Document Type : Research Paper
Authors
1
Department of Sports Pathology and Corrective Movements, Faculty of Sports Sciences, Isfahan University, Esfahan, Iran
2
full professor, Department of Physical Education , Isfahan University ,Esfahan,Iran
3
Department of Bone and Joint Surgery, Faculty of Medicine Isfahan University of Medical Sciences, Esfahan, Iran
Abstract
Background and Purpose
Tennis elbow is one of the most common extra-articular diseases that is associated with pain and acute tenderness at the junction of the forearm muscles. The use of Instrument Assisted Soft Tissue Mobilization (IASTM) is a new method that has been proposed in recent years and has been used in the treatment of many connective tissue problems. Therefore, the aim of this study was to determine the effect of IASTM on strength and range of motion (ROM) of patients with tennis elbow.
Methods
A total of 44 patients with tennis elbow referred to the clinic of an orthopedic specialist in Isfahan were selected in a purposeful and accessible manner. The samples were randomly divided into two experimental (age: 51.1 ± 12.1 years, height: 165.7 ± 9.4 cm, weight: 68.1 ± 11.3 kg) and control (age: 50.4 ± 13.0 years, height: 167.3 ± 10.5 cm, weight: 74.1 ± 12.9 kg) groups. The control group received corticosteroid injections, 10 sessions of physiotherapy, and daily use of a tennis elbow splint, while the experimental group, in addition to receiving treatments as the control group, underwent 4 weeks of IASTM, 2 sessions per week. Grip strength (dynamometer) and range of motion of elbow and wrist flexion and extension (goniometer) were measured before and after the 4 weeks. The data were analyzed using SPSS version 26, with dependent t statistic and variance analysis tests (p < 0.05).
Results
The results showed that in patients of the experimental group, grip strength (10.1 vs. 19.6), elbow flexion ROM (42.9 vs. 30.4), elbow extension ROM (161.9 vs. 169), wrist flexion ROM (120.9 vs. 115.4), and wrist extension ROM (117.4 vs. 113.7) showed significant improvement (p < 0.05). In control group patients, grip strength (11.7 vs. 12.2) improved significantly (p < 0.05), but elbow flexion ROM (38.7 vs. 40.5), elbow extension ROM (152.4 vs. 154.3), wrist flexion ROM (129.1 vs. 125.5), and wrist extension ROM (125.4 vs. 125.1) did not improve significantly (p > 0.05). A significant difference was observed between the experimental and control groups in grip strength, range of motion of elbow flexion and extension, and wrist extension, such that grip strength was about 87.6%, elbow flexion ROM about 58.3%, elbow extension ROM about 40.8%, and wrist extension ROM about 34.3% higher in the experimental group compared to the control group (p < 0.05). However, no significant difference was observed in wrist flexion ROM, with the experimental group improving only about 5.9% more than the control group (p > 0.05).
Conclusion
The results indicated that therapeutic interventions in both the experimental and control groups improved grip strength, with the experimental group showing a significantly higher recovery rate—87.6% more than the control group. IASTM is used to cause micro-trauma in the target tissue through friction, which initiates the healing process. The inflammatory process attracts white blood cells that bring nutrients and growth factors to the area, followed by a proliferative phase where fibroblasts produce new collagen. Once collagen fibers are restored, tissues enter maturation, resulting in stronger tissues. Therapeutic interventions in the experimental group significantly improved elbow flexion and extension ROM compared to controls. Wrist flexion and extension ROM showed significant improvement in the experimental but not control group. No significant difference was seen between groups in wrist flexion ROM post-test, while wrist extension ROM increased 34.3% more in the experimental group. IASTM appears to cause regrowth and redistribution of collagen fibers, optimizing range of motion and muscle flexibility. It affects myofascial tissue mechanically and nerve tissue by altering muscle tone and tissue water. Increased sensory involvement enhances mobility of soft tissue and movement programming. Therefore, tools aiding soft tissue mobility positively impact grip strength and range of motion in patients with tennis elbow and are recommended alongside conventional treatments.
Article Message
The use of IASTM along with conventional interventions for tennis elbow is effective in improving grip strength and range of motion of elbow flexion and extension and wrist extension and is recommended for these patients.
Ethical Considerations
Written informed consent was obtained from all participants. Participants were fully informed about the study protocol and allowed to withdraw at any point. The study was approved by the ethics committee of Isfahan University under code IR.UI.REC.1402.002.
Authors’ Contributions
Conceptualization: Sepideh Aghajani
Data Collection: Sepideh Aghajani
Data Analysis: Nader Rahnama, Sepideh Aghajani
Manuscript Writing: Sepideh Aghajani
Review and Editing: Sepideh Aghajani, Nader Rahnama, Abolghasem Zarezadeh
Responsible for funding: Sepideh Aghajani
Literature Review: Sepideh Aghajani
Project Manager: Nader Rahnama
Additional Contributions: Sepideh Aghajani contributed to study design, data collection, and drafting; Nader Rahnama supervised and revised the manuscript; Abolghasem Zarezadeh advised on instruments, provided corticosteroid injections, and performed final editing. All authors approved the final version.
Conflict of Interest
The authors declare no conflicts of interest.
Acknowledgments
We express our gratitude to all participants and contributors to this research.
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