Validity of Instrument Assisted Soft Tissue Mobilization for Detecting Myofascial Adhesions through Secondary Diagnostic Ultrasound Analysis

Abstract

Context: many patients have pain and restricted motion due to myofascial adhesions. Clinicians use both manual and instrument assisted soft tissue mobilization (IASTM) techniques to treat myofascial adhesions. The main difference between manual therapies and IASTM is that IASTM claims that their instruments can accurately qualitatively detect myofascial adhesions through their resonance capability. However, the validity of this capability has yet to be researched. Objective: To determine the validity of using IASTM to detect myofascial adhesions through secondary diagnostic ultrasound analysis. Design: Correlational validity study. Setting: Athletic Training Laboratory. Patients or other participants: nineteen men (age = 22.4 ± 2.5) and eleven women (age = 21.2 ± 1.9). Data collection and analysis: From the thirty participants, one hundred adhesions were found and imaged. We calculated the percent level of agreement between the two rates, and then considered chance by using a κ coefficient to understand the relationship between the two rates of diagnostic us. Results: We identified an 83% level of agreement between raters. However, when chance was considered, we found a poor inter-rater reliability (κ= 0.344, p<0.001). Conclusions: There is moderate evidence that IASTM is successful in quantitatively detecting myofascial adhesions. Sources creating instrument resonance other than myofascial adhesions may include blood vessels or adipose nodules. Future investigation should further examine what specifically IASTM is detecting through its resonance, if not myofascial adhesions. Key words: instrument assisted soft tissue mobilization, Graston technique, diagnostic ultrasound, myofascia, fascial adhesions