Date of Award
Master of Science (MS)
School of Kinesiology and Recreation
Context: Instrument assisted soft tissue mobilization (IASTM) can be applied as a myofascial treatment using a set of instruments and is growing in popularity with clinicians. There is a gap in the literature identifying the best pressure application recommendation without eliciting unnecessary discomfort.
Objective: To investigate if using light or firm pressure applied with the Graston Technique (GT) would have an impact on changing range of motion (ROM).
Design: Single blinded randomized control trial
Patients or Other Participants: Twenty-seven physically active participants (14 females and 13 males; age: 23±3.4 years; height: 68.59±3.32; weight: 83.6±30.79) were recruited and assessed for hamstring tightness. Participants were enrolled if they had 70° or less of a passive straight leg raise (PSLR) as measured at first resistance (R1). Qualifying participants were randomly allocated into three groups: firm pressure (FP), light pressure (LP), or control.
Interventions: The GT protocol was implemented for this study. Participants began treatment with a ten-minute bike warm up and were divided into groups. The two pressure groups were treated on the hamstring muscle of the participants’ dominant leg with the same treatment protocol while the control group only received stretching education and sat in the treatment room for seven minutes. GT1 and GT5 were used for one minute each to warm up the tissue and identify adhesions. The hamstring was divided into four sections and treated 30 second each with GT4. This was measured and applied using the pressure allocation. This was followed by GT5 and GT1 for one minute each. Firm pressure was maintained at 6.44 N±2.38 and light pressure at 1.68 N±0.83. After treatment, the participant completed three hamstring exercises and a static stretch of passive hip flexion with knee extended taken to the participants’ end range. Participants finished with a final measurement of PSLR to R1. Twenty-four hours later, the participant returned and was measured using a PSLR.
Main Outcome Measures: Hamstring ROM measurements taken at baseline, at the completion of the treatment session and 24-hours later using a PSLR. Subjects scored their perceived discomfort at baseline and at the 24 hour follow up using a visual analog scale (VAS).
Results: ROM was analyzed with a mixed between-within subjects ANOVA which showed that ROM had no statistically significant changes across time (p=.332) and there was no significance between pressure groups and the control group (p= .472). The VAS scale was analyzed using a Kruskal Wallis test which showed no significance between groups (χ2(2) = 3.61, p = 0.17).
Conclusion: GT does not increase hamstring ROM regardless of pressure. Clinicians can use their own clinical judgement when deciding when and how to apply GT or another form of IASTM to patients based on the patient’s history, pathology, etc.
KEYWORDS: Graston technique, IASTM, hamstring, range of motion, pressure, passive straight leg raise
Martz, Emily, "Graston Technique Pressure Changes on Hamstring Range of Motion" (2018). Theses and Dissertations. 870.