Manual Therapy Improves Immediate Blood Flow and Tissue Fiber Alignment of the Forearm Extensors

Abstract

Background: Manual therapy is commonly used by clinicians to improve blood flow and tissue fiber orientation. Hypothesis/Purpose: Using diagnostic ultrasound, the purpose of the study was to examine how the application of Positional Release Therapy (PRT), instrumented assisted soft tissue mobilization (IASTM), therapeutic ultrasound (US) and a combination of all three, affect lateral elbow immediate blood flow and tissue fiber alignment. Study Design: Controlled laboratory study. Methods: Twenty-five participants (26.0 ± 4.5 years; 69.3 ± 4.3 cm; 81.8 ± 16.9 kg) received PRT =13, US =12, IASTM =13, and a combination treatment = 12. Results: Blood flow was significantly higher following PRT (691.54 ± 1237.16 mm2) compared to IASTM (18.73 ± 227.10 mm2) (p=0.050; ES=0.073 (0.16-1.5) and US (-10.09 ± 479.26 mm2) (p=0.042; ES=0.72 (-0.03-1.29), but no different from the combination intervention (627.64 ± 820.22 mm2) (p=0.849). Seventy-five percent of elbows in the PRT intervention showed improvement in blood flow, 54% in the IASTM group, 45% in US, and 73% in the combination group. Tissue fiber alignment was significantly better following IASTM (-5756.00 ± 8156.19 mm2) compared to PRT (-1552.54 ± 3896.58 mm2) (p=0.042; ES=0.66 (-0.01 – 1.31), but no difference was demonstrated among the other interventions (p>0.066). All elbows (100%) that received IASTM showed improved tissue orientation, 77% in the PRT group, 64% in US and 64% in the combination group. Conclusion: Manual therapy, particularly PRT and IASTM, seem to be better at increasing blood flow and muscle fiber orientation, respectively. Level of Evidence: II.

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

“…Thus, IASTM researchers have investigated the effectiveness of light pressure to optimize treatments. Preliminary evidence that IASTM works from a neurophysiological mechanism is supported by findings of modulated grip strength [7] improved tactile discrimination [11] and increased blood flow [26] following light pressure IASTM. While each of these studies demonstrated that lighter forces can be effective, there is also evidence that increased forces stimulate connective tissue remodeling, reduce fascial adhesions, and break down scar tissue that limit ROM [4,27,28].…”