Browsing by Subject "Massage"

Now showing 1 - 6 of 6
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    A Handheld Quantifiable Soft Tissue Manipulation Device for Tracking Real-Time Dispersive Force-Motion Patterns to Characterize Manual Therapy Treatment
    (IEEE, 2023) Bhattacharjee, Abhinaba; Anwar, Sohel; Chien, Stanley; Loghmani, M. Terry; Physical Therapy, School of Health and Human Sciences
    Objective: Low back pain (LBP) is one of the leading neuromusculoskeletal (NMSK) problems around the globe. Soft Tissue Manipulation (STM) is a force-based, non-invasive intervention used to clinically address NMSK pain conditions. Current STM practice standards are mostly subjective, suggesting an urgent need for quantitative metrics. This research aims at developing a handheld, portable smart medical device for tracking real-time dispersive force-motions to characterize manual therapy treatments as Quantifiable Soft Tissue Manipulation (QSTM). Methods: The device includes two 3D load-cells to quantify compressive and planar-shear forces, coupled with a 6 degrees-of-freedom IMU sensor for acquiring volitionally adapted therapeutic motions while scanning and mobilizing myofascial restrictions over larger areas of the body. These force-motions characterize QSTM with treatment parameters (targeted force, application angle, rate, direction, motion pattern, time) as a part of post-processing on a PC software (Q-Ware©). A human case study was conducted to treat LBP as proof-of-concept for the device's clinical usability. Results: External validation of treatment parameters reported adequate device precision required for clinical use. The case study findings revealed identifiable therapeutic force-motion patterns within treatments indicating subject's elevated force-endurance with self-reported pain reduction. Conclusion: QSTM metrics may enable study of STM dosing for optimized pain reduction and functional outcomes using documentable manual therapy. Clinical trials will further determine its reliability and comparison to conventional STM. Significance: This medical device technology not only advances the state-of-the-art manual therapy with precision rehabilitation but also augments practice with reproducibility to examine neurobiological responses of individualized STM prescriptions for NMSK pathology.
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    Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments
    (Springer Nature, 2013-09-28) Loghmani, M. Terry; Warden, Stuart J.; Physical Therapy, School of Health and Human Sciences
    Background: Ligament injuries are common clinical problems for which there are few established interventions. Instrument-assisted cross fiber massage (IACFM) was recently shown to accelerate the restoration of biomechanical properties in injured rodent knee medial collateral ligaments (MCL). The current study aimed to investigate the influence of IACFM on regional perfusion and vascularity in the vicinity of healing rodent knee MCL injuries. Methods: Bilateral knee MCL injuries were induced in female Sprague-Dawley rats. Commencing 1 week post-injury, 1 minute of IACFM was introduced unilaterally 3 times/week for 3 weeks. The contralateral injured MCL served as an internal control. Regional tissue perfusion was assessed in vivo throughout healing using laser Doppler imaging, whereas regional microvascular morphology was assessed ex vivo via micro-computed tomography of vessels filled with contrast. Results: IACFM had no effect on tissue perfusion when assessed immediately, or at 5, 10, 15 or 20 min following intervention (all p > 0.05). However, IACFM-treated hindlimbs had enhanced tissue perfusion when assessed 1 day following the 4th and 9th (last) treatment sessions (all p < 0.05). IACFM-treated hindlimbs also had greater perfusion when assessed 1 wk following the final treatment session (32 days post-injury) (p < 0.05). Subsequent investigation of microvascular morphology found IACFM to increase the proportion of arteriole-sized blood vessels (5.9 to <41.2 μm) in the tibial third of the ligament (p < 0.05). Conclusions: These findings suggest IACFM alters regional perfusion and vascularity in the vicinity of healing rodent knee MCL injuries. This effect may contribute to the beneficial effect of IACFM observed on the recovery of knee ligament biomechanical properties following injury.
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    International Expert Consensus on Instrument-Assisted Soft-Tissue Mobilization Precautions and Contraindications: A Modified Delphi Study
    (MDPI, 2025-03-15) Cheatham, Scott W.; Baker, Russell T.; Loghmani, M. Terry; Schleip, Robert; Physical Therapy, School of Health and Human Sciences
    Background: Instrument-assisted soft-tissue mobilization (IASTM) is a popular myofascial intervention used by healthcare professionals. Despite the growing body of research evidence, there is still a gap in understanding what healthcare professionals consider as treatment precautions or contraindications. To date, no consensus on precautions and contraindications has been established among IASTM experts. The purpose of this modified Delphi survey was to determine IASTM precautions and contraindications among international IASTM experts. Methods: A three-round Delphi study of 24 international IASTM experts was conducted. In round 1, experts chose from a list of 81 medical conditions and treatment considerations that could be a concern for IASTM treatment. Consensus was considered if more than 70% of experts agreed on an item. Round 2 included the updated list of 39 items, and the experts decided if each item should be a precaution, contraindication, or both. The strength of agreement grade scale was used to rank the precautions and contraindications, by the level of expert agreement using grades A-D (e.g., A-strong, B-moderate, C-weak, D-both). Grade D conditions could potentially be both a precaution and contraindication. In round 3, the final list of categories and items was presented to the experts for final approval. Results: All recruited experts (n = 24) participated in the three rounds and the final list of items received 100% approval. Contraindications had the highest number of conditions (n = 16) across the strength of agreement grade categories A-C followed by category D (both) (n = 8). Discussion: This Delphi study was the first survey to document expert consensus on precautions and contraindications based upon the strength of agreement. This study offers a beginner's guide for clinicians to safely implement IASTM by establishing required precautions and contraindications through consensus agreement. Conclusions: This survey should be the first step in a series of planned IASTM studies on precautions and contraindications to establish the best-practice recommendations for the application of IASTM in clinical practice.
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    Quantifiable Soft Tissue Manipulation (QSTM): A Requisite to Advance the Field of Manual Therapy
    (2017) Loghmani, Marry Terry; Neff, Bruce; Alotaibi, Ahmed M; Anwar, Sohel; Chien, Stanley; March, Keith; Physical Therapy, School of Health and Rehabilitation Sciences
    Quantifiable soft tissue manipulation (QSTM) that can characterize the motion and forces delivered during soft tissue examination and treatment of common musculoskeletal (MS) conditions in a real-time and clinically applicable manner is needed to achieve optimal outcomes. Soft tissue manipulation (STM), e.g. massage, is a type of mechanotherapy that has been used with benefit frequently by clinicians worldwide since ancient times. Instrument-assisted STM (IASTM) is a type of STM that uses rigid devices to assess and treat soft tissue abnormalities in a targeted and precise manner. Remarkably, however, the forces delivered during STM approaches have not been adequately quantified. Unlike other mechano-therapeutic approaches, e.g. ultrasound, traction, exercise, electrical stimulation, current manual therapy practice relies mostly on subjective description of STM evaluation findings and treatment parameters. This makes documentation, analysis, comparison, progression and optimization of this non-invasive intervention difficult to establish and validate. It is the authors’ strong opinion that there is need for QSTM to objectively measure, characterize and record the 3-dimensional (3D) forces and motion trajectories of STM evaluation and intervention. Innovative technology aimed to help address this void in research, educational and clinical practice has been developed by our research team and introduced in this article. The QSTM system has two components: an electronic, handheld device (applicator) for 3D characterization of force and a computer with software for data acquisition and analysis. Preliminary testing has demonstrated that the QSTM prototype can provide accurate sensed values and good intra-, inter-rater reliability. Device revisions are in progress and further testing is planned in animals and humans. QSTM is an essential technology needed for the standardization, comparison and optimization of STM therapies and a requisite to advance the field of manual therapy.
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    Successful treatment of a guitarist with a finger joint injury using instrument-assisted soft tissue mobilization: a case report
    (Taylor & Francis, 2015-12) Loghmani, M. Terry; Bayliss, Amy J.; Clayton, Greg; Gundeck, Evelina; Department of Physical Therapy, School of Health and Rehabilitation Sciences
    Finger injuries are common and can greatly affect a musician's quality of life. A 55-year-old man, who had injured the proximal interphalangeal joint of the left index finger 6 months prior to any intervention, was treated with a manual therapy approach incorporating instrument-assisted soft tissue mobilization (IASTM). Initial examination findings included self-reported pain and functional limitations and physical impairments that significantly impeded his ability to play the acoustic guitar. He was treated once a week for 6 weeks with IASTM, joint mobilization, therapeutic exercise, and ice massage. Additionally, a home exercise program and self-care instructions were provided. The patient gained positive outcomes with improvements in pain (Numerical Pain Rating Scale while playing the guitar: initial 5/10, discharge 1/10) and function (Disability Arm Shoulder Hand Sports-Performing Arts Optional Module: initial 75; discharge 6·25), each reaching a minimum clinically important difference. Importantly, he was able to play the guitar with minimal to no pain as desired. Physical measures also improved, including an immediate gain in finger range of motion with IASTM alone. Manual therapy approaches integrating IASTM may provide an effective conservative treatment strategy for patients with finger/hand conditions in the performing arts and other patient populations.
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    Trigger-Point Self-Care for Chronic Neck Pain: Pilot and Feasibility
    (Office of the Vice Chancellor for Research, 2016-04-08) Benjamin, Ellen; Davies, Amber; Shue, Sarah; Bair, Matthew J.; Munk, Niki
    Massage is a non-pharmacological approach for neck pain with building evidence. Trigger points (TrPts) are thought to be associated with chronic neck pain (CNP) and can be treated with massage techniques. Due to massage’s out-of-pocket costs, TrPt self-care (TrPtSC) may serve as a cost-effective treatment that may reach broader populations. No study has examined a) feasibility of conducting TrPtSC training in a research setting, b) ability of such programs to meet stated training objectives, c) adherence to personalized TrPtSC plans, and d) TrPtSC outcomes for CNP. A pilot observational, pre- post-intervention cohort study with 1-, 4-, and 8-week follow-ups was implemented. Participants: self-identified adults with CNP and Neck Disability Index (NDI) ≥4. Measures: pre-/post-TrPtSC training objectives survey, TrPtSC daily self-report log, NDI and 11-point pain rating scale. Intervention: three-hour TrPtSC training with interactive lecture, demonstration, supervised practice, and private assessment with individualized TrPtSC plan development. Handouts and tools were provided for training and home TrPtSC. Participants documented their individualized TrPtSC plan adherence daily. Five participants (women=3; ages 22-58; White=5) enrolled in the study and two separate group training sessions occurred (n=3 & 2, respectively). By the end of the TrPtSC training, all participants agreed or strongly agreed they achieved all intended training objectives. Baseline NDI categorized all participants as mild neck pain with disability (mean NDI=10.4±2.1). Week-1 follow-up: 1 participant had no NDI change, 1 participant worsened, and 3 reported 23-50% improvement. All participants had improved NDI at week-4 and week-8 compared to baseline. Three participants reported 23-30% improvement by study’s end. Our TrPtSC group training approach met objectives and our study design is feasible for larger scale trials. Results suggest TrPtSC may improve CNP outcomes. More robust studies with greater than mild neck pain and disability participants are needed to estimate effect sizes and adequately power larger comparison trials.