https://orcid.org/0000-0002-9817-5372
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Abstract
Purpose
To critically appraise randomized controlled trials (RCTs) on Instrument-Assisted Soft Tissue Mobilisation (IASTM) and quantify the effects of IASTM compared with other treatment in individuals with or without pathologies on function, pain, and range of motion.
Materials and methods
We search four electronic databases from January 1999 to January 2022 and included RCTs of healthy participants/athletes and people with upper, lower, or spinal conditions, who received IASTM versus other active treatment for clinical outcomes (function, pain, and range of motion).
Results
Forty-six RCTs were considered eligible for data analysis. Effects of IASTM plus other treatment versus other treatment on function and pain intensity were not statistically significant or clinically meaningful (very low quality, SMD −0.28, 95% CI −0.66 to 0.09) and (very low quality, SMD −0.05, 95% CI −0.53 to 0.43) at up to one-year follow-up respectively. No clinically meaningful improvements were found on range of motion outcomes. Out of the 46 included RCTs, only 10 assessed and reported IASTM-related adverse events.
Conclusion
Evidence of very low-quality certainty does not support the efficacy of IASTM in individuals with or without various pathologies on function, pain, and range of motion in the management of upper body, lower body, or spinal conditions.
The included RCTs had a high risk of bias and were assessed as very-low quality evidence for all the included outcomes.
IASTM does not lead to clinically meaningful improvements in function, pain, or range of motion in individuals with upper body, lower body, and spinal conditions.
The publication of IASTM trials in suspected predatory journals is increasing.
The available evidence on IASTM does not support its use to improve function, pain, or range of motion in individuals with upper body, lower body, and spinal conditions.
Health care practitioners should consider other evidence-based management strategies (physical activity and exercise) to improve function, pain, or range of motion in individuals with musculoskeletal injuries and disorders.
Given the rise of publications on IASTM in suspected predatory journals, health care practitioners should be judicious to examine the legitimacy of a journal when searching for evidence on IASTM treatment technique.
IMPLICATIONS FOR REHABILITATION
Correction Statement
This article has been corrected with minor changes. These changes do not impact the academic content of the article.
Disclosure statement
Goris Nazari was supported by the Transdisciplinary Bone & Joint Training Award, the Collaborative Training Program in Musculoskeletal Health Research, Western University; and a Canadian Institutes of Health Research (CIHR) Postdoctoral Fellowship Award. Pavlos Bobos was supported by a CIHR Doctoral Award and the Arthritis Society Postdoctoral Fellowship Award. Steve (Ze) Lu was supported by a CIHR Doctoral Award. Christina Y Le was supported by an Arthritis Society Training Graduate PhD Salary Award and Canadian MSK Rehab Research Network 2017 Trainee Award. Saurab Sharma was supported by the International Association for the Study of Pain John J. Bonica Trainee Fellowship Award. Kyle Vader was supported by a Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-D) from the CIHR. Nicholas Held was supported by the Mitacs Accelerate Industrial Postdoc Fellowship. Joy C MacDermid was supported by a Canada Research Chair in MSK Health Outcomes and Knowledge Translation and Dr. James Roth Research Chair in Musculoskeletal Measurement and Knowledge Translation.