Transverse forces in skeletal muscle with massage-like loading in a rabbit model

Quantifiable Soft Tissue Manipulation (QSTM™) - A novel modality to improve clinical manual therapy with objective metrics

Soft Tissue Manipulation (STM), a form of mechanotherapy, offers a clinical modality to examine and treat Neuromusculoskeletal (NMS) pain disorders and dysfunction. The, current STM practice is mostly subjective and reliant on anecdotal patient feedback and lacks quantification with objective metrics. This paper proposes Quantifiable Soft Tissue Manipulation (QSTM™), a sensor based computerized technological advancement in Soft tissue examination and treatment enabling new standard of practice in manual therapy. This novel medical device technology aims to produce optimum STM prescriptions using ergonomic, portable, handheld medical tools with specially contoured tips designed to palpate and assess tissue anomalies of specific musculoskeletal conditions. QSTM™ captures three-dimensional forces and motion of the mechatronic handheld tools to quantify STM treatment parameters, such as (resultant force, force application angle, rate, direction, and treatment time). Clinical practice using QSTM™ facilitates real-time visual feedback of treatment metrics and subsequent treatment documentation for comparison and analysis on a Windows based computer software (Q-Ware^©). Pre-clinical testing using the QSTM™ medical device system clearly identifies inconsistencies among practitioners and distinguishes STM practice variabilities. Thus, QSTM™ is an apt tool for soft tissue treatment assessment, analysis, and individualized prescriptions for targeted STM dosing and commercialization.

Force Sensing for an Instrument-Assisted Soft Tissue Manipulation Device

Instrument-assisted soft tissue manipulation (IASTM) is a form of mechanotherapy, e.g., massage, that uses rigid devices which may be machined or cast. The delivered force, which is a critical parameter during IASTM, is not measured and not standardized in current clinical IASTM practice. In addition to the force, the angle of treatment and stroke frequency play an important role during IASTM. For accurate IASTM treatment, there is a strong need to scientifically characterize the IASTM delivered force, angle of treatment, and stroke frequency. This paper presents a novel, mechatronic design of an IASTM device that can measure the localized pressure on the soft tissue in a clinical treatment. The proposed design uses a three-dimensional (3D) load cell, which can measure all three-dimensional force components simultaneously. The device design was implemented using an IMUduino microcontroller board which provides tool orientation angles. These orientation angles were used for coordinate transformation of the measured forces to the tool–skin interface. Additionally, the measured force value was used to compute the stroke frequency. This mechatronic IASTM tool was validated for force measurements in the direction of tool longitudinal axis using an electronic plate scale that provided the baseline force values to compare with the applied force values measured by the tool. The load cell measurements and the scale readings were found to agree within the expected degree of accuracy.

Manual therapy as an effective treatment for fibrosis in a rat model of upper extremity overuse injury

Key clinical features of carpal tunnel syndrome and other types of cumulative trauma disorders of the hand and wrist include pain and functional disabilities. Mechanistic details remain under investigation but may involve tissue inflammation and/or fibrosis. We examined the effectiveness of modeled manual therapy (MMT) as a treatment for sensorimotor behavior declines and increased fibrogenic processes occurring in forearm tissues of rats performing a high repetition high force (HRHF) reaching and grasping task for 12 weeks. Young adult, female rats were examined: food restricted control rats (FRC, n=12); rats that were trained for 6 weeks before performing the HRHF task for 12 weeks with no treatment (HRHF-CON, n=11); and HRHF task rats received modeled manual therapy (HRHF-MMT, n=5) for 5 days/week for the duration of the 12-week of task. Rats receiving the MMT expressed fewer discomfort-related behaviors, and performed progressively better in the HRHF task. Grip strength, while decreased after training, improved following MMT. Fibrotic nerve and connective tissue changes (increased collagen and TGF-β1 deposition) present in 12-week HRHF-CON rats were significantly decreased in 12-week HRHF-MMT rats. These observations support the investigation of manual therapy as a preventative for repetitive motion disorders.