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Technical Brief

A Hand-Held Device to Apply Instrument-Assisted Soft Tissue Mobilization at Targeted Compression Forces and Stroke Frequencies

[+] Author and Article Information
John B. Everingham, Peter T. Martin

Department of Mechanical and Biomedical Engineering,
Boise State University,
1910 University Drive,
Boise, ID 83725-2085

Trevor J. Lujan

Department of Mechanical and Biomedical Engineering,
Boise State University,
1910 University Drive,
Boise, ID 83725-2085
e-mail: trevorlujan@boisestate.edu

1Corresponding author.

Manuscript received March 30, 2018; final manuscript received October 3, 2018; published online December 4, 2018. Assoc. Editor: Rita M. Patterson.

J. Med. Devices 13(1), 014504 (Dec 04, 2018) (5 pages) Paper No: MED-18-1062; doi: 10.1115/1.4041696 History: Received March 30, 2018; Revised October 03, 2018

Instrument-assisted soft tissue mobilization (IASTM) is a manual therapy technique that is commonly used to treat dysfunctions in ligaments and other musculoskeletal tissues. The objective of this study was to develop a simple hand-held device that helps users accurately apply targeted compressive forces and stroke frequencies during IASTM treatments. This portable device uses a force sensor, tablet computer, and custom software to guide the application of user-specified loading parameters. To measure performance, the device was used to apply a combination of targeted forces and stroke frequencies to foam blocks and silicone pads. Three operators using the device applied targeted forces between 0.3 and 125 N with less than 10% error and applied targeted stroke frequencies between 0.25 and 1.0 Hz with less than 3% error. The mean error in applying targeted forces increased significantly at compressive forces less than 0.2 N and greater than 125 N. For experimental validation, the device was used to apply a series of IASTM treatments over three-weeks to rodents with a ligament injury, and the targeted compressive force and stroke frequency were repeatedly applied with an average error less than 5%. This validated device can be used to investigate the effect of IASTM loading parameters on tissue healing in animal and human studies, and therefore can support the optimization and adoption of IASTM protocols that improve patient outcomes.

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Figures

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Fig. 1

Design and components of device: (a) Graston IASTM tool, (b) hand-held device, and (c) data acquisition and graphical user interface used with the hand-held device

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Fig. 2

Automated calculation of loading parameters: (a) force data measured by the device during performance testing overlaid with the target loading profile. Black circles represent data included in the overall calculation of mean stroke force, while open circles were excluded from this calculation. (b) Fourier series fit for measured force data with a target frequency of 0.5 Hz. This fit was used to measure frequency during testing. Note: the compressive force is applied every half cycle.

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Fig. 3

Experimental setup: (a) device at a 60 deg shaft angle to determine error between the applied axial force measured by the device (Pdevice) and the compressive force applied to the surface (Psurface), which is measured by an auxiliary force sensor and (b) illustration of thedevice being used to apply IASTM to a rodent's MCL (gray structure in figure inset)

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Fig. 4

Results from device performance tests: (a) comparison between the axial force measured by the device and the compressive surface force measured by the auxiliary force sensor. A slope of 1 indicates the force measured by the device equals the compressive force applied to the surface. (b) Percent error in applying each targeted compressive force (0.2, 0.3, 0.4, 0.5, 1, 3, 5, 10, 25, 50, 75, 100, 125, 150, 175 N; log scale), averaged over three different operators. The error bars indicate the standard deviation between operators. Note: the mean error at a 0.1 N target force was 78±35% (not shown on plot). * = significantly greater error than other targeted forces (25, 50, and 75 N).

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Fig. 5

Results from experimental validation: (a) average applied force and (b) average applied stroke frequency across five IASTM treatments for three rats

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