Therapeutic Effects of Instrument-assisted Versus Sound-assisted Soft Tissue Mobilization in Chronic Non-specific Low Back Pain (IASTM VS SASTM)

December 30, 2025 updated by: Tahir Mahmood, University of Lahore

Therapeutic Effects of Instrument-assisted Versus Sound-assisted Soft Tissue Mobilization Among Patients With Chronic Non-specific Low Back Pain

Chronic low back pain (CLBP) is the most common medical problem observed among musculoskeletal pain and spinal pain problems. It can reduce the movements due to muscular imbalances, decreased activity of daily living, and effects on health-related quality of life. It is the major cause of activity limitation, work absence, and reported clinical issues. Most of the cases of low back pain remained undiagnosed and received only symptomatic management.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

There is limited literature on advanced soft tissue release techniques provided by primary healthcare practitioners specific to low back pain. Some of the studies are based on soft tissue mobilization using a mechanically assisted method, but they have limited outcomes, acute effects, and small sample sizes, which limit their generalization. Further literature is limited in the comparison of IASTM and SASTM. Further, there are limited techniques that can facilitate practitioners to identify the restrictions.

Firstly, instrument-assisted soft tissue mobilization (IASTM), due to its body contour and shape, recognizes specific tissue lesions and restriction sites while targeting specific points rather than using manual methods that cover a larger contact area. Using the mechanotransduction phenomenon, its mechanical stimuli initiate biochemical signals that trigger cellular responses and ultimately functional improvement. Biomechanically, fascial elasticity, fascial stiffness, and viscosity absorb and distribute forces. While tissue hydration level is increased, that is compromised in chronic low back pain.

Secondly, sound-assisted soft tissue mobilization could be an intervention for treating musculoskeletal disorders. The SASTM technique has the potential to be a game-changer in pain management after IASTM. The sound decreases as adhesions are broken. While breakdown of scar tissue can be a facilitator for ease of movement patterns.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Recruiting
        • Arif Memorial Teaching Hospital
        • Contact:
          • Dr. Nazeer Ahmad Naseer Mehrvi Physical Therapist (Incharge), BSPT, PPDPT, NMPT
          • Phone Number: +923338054247
          • Email: nazeermehrvi76@gmail.com
        • Contact:
        • Principal Investigator:
          • Tahir Mahmood, PhD PT(Scholar)
        • Sub-Investigator:
          • Ashfaq Ahmad, PhD PT
        • Sub-Investigator:
          • Alberto Sumiya, PhD (Motricity Sciences)
      • Lahore, Punjab Province, Pakistan, 54000
        • Recruiting
        • Re Active Physio Clinic Lahore.
        • Principal Investigator:
          • Tahir Mahmood, PhD PT(Scholar)
        • Sub-Investigator:
          • Alberto Sumiya, PhD (Motricity Sciences)
        • Contact:
          • Dr. Ali Shehvaiz Younas Physical Therapist, DPT, M.Phil. (Biomechanics)
          • Phone Number: +923134142899
          • Email: shehvaizch@gmail.com
        • Contact:
        • Sub-Investigator:
          • Ashfaq Ahmad, PhD-PT

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Pain between the inferior gluteal folds and the costal margins.
  • Pain with a duration of a minimum of 24 weeks.
  • Moderate to severe pain (>3) was measured using the Numeric Pain Rating Scale.
  • Straight Leg raise Limited (hamstring tightness)

Exclusion Criteria:

  • Pain in lower back with radiating/referring but limited to proximal legs
  • Pain for the last 03 months and at least half of the days in the last six months.
  • Presence of neurological problem/deficit/disease (e.g., nerve root compression, motor deficit, paresthesia) and lower limb symptoms.
  • Presence of disease like Infection, tumors, spondylolisthesis grade II or higher, vertebral fractures, identifiable cause like endometriosis
  • Medicine like immunosuppression or steroid medication;
  • Spinal deformities
  • History of severe rheumatic, orthopedic, or cardiovascular disease in the last three months before study participation.
  • Previously diagnosed Osteoporosis
  • SIJ dysfunction is evaluated by a positive compression test.
  • BMI over 35.
  • Skin allergy or hypersensitivity that can lead to skin irritation due to IASTM/SASTM tools.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Group A
Group A (IASTM + Conventional therapy)
Device: IASTM
The IASTM technique contains a protocol for treatment that contains five components: i. Examination, ii. warm-up exercises 5 min iii. IASTM treatment (e.g., 30-60 seconds per session), iv. Post treatment stretching and strengthening, v. Icing (only when sub-acute inflammation is of concern).
Other: Exercise
In conventional therapy, patients will be given an exercise program that will be targeted to low back muscles. This will be include three type of exercise focusing on stretching, strengthening and postural correction exercise.(Yana et al., 2024)
Experimental: Group B
Group B (SASTM + Conventional)
Other: Exercise
In conventional therapy, patients will be given an exercise program that will be targeted to low back muscles. This will be include three type of exercise focusing on stretching, strengthening and postural correction exercise.(Yana et al., 2024)
Device: SASTM
The therapist will apply sound instrument-assisted soft tissue mobilization (SASTM) with a convex plastic (Ceramic) tool (Beer JA, 2019).
Other: Group C
Conventional therapy
Other: Exercise
In conventional therapy, patients will be given an exercise program that will be targeted to low back muscles. This will be include three type of exercise focusing on stretching, strengthening and postural correction exercise.(Yana et al., 2024)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Intensity
Time Frame: Pain intensity will be noted at baseline ,after the 2nd week, 3rd week, 4th week, and follow up will be taken at 2nd month, and after the 4th month post intervention.
The pain will be assessed using Chronic Pain grading Scale (CPGS).
Pain intensity will be noted at baseline ,after the 2nd week, 3rd week, 4th week, and follow up will be taken at 2nd month, and after the 4th month post intervention.
Flexibility
Time Frame: The lumbar flexibility will be noted at basline after the 2nd week, 3rd week, 4th week, and follow up will be taken at 2nd month, and after the 4th month post intervention.
Modified-Modified Schober Test will be used to measure Lumbar flexibility.
The lumbar flexibility will be noted at basline after the 2nd week, 3rd week, 4th week, and follow up will be taken at 2nd month, and after the 4th month post intervention.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Function
Time Frame: The functional movement screening will be noted at baseline, after the 2nd week, 3rd week, 4th week, and follow up will be taken at 2nd month, and after the 4th month post intervention.
Functional movement Screen (FMS) will be used.
The functional movement screening will be noted at baseline, after the 2nd week, 3rd week, 4th week, and follow up will be taken at 2nd month, and after the 4th month post intervention.
Disability
Time Frame: Disability will be assessed before treatment, after the 2nd month, and 4th month post-intervention.
Roland Morris Disability Index will be used to measure disability Index.
Disability will be assessed before treatment, after the 2nd month, and 4th month post-intervention.
Hamstring Flexibility
Time Frame: Hamstring flexibility will be measured at basline, 2nd month, and after the 4th month post intervention.
Active knee Extension Test will be used to assess hamstring Flexibility.
Hamstring flexibility will be measured at basline, 2nd month, and after the 4th month post intervention.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pelvic obliquity
Time Frame: The pelvic obliquity will be assessed before treatment, after 2nd month and 4th month post-intervention.
Leg length difference will be measured as an indicator of pelvic obliquity.
The pelvic obliquity will be assessed before treatment, after 2nd month and 4th month post-intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Lahore

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 23, 2025

Primary Completion (Estimated)

May 9, 2026

Study Completion (Estimated)

June 4, 2026

Study Registration Dates

First Submitted

November 17, 2025

First Submitted That Met QC Criteria

November 17, 2025

First Posted (Estimated)

November 24, 2025

Study Record Updates

Last Update Posted (Estimated)

January 2, 2026

Last Update Submitted That Met QC Criteria

December 30, 2025

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UOL/IREB/25/12/0015

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

It will be decided later.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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