Effect of instrument-assisted soft tissue mobilization combined with exercise therapy on pain and muscle endurance in patients with chronic neck pain: a randomized controlled study

ABSTRACT

Objectives

The use of instrument-assisted soft tissue mobilization (IASTM) has been documented to be effective for improving pain and function, but it is unclear whether it helps improve muscle performance in musculoskeletal diseases. This study investigated the effects of IASTM combined with exercise therapy on muscle endurance and pain intensity in patients with chronic neck pain.

Methods

Forty-eight individuals with chronic neck pain were randomly divided into exercise therapy (ET, n = 24) and combined therapy (CT, n = 24) groups. For 4 weeks, each group underwent exercise therapy 3 days a week for a total of 12 sessions. The ET group received exercise therapy only. The CT group received IASTM combined with exercise therapy twice per week for a total of 8 sessions. The muscle endurance of the participants was assessed with the Deep Neck Flexor Muscle Endurance (DNFE) test and pain intensity with Visual Analogue Scale (VAS) at baseline and post-treatment.

Results

While both groups showed significant improvement in pain intensity (p < 0.05), the CT group showed a greater effect size for pain (CT group: Cohen’s d = 3.28; ET group: Cohen’s d = 2.12). The CT group showed significant improvement for muscle endurance (p < 0.05), whereas the ET group did not (p > 0.05).

Conclusion

In the current study, the IASTM intervention combined with ET improved pain and muscular endurance in participants with chronic neck pain compared to exercise therapy alone. As an alternative method, IASTM intervention before exercise seems to increase the short-term recovery effect in chronic neck pain conditions.

KEYWORDS:

• Chronic neck pain
• instrument-assisted soft tissue mobilization
• muscle endurance
• rehabilitation

Acknowledgements

We would like to thank Dr. Kıvanç Katmerlikaya, Dr. Şen Bezirgan, and Sefaköy Hospital Physiotherapy and Rehabilitation Clinic for their clinical assistance. Particular thanks to Prof. Dr. Özlem Ülger who proof-read the final version of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Aysegul Bostan

Ayşegül BOSTAN graduated with a bachelor's degree in 2011 Istanbul Medipol University School of Physical Therapy and Rehabilitation in Turkey. She graduated from the same university with her master's in 2021. She continues her PhD's program in physical therapy and rehabilitation at Hacettepe University. After spending three years treating patients with various diseases in a physiotherapy clinic, she started her career as a research assistant in 2020. She is now a research assistant at Bahçeşehir University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation. She continues to work on projects and research in the fields of chronic pain, low back and neck health, orthopedic rehabilitation and neuroscience. In her doctoral thesis, she is developing a project investigating brain activities with EEG in individuals with chronic neck pain.

Pinar Kaya

Pınar Kaya graduated with a bachelor's degree in 2009 Hacettepe University School of Physical Therapy and Rehabilitation in Turkey. She graduated from her master's university with her master's in 2013 and her PhD in the six years of rehabilitation in 2018. After various clinics in a physiotherapy her career as lecturer at Istanbul Medipol University's Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation after gaining master degree. She started to work as an assistant professor at Istanbul Medipol University after gaining her PhD, and she is now working as an associate professor at the same university. She also continues in research on projects and conduct research domains in the chronic pain and rehabilitation rehabilitation, and she also in undergraduate and master students in these subjects. She keeps working on technology solutions for rehabilitation in collaboration with engineers from several universities. Moreover, she continues to work to raise the standard of physiotherapy education in Turkey.