Comparison between effects of instrument-assisted soft tissue mobilization and manual myofascial release on pain, range of motion and function in myofascial pain syndrome of upper trapezius - A randomized controlled trial.
Shweta Agarwal, Nilima Bedekar, Ashok Shyam and 1 others
PMID 38577397WHAT IT FOUND
Both instrument-assisted and manual soft tissue release reduced pain, improved mobility, and lowered disability in upper trapezius myofascial pain.
The instrument group reported significantly less pain than the manual group, but there was no difference in range of motion, pressure tolerance, or function.
Key findings
01Instrument-assisted soft tissue mobilization produced significantly greater improvement in pain scores compared to manual myofascial release.
02There was no significant difference between the two techniques for improvements in pain pressure threshold, cervical range of motion, or neck disability.
03Both groups received the same adjunctive care, including hot packs, specific neck and scapular exercises, and cryotherapy, so the isolated effect of the manual versus instrument technique cannot be separated from this shared protocol.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was small (14 per group after dropouts), which reduces the reliability of the findings. There was no long-term follow-up, so it is unknown whether the improvements lasted beyond the treatment period. Pain was measured by self-report, and participants were not blinded to their treatment, which introduces bias. The study cannot isolate the effect of the soft tissue technique because both groups received the same hot packs, exercises, and ice packs. The authors note that the subjective nature of pain scores and the novelty of the instrument may have influenced patient expectations and reporting.
Declared interests
The authors declared no conflicts of interest, and the study received no specific funding.
The easy way to misread this
Do not conclude that IASTM is superior for all outcomes. It only showed a statistically significant advantage in self-reported pain scores. There was no difference between the techniques in range of motion, pressure tolerance, or functional disability, and both groups improved similarly in those areas.