Comparing the Effectiveness of Soft Tissue Manipulation and IASTM for Calf Muscle Tightness in Spastic Cerebral Palsy Children
Abstract
This experimental study aimed to assess the effectiveness of soft tissue manipulation and Instrument Assisted Soft Tissue Mobilization (IASTM) in alleviating calf muscle tightness in children diagnosed with spastic cerebral palsy (CP). Cerebral palsy, a condition affecting two to three out of every 1,000 live births, encompasses a range of challenges related to movement, posture, gait abnormalities, and balance issues. Specifically, spastic diplegic cerebral palsy, characterized by leg spasticity, often results in walking difficulties, with tiptoeing as a common symptom due to calf muscle tightness. The study involved 30 children aged 5-12 diagnosed with spastic cerebral palsy at ACS Medical College and Hospital. Participants meeting the inclusion criteria were divided into two groups: Group receiving soft tissue manipulation and Group B undergoing IASTM. Outcome measures included goniometry and the Modified Ashworth Scale. Random sampling was employed to select subjects, with exclusions for specific medical conditions. Written consent was obtained and demographic data were collected. Based on goniometry and the Modified Ashworth Scale, both interventions demonstrated highly significant differences in mean values within their respective groups. The findings underscore the potential efficacy of both soft tissue manipulation and IASTM in addressing calf muscle tightness in children with spastic cerebral palsy.
References
Agarwal, A., & Verma, I. (2012). Cerebral palsy in children: An overview. Journal of Clinical Orthopaedics and Trauma, 3(2), 77–81. https://doi.org/10.1016/j.jcot.2012.09.001
Armand, S., Decoulon, G., & Bonnefoy-Mazure, A. (2016). Gait analysis in children with cerebral palsy. EFORT Open Reviews, 1(12), 448–460. https://doi.org/10.1302/2058-5241.1.000052
Ashton, B. B., Pickles, B., & Roll, J. W. (1978). Reliability of goniometric measurements of hip motion in spastic cerebral palsy. Developmental Medicine and Child Neurology, 20(1), 87–94. https://doi.org/10.1111/j.1469-8749.1978.tb15184.x
Bar-On, L., Molenaers, G., Aertbeliën, E., Van Campenhout, A., Feys, H., Nuttin, B., & Desloovere, K. (2015). Spasticity and its contribution to hypertonia in cerebral palsy. BioMed Research International, 2015, 317047. https://doi.org/10.1155/2015/317047
Basak, S. (2019). The Relationship between Core Muscle Stability and Balance in Yoga. Int. J. Exp. Res. Rev., 19, 49-52. https://doi.org/10.52756/ijerr.2019.v19.006
Bottcher L. (2010). Children with spastic cerebral palsy, their cognitive functioning, and social participation: a review. Child neuropsychology: a Journal on Normal and Abnormal Development in Childhood and Adolescence, 16(3), 209–228. https://doi.org/10.1080/09297040903559630
Carriero, A., Zavatsky, A., Stebbins, J., Theologis, T., & Shefelbine, S. J. (2009). Determination of gait patterns in children with spastic diplegic cerebral palsy using principal components. Gait & Posture, 29(1), 71–75. https://doi.org/10.1016/j.gaitpost.2008.06.011
Cheatham, S. W., Baker, R., & Kreiswirth, E. (2019). Instrument Assisted Soft-Tissue Mobilization: A Commentary on Clinical Practice Guidelines for Rehabilitation Professionals. International Journal of Sports Physical Therapy, 14(4), 670–682. https://doi.org/10.26603/ijspt20190670.
Cheatham, S. W., Kreiswirth, E., & Baker, R. (2019). Does a light pressure instrument assisted soft tissue mobilization technique modulate tactile discrimination and perceived pain in healthy individuals with DOMS? The Journal of the Canadian Chiropractic Association, 63(1), 18–25. https://doi.org/10.1123/jsr.2022-0356
Croft, B. D., Patricia, A. A., & Thomas, G. B. (2022). Effects of Instrument Assisted Soft-Tissue Mobilization on Dynamic Balance in Those with Chronic Ankle Instability. Trauma Care, 2(2), 197-204. https://doi.org/10.3390/traumacare2020016.
Das, R., Jhajharia, B., Ciocan, V. C., Sharma, A., & Majumdar, I. (2022). Myofascial Trigger Points and its Influence on Athletic performance-A Review. NeuroQuantology, 20(19), 467. https://doi.org/10.48047/nq.2022.20.19.NQ99043.
Davids, Jon. (2010). The Foot and Ankle in Cerebral Palsy. The Orthopaedic Clinics of North America, 41, 579-593.
https://doi.org/10.1016/j.ocl.2010.06.002
Harris, L. S., Freeman, S., & Wang, Y. C. (2019). Astym® therapy improves FOTO® outcomes for patients with musculoskeletal disorders: an observational study. Annals of Translational Medicine, (7), S251. https://doi.org/10.21037/atm.2019.04.09
Jo, M., & Purushothaman, V. K., Ambusam, S., & Krishnan, V. R. (2023). The Awareness, Practice and Perception of Instrument-Assisted Soft Tissue Mobilization (IASTM) among Malaysian Physiotherapists. Malaysian Journal of Medicine and Health Sciences, 19, 135-139. https://doi.org/10.47836/mjmhs.19.1.19.
Khant, A., Dave, Y., Tare, H., Udugade, B., Udugade, S., Choudante, S., & Pulate, C. (2023). Effectiveness of respiratory muscle training on pulmonary function and quality of life in cotton industry workers. Int. J. Exp. Res. Rev., 32, 160-165. https://doi.org/10.52756/ijerr.2023.v32.013
Kim, J., Sung, D. J., & Lee, J. (2017). Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. Journal of Exercise Rehabilitation, 13(1), 12–22.
https://doi.org/10.12965/jer.1732824.412
Kini, R. R. (2020). The outcome of instrument-assisted soft-tissue mobilization in conjunction with functional training in a patient with chronic regional pain syndrome post-supraspinatus arthroscopic repair. Indian Journal of Case Reports, 96-98. https://doi.org/10.32677/IJCR.2020.v06.i02.018
Lee, J. J., Lee, J. J., Kim, D. H., & You, S. J. (2014). Inhibitory effects of instrument-assisted neuromobilization on hyperactive gastrocnemius in a hemiparetic stroke patient. Bio-medical Materials and Engineering, 24(6), 2389–2394. https://doi.org/10.3233/BME-141052
Lee, J., Park, C., Cha, Y., & You, J. S. H. (2021). Comparative effects of different manual techniques on electromyography activity, kinematics, and muscle force in limited ankle dorsiflexion syndrome. Journal of Back and Musculoskeletal Rehabilitation, 34(6), 1105-1112. https://doi.org/10.3233/BMR-200257
Liu, Y., & Wang, Y. (2023). A comparative study of the efficacy of instrument-assisted soft tissue mobilization and massage techniques in patients with patellofemoral joint pain. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1305733
Looney, B., Srokose, T., Fernández-de-las-Peñas, C., & Cleland, J. A. (2011). Graston instrument soft tissue mobilization and home stretching for the management of plantar heel pain: a case series. Journal of Manipulative and Physiological Therapeutics, 34(2), 138–142. https://doi.org/10.1016/j.jmpt.2010.12.003
Miller, M. M., Ray, J. M., & Van Zant, R. S. (2017). The Effects of Astym Therapy® on a Child with Spastic Diplegic Cerebral Palsy. Clinical Medicine Insights. Case Reports, 10, 1179547617746992. https://doi.org/10.1177/1179547617746992
Mutlu, A., Livanelioglu, A., & Gunel, M. K. (2008). Reliability of Ashworth and Modified Ashworth scales in children with spastic cerebral palsy. BMC Musculoskeletal Disorders, 9, 44. https://doi.org/10.1186/1471-2474-9-44
Myeong-Jun Kim1, Tae-Ho Kim2 Effect of Neuro Dynamic Technique and Instrument Assisted Soft Tissue Mobilization on Lower Extremity Muscle Tone, Stiffness, Static Balance in Stroke Patients. The Korean Society of Physical Therapy, 32(6), 359-364. http://doi.org/10.18857/jkpt.2020.32.6.359
Nadeem, K., Arif, M. A., Akram, S., Arslan, S., Ahmad, A., & Gilani, S. (2023). Effect of IASTM ergon technique on pain, strength and range of motion in plantar fasciitis patients. RCT. Physiotherapy Quarterly, 31(4). https://doi.org/10.5114/pq.2023.125109
Nazary-Moghadam, S., Yahya-Zadeh, A., Zare, M. A., Mohammadi, M. A., Marouzi, P., & Zeinalzadeh, A. (2023). Comparison of utilizing modified hold-relax, muscle energy technique, and instrument-assisted soft tissue mobilization on hamstring muscle length in healthy athletes: Randomized controlled trial. Journal of Bodywork and Movement Therapies, 35, 151-157. https://doi.org/10.1016/j.jbmt.2023.04.079
Orhan, C., Kaya Kara, O., Kaya, S., Akbayrak, T., Kerem Gunel, M., & Baltaci, G. (2018). The effects of connective tissue manipulation and Kinesio Taping on chronic constipation in children with cerebral palsy: a randomized controlled trial. Disability and Rehabilitation, 40(1), 10–20. https://doi.org/10.1080/09638288.2016.1236412
Pisirici, P., Balci, L. A., & Akkoyun, S. (2021). The effect of instrument assisted soft tissue mobilization technique on proprioception and balance in individuals with non-specific neck pain-pilot study. In Scientific Researches in Health Sciences II, pp. 175-189. Peter Lang AG. https:// https://doi.org/10.35120/medisij020423n
Scheer, N. A., Alstat, L. R., & Van Zant, R. S. (2016). Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report. Clinical Medicine Insights. Case Reports, 9, 95–98. https://doi.org/10.4137/CCRep.S40623
Simatou, M., Papandreou, M., Billis, E., Tsekoura, M., Mylonas, K., & Fousekis, K. (2020). Effects of the Ergon® instrument-assisted soft tissue mobilization technique (IASTM), foam rolling, and static stretching application to different parts of the myofascial lateral line on hip joint flexibility. Journal of Physical Therapy Science, 32(4), 288–291.
https://doi.org/10.1589/jpts.32.288.
Singh, H., & Sharma, D. (2023). Efficacy and Safety of Muscle Rub Ointment in The Management of Arthritis and Certain Musculoskeletal Disorders. Int. J. Exp. Res. Rev., 34(Special Vol.), 146-151. https://doi.org/10.52756/ijerr.2023.v34spl.014
Stevenson, T. C., Whitlock, J. A., Martonick, N., Cheatham, S. W., Reeves, A., McGowan, C., & Baker, R. T. (2023). Descriptive analysis of forces applied by trained clinicians during 2-handed instrument-assisted soft tissue mobilization. Journal of Athletic Training, 58(1), 60-64. https://doi.org/10.4085/1062-6050-282-21
Syed, H., Shamim, Q., Niaz, T., Dastgir, H.., Ilyas, A., & Rasul, A. (2023). Reliability of Modified Ashworth Scale as compared to Modified Tardieu Scale on Assessment of Lower Limb Spasticity in Children with Diplegic Cerebral Palsy: Reliability of Ashworth Scale in Cerebral Palsy. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 3(7), 696–702. https://doi.org/10.55735/hjprs.v3i7.183
Copyright (c) 2024 International Academic Publishing House (IAPH)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
