Effects of a two-week instrument-assisted soft tissue mobilization and exercise therapy versus sham and exercise on gait kinetics in moderate knee osteoarthritis: a randomized controlled trial.

Abstract

Introduction: Knee osteoarthritis (KOA) is a common joint disease that affects mobility and daily activities. Instrument-assisted soft tissue mobilization (IASTM) is widely used as a conservative treatment due to its potential effects on soft tissues. This study evaluates the effects of IASTM on pain, range of motion (ROM), health status, and gait kinetics in KOA patients.

Methods:   Thirty individuals with unilateral KOA were randomized into two groups: IASTM with routine exercises and sham IASTM with exercises, over four sessions in two weeks. Pain, ROM, and WOMAC scores were assessed pre-treatment and 48 hours post-treatment. Gait kinetics, including vertical ground reaction force and knee adduction moment, were measured at three walking speeds (preferred, fixed, and fast) before and after treatment.

Results: Mixed ANOVA revealed significant improvements in pain, ROM, and WOMAC scores in both groups. The IASTM group showed greater improvements in pain, knee flexion, ankle plantarflexion, and WOMAC pain scores, as indicated by a significant group*time interaction. For kinetics, the only significant finding was a longer time to heel strike transient in the IASTM group. At fast speed, most kinetic variables increased significantly in both groups.

Conclusion: Both IASTM and sham interventions with exercise improved pain and ROM. However, the IASTM group experienced greater improvements. Additionally, IASTM led to a longer time to heel strike transient, suggesting improved shock absorption. Overall, IASTM may serve as a beneficial adjunctive intervention for alleviating symptoms in KOA patients and improving gait under challenging conditions, such as fast-speed walking.