Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (29): 4709-4716.doi: 10.3969/j.issn.2095-4344.2786
Previous Articles Next Articles
Lu Shuqing1, 2, Li Xin1, 2, 3, 4, Guo Jin1, 2, 3, Liu Shiyu1, 2, Yang Shunbo1, 2, Feng Yuxia1, 2, Pang Wei1, 2, 3
1Rehabilitation Medical School, Jiamusi University; 2Children’s Rehabilitation Neurology Laboratory, Jiamusi University; 3Affiliated Third Hospital, Jiamusi University; 4School of Sports Medicine and Rehabilitation, Beijing Sport University
Received:
2019-12-03
Revised:
2019-12-06
Accepted:
2020-01-08
Online:
2020-10-18
Published:
2020-09-15
Contact:
Pang Wei, MD candidate, Professor, Rehabilitation Medical School, Jiamusi University, Jiamusi 154007, Heilongjiang Province, China; Children’s Rehabilitation Neurology Laboratory, Jiamusi University, Jiamusi 154007, Heilongjiang Province, China; Affiliated Third Hospital, Jiamusi University, Jiamusi 154007, Heilongjiang Province, China
About author:
Lu Shuqing, Master candidate, Rehabilitation Medical School, Jiamusi University, Jiamusi 154007, Heilongjiang Province, China; Children’s Rehabilitation Neurology Laboratory, Jiamusi University, Jiamusi 154007, Heilongjiang Province, China
Supported by:
CLC Number:
Lu Shuqing, Li Xin, Guo Jin, Liu Shiyu, Yang Shunbo, Feng Yuxia, Pang Wei. Advantages in instrument-assisted soft tissue mobilization for chronic soft tissue injury[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(29): 4709-4716.
器具辅助松解技术(instrument-assisted soft tissue mobilization,IASTM)是一种使用符合人体工程学设计的工具,辅助治疗软组织相关损伤并促进其愈合的改良的软组织治疗技术[1-2]。IASTM技术所使用的辅助器具材质种类较多(如陶瓷、塑料、不锈钢等),以不锈钢材质为主[1-3],见图1[3]。IASTM可将医生或治疗师施加于功能异常组织局部较小的力转化成较大的压力和剪切力传递至深层受损软组织,与常用于治疗软组织肌腱病变的按摩疗法相比,IASTM产生积极治疗效果的时间更 短[4-5]。目前国内尚未有关于IASTM的综述类文献研究,文章将总结国内外相关资料,为IASTM更好的应用于临床实践提供理论支持。 "
2.1.2 IASTM介绍 IASTM是一种利用手持式辅助器具治疗局部软组织功能障碍的非侵入性软组织治疗方法,见图3[8]。当辅助器具滑过软组织功能异常部位时,可放大软组织触感,为医生或治疗师确定软组织功能障碍部位。通过评估受损软组织(感觉评估、皮肤评估、运动功能评估等)、热身、根据软组织损伤部位及程度选择IASTM治疗方案进行治疗、拉伸训练、强化训练以及局部冷敷6个步骤对软组织功能障碍部位进行治疗。根据软组织受损部位及损伤程度的不同选择合适的IASTM辅助工具;施加于治疗局部的力度;辅助器具接触皮肤的角度、走向及速度等。一般根据患者的耐受程度大多选择中等力度,辅助器具与皮肤之间的角度为30°-60°,治疗时辅助器具的走向根据肌肉肌腱等软组织的结构和走向不同而灵活变化,每周两三次,四五周为1个疗程[2,8]。实验研究和病例报道表明,IASTM可显著改善运动损伤及各种疾病引起的软组织疼痛及功能受限等症状。 "
受损组织重新开始修复过程时,成纤维细胞被活化并迁移至受损部位,产生大量纤维连接蛋白。纤维连接蛋白是一种非胶原糖蛋白,与间质胶原一起相互作用形成细胞外基质的纤维成分,可由成纤维细胞和上皮细胞合成,对成纤维细胞正常胶原的沉积有积极作用[9-11]。此外,纤维连接蛋白作为趋化因子在组织愈合期间具有引导细胞迁移和定位的能力,可诱导毛细渗透,使白细胞、红细胞及生长因子从血清中释放到软组织受损区域,并刺激巨噬细胞介导吞噬作用[9-10]。这一生理效应在动物实验研究中得到证实,IASTM技术能促进胶原蛋白水解酶诱导SD大鼠跟腱损伤动物模型肌腱中的成纤维细胞增殖活化,使其运动模式恢复至正常水平[9-10]。LOGHMANI等[12-13]研究发现,IASTM还可引起局部受损软组织的血管反应。应用IASTM技术对膝关节内侧副韧带损伤模型大鼠单侧下肢进行治疗,与未治疗侧相比治疗侧局部血流灌注显著增加,且动脉血管(管径在5.9-41.2 μm)比例也有所增加,使损伤区域的血液和营养供应增加,有利于减少受损区域瘢痕组织生成。因此,IASTM技术具有改善软组织修复能力,提高肢体功能的作用[8],见图4。 "
[1] KIVLAN BR, CARCIA CR, CLEMENTE FR, et al. The effect of Astym® therapy on muscle strength: a blinded, randomized, clinically controlled trial.BMC Musculoskelet Disord. 2015; 16(1):325.
[2] SEVIER TL, STEGINK-JANSEN CW. Astym treatment vs eccentric exercise for lateral elbow tendinopathy: a randomized controlled clinical trial.Peerj.2015;3:e967.
[3] DANIEL M. Effect of instrument-assisted soft tissue mobilization for isokinetic knee extensor strength and fatigue. Sacramento: Sacramento State University, 2014.
[4] CHAVES P, SIMÕES D, PAÇO M, et al. Cyriax's deep friction massage application parameters: evidence from a cross-sectional study with physiotherapists .Musculoskelet Sci Pract.2017;12(32):92-97.
[5] RIVERA M, EBERMAN L, GAMES K, et al. Comparison of Myofascial Release Techniques on Pectoralis Minor Length, Glenohumeral Total Arc of Motion, and Skin Temperature: A Pilot Study. J Sport Rehabil. 2019;24:1-5.
[6] STANEK J, SULLIVAN T, DAVIS S. Comparison of Compressive Myofascial Release and the Graston Technique for Improving Ankle-Dorsiflexion Range of Motion. J Athl Train. 2018;53(2):160-167.
[7] 步宏, 李一雷.病理学[M].9版.北京:人民卫生出版社, 2018: 29-41.
[8] KIM J, SUNG DJ, LEE J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. J Exerc Rehabili. 2017;13(1):12-22.
[9] DAVIDSON CJ, GANION LR, GEHLSEN GM, et al. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc.1997;29(3): 313-319.
[10] GEHLSEN GM, GANION LR, HELFST R. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exerc.1999; 31(4):531-535.
[11] ALOTAIBI MA, ANWAR S, LOGHMANI MT. Skin modeling analys of a force sensing instrument-assisted soft tiss manipulation device.J Eng Sci Med Diagn Ther.2018;1:1-11.
[12] LOGHMANI MT, WARDEN SJ. Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments. BMC Complement Altern Med. 2013;13:240.
[13] LOGHMANI MT, FULLER EM, HANDT R, et al. Instrument-assisted soft tissue mobilization in healthy young adult males mobilizes tissue-resident mesenchymal stem cells into circulation.J Orthop Sports Phys Ther. 2016;46:107.
[14] SCIFERS JR, BAKER R, GARDINER-SHIRES A, et al. Instrument-assisted soft tissue mobilization. Athlet Train Sports Health Care. 2017;9(2):49-52.
[15] CHEATHAM SW, KREISWIRTH E, BAKER R. Does a light pressure instrument assisted soft tissue mobilization technique modulate tactile discrimination and perceived pain in healthy individuals with DOMS? J Can Chiropr Assoc. 2019; 63(1):18-25.
[16] GE W, ROTH E, SANSONE A. A quasi-experimental study on the effects of instrument assisted soft tissue mobilization on mechanosensitive neurons.J Phys Ther Sci. 2017;29(4): 654-657.
[17] GULICK DT. Instrument-assisted soft tissue mobilization increases myofascial trigger point pain threshold. J Bodyw Mov Ther. 2018;22(2):341-345.
[18] LEE JH, LEE DK, OH JS. The effect of Graston technique on the pain and range of motion in patients with chronic low back pain. J Phys Ther Sci. 2016;28:1852-1855.
[19] MOON JH, JUNG JH, WON YS, et al. Immediate effects of Graston Technique on hamstring muscle extensibility and pain intensity in patients with nonspecific low back pain. J Phys Ther Sci. 2017;29(2):224-227.
[20] COVIELLO JP, KAKAR RS, REYNOLDS TJ. Short-term effects of instrument-assisted soft tissue mobilization on pain free range motion in a weightlifter with subacromial pain syndrome. Int J Sports Phys Ther.2017;12(1):144-154.
[21] SENBURSA G, BALTACI G, ATAY A.Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome: a prospective, randomized clinical trial. Knee Surg Sports Traumatol Arthrosc. 2007;15(7): 915-921.
[22] BAYLISS AJ, KLENE FJ, GUNDECK EL, et al. Treatment of a patient with post-natal chronic calf pain utilizing instrument- assisted soft tissue mobilization: a case study. J Man Manip Ther. 2011;19(3):127-134.
[23] JONES ER, FINLEY MA, FRUTH SJ. Instrument-assisted soft-tissue mobilization for the management of chronic plantar heel pain: a pilot study. J Am Podiatr Med Assoc. 2019;109(3): 193-200.
[24] CROTHERS AL, FRENCH SD, HEBERT JJ. Spinal manipulative therapy, Graston technique and placebo for non-specific thoracic spine pain: a randomised controlled trial.Chiropr Man Therap.2016;24(16):1-9.
[25] FRANCESCHI C, CAMPISI J. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci.2014; 69(S1):S4-S9.
[26] HARRIS LS, FREEMAN S, WANG YC, et al. Astym® therapy improves FOTO® outcomes for patients with musculoskeletal disorders: an observational study. Ann Transl Med. 2019; 7(17):S251.
[27] RODRIGUEZ-MERCHAN EC, DE LA CORTE-RODRIGUEZ H, ROMAN-BELMONTE JM. The current role of Astym therapy in the treatment of musculoskeletal disorders. Postgrad Med. 2019;28:1-6.
[28] CHUGHTAI M, NEWMAN JM, SULTAN AA, et al. Astym® therapy: a systematic review. Ann Transl Med. 2019;7(4): 70.
[29] KIM DH, LEE JJ, SUNG HYUN YOU J. Effects of instrument-assisted soft tissue mobilization technique on strength, knee joint passive stiffness, and pain threshold in hamstring shortness. J Back Musculoskelet Rehabil. 2018; 31(6):1169-1176.
[30] KARMALI A. Conservative management of MRI-confirmed knee osteoarthritis with instrument-assisted soft-tissue mobilization, joint manipulation, and platelet-rich plasma. J Can Chiropr Assoc. 2017;61(3):253-260.
[31] CRANE P, LADDEN J, MONICA D.Treatment of axillary web syndrome using instrument assisted soft tissue mobilization and thoracic manipulation for associated thoracic rotation dysfunction.Physiother Theory Pract. 2018;34(1):74-78.
[32] IKEDA N, OTSUKA S, KAWANISHI Y, et al. Effects of instrument-assisted soft tissue mobilization on musculoskeletal properties. Med Sci Sports Exerc. 2019; 51(10): 2166-2172.
[33] CHUGHTAI M, MONT MA, CHERIAN C. A novel, nonoperative treatment demonstrates success for stiff total knee arthroplasty after failure of conventional therapy. J Knee Surg. 2016;29(3):188-193.
[34] BHAVE A, CORCORAN J, CHERIAN JJ, et al. Astym® therapy for the management of recalcitrant knee joint stiffness after total knee arthroplasty. J Long Term Eff Med Implants. 2016;26(2):151-159.
[35] GRIBBLE PA, DELAHUNT E, BLEAKLEY C, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med. 2014;48(13):1014-1018.
[36] SCHAEFER JL, SANDREY MA. Effects of a 4-week dynamic-balance-training program supplemented with graston instrument-assisted soft-tissue mobilization for chronic ankle instability. J Sport Rehabil. 2012;21(4):313-326.
[37] BAKER R, NASYPANY A, SEEGMILLER J, et al. Instrument-assisted soft tissue mobilization in treatment for tissue extensibility dysfunction. J Athl Train. 2013;18(5):16-21.
[38] SEFFRIN CB, CATTANO NM, REED MA, et al. Instrument-Assisted Soft Tissue Mobilization: A Systematic Review and Effect-Size Analysis.J Athl Train. 2019;54(7): 808-821.
[39] LAUDNER K, COMPTON BD, MCLODA TA, et al. Acute effects of instrument assisted soft tissue mobilization for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. 2014;9(1):1-7.
[40] BAILEY LB, SHANLEY E, HAWKINS R, et al. Mechanisms of shoulder range of motion deficits in asymptomatic baseball players. Am J Sports Med. 2015; 43(11): 2783-2793.
[41] RHYU HS, HAN HG, RHI SY, et al. The effects of instrument-assisted soft tissue mobilization on active range of motion, functional fitness, flexibility, and isokinetic strength in high school basketball players . Technol Health Care. 2018; 26(5): 833-842.
[42] MARKOVIC G. Acute effects of instrument assisted soft tissue mobilization vs. foam rolling on knee and hip range of motion in soccer players. J Bodyw Mov Ther. 2015; 19(4): 690-696.
[43] CARRIE AR, WILLIAM JH, PATRICK SP, et al. Efficacy of instrument-assisted soft tissue mobilization to gastrocnemius-soleus stretching for dorsiflexion range of motion: A randomized controlled trial. J Bodyw and Mov Ther. 2019; 23(2):233-240.
[44] GUNN LJ, STEWART JC, MORGAN B, et al. Instrument- assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial. J Man Manip Ther. 2019;27(1):15-23.
[45] KIM J. Instrument-assisted Soft Tissue Mobilization Improves Physical Performance of Young Male Soccer Players.Int J Sports Med. 2018;39:936-943.
[46] DONAHUE M. The Effect of the Graston Technique on Quadracieps Muscle Activation and Force Production. Bloomington: Indiana University, Department of Kinesiology, 2008.
[47] GAMBOA AJ, CRAFT DR, MATOS JA, et al. Functional Movement Analysis Before and After Instrument-Assisted Soft Tissue Mobilization. Int J Exerc Sci. 2019;12(3):46-56.
[48] MACDONALD M, BAKER R, CHEATHAM SW. The effects of instrument assisted soft tissue mobilization on lower extremity muscle performance: a randomized controlled trial. Int J Sports Ther. 2016;11(7):1040-1047.
[49] 王国义.章氏理筋手法联合体外冲击波治疗肱骨外上髁炎的临床疗效观察[D].福州:福建中医药大学, 2019.
[50] RAMAN J, MACDERMID JC, GREWAL R. Effectiveness of different methods of resistance exercises in lateral epicondylosis: a systematic review. J Hand Ther. 2012,25(1):5-25.
[51] AL RIFAI M, SILVERMAN MG, NASIR K, et al. The association of nonalcoholic fatty liver disease, obesity, and metabolic syndrome, with systemic inflammation and subclinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2015;239(2): 629-633.
[52] LEIDENIUS M, LEPPANEN E, KROGERUS L, et al. Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer. Am J Surg. 2003;185(2): 127-130.
[53] DAVIES CC, BROCKOPP DY, MOE K. Astym therapy improves function and range of motion following mastectomy. Breast Cancer (Dove Med Press). 2016;8:39-45.
[54] DAVIES CC, BACKOPP DY. Use of Astym treatment on scar tissue following surgical treatment for breast cancer: a pilot study. Rehabil Oncol. 2010;28: 3-12.
[55] CHEATHAM SW, BAKER R, KREISWIRTH E. Instrument assisted soft-tissue mobilization:a commentary on clinical practice guidelines for rehabilitation professionals. Int J Sports Phys Ther. 2019;14(4): 670-682.
[56] NIELSEN A, KLIGLER B, KOLL BS. Safety protocols for gua sha(press-stroking) and baguan(cupping).Complement Ther Med.2012;20(5):340-344.
[57] KARMALI A, WALIZADA A, STUBER K. The efficacy of instrument assisted soft tissue mobilization for musculoskeletal pain: a systematic reciew.J Contemp Chiropr. 2019;2:25-33. [58] HUSSEY MJ, BORON-MAGULIK AE, MCLEOD TCV, et al. The comparison of instrument-assisted soft tissue mobilization and self-stretch measures to increase shoulder range of motion in overhead athletes: a critically appraised topic. J Sport Rehabil. 2018;27(4):385-389. |
[1] | Huang Dengcheng, Wang Zhike, Cao Xuewei. Comparison of the short-term efficacy of extracorporeal shock wave therapy for middle-aged and elderly knee osteoarthritis: a meta-analysis [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(9): 1471-1476. |
[2] | Li Dadi, Zhu Liang, Zheng Li, Zhao Fengchao. Correlation of total knee arthroplasty efficacy with satisfaction and personality characteristics [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(9): 1346-1350. |
[3] | Wei Wei, Li Jian, Huang Linhai, Lan Mindong, Lu Xianwei, Huang Shaodong. Factors affecting fall fear in the first movement of elderly patients after total knee or hip arthroplasty [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(9): 1351-1355. |
[4] | Lü Zhen, Bai Jinzhu. A prospective study on the application of staged lumbar motion chain rehabilitation based on McKenzie’s technique after lumbar percutaneous transforaminal endoscopic discectomy [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(9): 1398-1403. |
[5] | Chen Jinping, Li Kui, Chen Qian, Guo Haoran, Zhang Yingbo, Wei Peng. Meta-analysis of the efficacy and safety of tranexamic acid in open spinal surgery [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(9): 1458-1464. |
[6] | Gao Yan, Zhao Licong, Zhao Hongzeng, Zhu Yuanyuan, Li Jie, Sang Deen. Alteration of low frequency fluctuation amplitude at brain-resting state in patients with chronic discogenic low back pain [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(8): 1160-1165. |
[7] | Wu Gang, Chen Jianwen, Wang Shilong, Duan Xiaoran, Liu Haijun, Dong Jianfeng. Simple HyProCure subtalar stabilization in treatment of adolescent flexible flatfoot combined with painful accessory navicular bone [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(6): 901-905. |
[8] | Li Yan, Wang Pei, Deng Donghuan, Yan Wei, Li Lei, Jiang Hongjiang. Electroacupuncture for pain control after total knee arthroplasty: a meta-analysis [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(6): 957-963. |
[9] | Zhao Zhongyi, Li Yongzhen, Chen Feng, Ji Aiyu. Comparison of total knee arthroplasty and unicompartmental knee arthroplasty in treatment of traumatic osteoarthritis [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(6): 854-859. |
[10] | Zhang Nianjun, Chen Ru. Analgesic effect of cocktail therapy combined with femoral nerve block on total knee arthroplasty [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(6): 866-872. |
[11] | Li Quanxi, Shen Yu, Wan Wei, Sun Shanzhi. Changes of abdominal wall mechanics and pain after tension-free inguinal hernia repair with polypropylene mesh [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(4): 548-552. |
[12] | Peng Kun, Lin Yimin, Gan Xiaoling, Wu Zhiyong. Development prospect of orthopedic rehabilitation medicine based on three-dimensional printing technology [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(4): 632-637. |
[13] | Wang Xiaofei, Teng Xueren, Cong Linyan, Zhou Xu, Ma Zhenhua. Herbert screw internal fixation for treating adult osteochondritis dissecans of the knees [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(3): 397-402. |
[14] | Huang Maomao, Hu Yue, Wang Binchuan, Zhang Chi, Xie Yujie, Wang Jianxiong, Wang Li, Xu Fangyuan. Bibliometric and visual analysis of international literature addressing ischemic stroke rehabilitation in recent 10 years [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(23): 3725-3733. |
[15] | Yang Wei, Chen Zehua, Yi Zhiyong, Huang Xudong, Han Qingmin, Zhang Ronghua. Effectiveness of intra-articular injection of hyaluronic acid versus placebo in the treatment of early and mid-stage knee osteoarthritis: a Meta-analysis based on randomized, double-blind, controlled, clinical trials [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(23): 3760-3766. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||