (p = .001). Instrument-assisted soft-tissue mobilization was more effective in VAS score than sham and control group (p < .001). Significant improvement was found in JPE in all range of motions of the cervical region in the instrument-assisted soft-tissue mobilization group (p < .05). In the sham group, significant improvements were observed in cervical extension, left rotation, and left lateral flexion movements in JPE during each cervical spine active movement (p < .05). Instrument-assisted soft-tissue mobilization group was more effective in JPE all directions than sham and control group. Conclusions Instrument-assisted soft-tissue mobilization may be a useful technique in individuals with chronic neck pain. Instrument-assisted soft-tissue mobilization decreases VAS and improves JPE. Clinical Trial Registration Number NCT04882397 (05 August 2021).

Effects of Instrumented Assisted Soft Tissue Mobilization (IASTM) Technique Versus Stretching on Ililotibal Band in Patients with Anterior Knee Pain

Background: Anterior knee pain is caused by many factors iliotibial band tightness is one of cause of knee pain. The repeated hip abduction or postural imbalance usually results in contracture and tightness of the iliotibial band. Soft tissue mobilization is hypothesized as one of effective treatment. Instrumented assisted soft tissue (IASTM) technique is a soft tissue mobilizing technique and have remarked effects. Objective: This study's objective was to assess how well IASTM improved hip adduction range of motion (ROM). Methodology: This study was quasi experimental trial. And duration for this study was 6 month after the approval of synopsis. Sample of total 46 with knee pain was recruited in two groups. Non- probability convenience sampling technique was used. Total sample size was 30(15 each group). Subjects were allocated into 02 Groups. Inclusion criteria were Age 25 to 50 years and patients with Anterior Knee Pain, Patients of both genders. One group received IASTM and other group received self stretching for flexor group. Outcome was measured on NPRS, goiniomere and lower extremity function scale (LEFS) and values were be taken at baseline and after one week of treatment and then at third week of treatment. The data was analyses using SPSS v 25. Results: The results shows no significant improvement in pain, LEFS and hip abduction range between both groups comparison but both treatments IASTM and stretching exercises shows significant results within each group.The individuals in the GT group showed better hip abduction strength after three treatment sessions. Furthermore, after the one-month follow up, the gain in strength persisted. HoweverThere was no significant difference statistically in hip adduction ROM or VAS scores for pain and function between both the control group and graston (GT) group. Practical application :This study is going to help physical therapist and instrumented assisted soft tissue mobilization practitioners that how Graston technique and stretching effective in terms of decreasing pain, improving flexibility and lower extremity functions in patient with illiotibal band tightness having anterior knee pain. Conclusion: IASTM technique and stretching was equally effective in terms of decreasing pain, improving flexibility and lower extremity functions in patient with illiotibal band tightness having anterior knee pain. Keywords: instrumented assisted soft tissue mobilization, iliotibial band, ant knee pain, soft tissue mobilization.

Soft Tissue Mobilization Improves Neck and Upper Back Range of Motion

Introduction: Limited research reveals that the use of different soft tissue mobilization techniques increases tissue mobility and decreases pain in various regions of the body. The purpose of this study was to determine if there was a difference between instrument-assisted soft tissue mobilization and cupping therapy for neck and upper back discomfort. Methods: Subjects were treated for neck and upper back discomfort using one of two soft tissue mobilization techniques. They were assessed with a numeric rating scale, neck range of motions, and superficial skin temperature before and after each treatment to document changes observed. Results: There was a statistically significant difference in range of motion, superficial skin temperature, and pain numeric rating scale regardless of the treatment (P &lt;.05). Conclusions: Both methods of soft tissue mobilization showed to have a significant impact on pain and neck range of motion. Based on patient-clinician collaborative treatment process, healthcare providers should consider IASTM and cupping therapy.

Physical Therapy Approaches for the Treatment of Iliotibial Band Syndrome: A systematic review

Iliotibial band syndrome (ITBS) is a common overuse injury, which involves lateral knee pain after activities with repetitive knee flexion and extension. It’s typically seen in athletes especially runners, cyclists as well as in triathlon. This syndrome is an inhibiting factor that affects the athlete’s participation, results and performance. This study aimed to investigate the efficacy of physical therapy methods and techniques in ITBS management. A computerized research was conducted in Google Scholar, PubMed and PEDro. A total of 14 studies were included. GT mobilization showed pain relief and negative Ober’s test. Self-stretch of the ITB with a FR contributes to short-term increases in flexibility. Deep transverse frictions did not seem to modify symptoms and are not recommended as a therapeutic approach. Therapeutic currents reduce pain in an average of 2 days. Trigger point release showed a significant decrease in pain and an improvement in function ability. The comparison of shockwave therapy and soft tissue mobilization techniques led to pain reduction without significant difference, while the comparison of dry needling and shockwave therapy showed improvement in pain and limb function in both groups. Research has shown that physical therapy approach can include many techniques and methods for a successful treatment of ITBS. Further research is needed in order to fully examine the effects of each treatment in large number of patients with ITB.

Nonoperative Treatment of Dupuytren’s Contracture: The Use of Ultrasound Imaging to Assess Efficacy

ObjectiveWe have used ultrasound imaging technology to objectively demonstrate changes in the degree and quality of diseased fascia in patients with Dupuytren’s disease treated nonoperatively with therapeutic splinting and tissue mobilization. Materials and MethodsMeasurement of active proximal interphalangeal and metacarpophalangeal joint extension along with ultrasound elastography imaging of the fascia was performed prior to, and 6 months after, the initiation of therapy. ResultsImprovement in active joint extension over the course of therapy was associated with a consistent decrease in the radiologic dimensions of the diseased fascia in combination with qualitative changes in its composition. ConclusionThe use of a simple orthosis and soft tissue mobilization techniques have a quantifiable effect on the degree of deformity and the quantity and quality of contracted fascia in Dupuytren’s disease, and would appear to have a role in the management of mild to moderate presentations of the disease when enzymatic or surgical interventions may not be practical.

Effectiveness of instrument assisted soft tissue mobilization (IASTM) and muscle energy technique (MET) on post-operative elbow stiffness: a randomized clinical trial

ABSTRACT Background Stiffness is a common complication following trauma and surgeries around the elbow, which can result in upper limb functional disabilities. Soft tissue mobilization techniques such as Instrument-assisted Soft Tissue Mobilization (IASTM) and Muscle Energy Technique (MET) have limited evidence in elbow rehabilitation. This study aimed to compare their effects on postoperative elbow stiffness. Methodology 26 subjects were recruited (13 each group) with postoperative elbow stiffness (minimum 6 weeks post surgery) and randomly allocated in two groups: IASTM and MET. Pain [Numeric Pain Rating Scale NPRS)], ROM (Goniometer), and Function [Disability of Arm, Shoulder and Hand (DASH) and Patient-Specific Functional Scale (PSFS)] were assessed at baseline and post-intervention. Results The data of 26 subjects were analyzed and both groups significantly improved in outcome scores post-intervention. The improvements in ROM and function between groups were comparable, but NPRS and PSFS showed greater improvement in the IASTM group (p < 0.05). Conclusion IASTM and MET were both effective in improving outcomes in postoperative elbow stiffness. IASTM was more effective in improving pain and patient-specific function.

Manual therapy on Plantar Fascia affects Superficial Back Line Flexibility: A Randomized Controlled Pilot Study

Background and Aim: Myofascial Release (MFR) is a soft tissue mobilization technique that has been widely researched and supported to increase muscular flexibility and joint range of motion along superficial back line (SBL) structures. The purpose of the present study is to examine and compare the acute effects of MFR and post-isometric relaxation (PIR) applied on plantar fascia, on flexibility of superficial back line (hamstring muscle). Design: This was a pilot single blind randomized control trial (RCT). Participants: Thirty young healthy students (24 boys and 6 girls; mean age 21.46±0.97) Methods: Inclusion and exclusion criteria were followed, and baseline measurements for the Toe-Touch test (TTT) and active straight leg raise test (SLRT) were obtained. Subjects were then randomly assigned to the MFR group and the PIR group. The MFR group received the technique on plantar surface of the feet by applying a gentle and sustained pressure into the myofascial connective tissue. The PIR group received the technique on plantar flexors by placing them in stretched position, performing isometric contraction followed by relaxation and lengthening. Both interventions will be performed for 10 minutes. Afterwards, the Toe Touch Test and straight leg raise test were re-assessed. Results: Before and after intervention SLRT (both right and left) and TTT difference (within group differences) is statistically significant (p&lt;0.05) in both MFR and PIR group. Between-group comparison also shows significant difference in both groups with p&lt;0.05. The MFR group showed a significant difference in the SLR test and Toe Touch test compared to the PIR group (p&lt;0.05). Conclusion: The results of the current study showed that MFR on the planter fascia was immediately effective for improving flexibility of the SBL for the hamstring muscle.