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Mechanisms of Instrument-Assisted Soft Tissue Manipulation (IASTM) Force Dose-Response Effects in the Calf-Foot Region

2 november 2026 uppdaterad av: Mary T. Loghmani, Indiana University

Dual Pathway Mechanisms of Instrument-Assisted Soft Tissue Manipulation (IASTM) Dose-Response Effects in the Calf-Foot Region: Mechanical and Contextual Contributions

The goal of this clinical trial is to learn how different levels of force applied during instrument-assisted soft tissue manipulation (IASTM), a common rehabilitation treatment, affect muscle and soft tissue function in healthy adults with limited ankle flexibility. The study will also examine whether participant expectations, treatment comfort, and other contextual factors influence treatment outcomes. The main questions it aims to answer are:

Do higher-force and lower-force IASTM treatments produce different changes in ankle flexibility, muscle stiffness, pressure pain sensitivity, walking performance, and jumping ability? How do participant expectations, anxiety, comfort, and treatment perceptions contribute to treatment outcomes?

Researchers will compare a higher-force IASTM treatment to a lower-force IASTM treatment to determine whether force dose influences physical and patient-reported outcomes.

Participants will:

Attend two study visits separated by a washout period of 3-7 days. Receive a lower-force IASTM treatment during one visit and a higher-force IASTM treatment during the other visit, in a randomly assigned order.

Complete questionnaires about expectations, anxiety, treatment comfort, and treatment experience.

Undergo assessments of ankle flexibility, calf muscle stiffness, sensitivity to pressure, walking speed, and lower-body performance before and after each treatment session.

The findings from this study will help researchers better understand how biomechanical and non-biomechanical factors contribute to the effects of soft tissue treatments and may help inform the development of more effective rehabilitation interventions.

Studieöversikt

Studietyp

Interventionell

Inskrivning (Beräknad)

40

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

  • Namn: Mary Loghmani, PhD, PT
  • Telefonnummer: 3176910175
  • E-post: mloghman@iu.edu

Studera Kontakt Backup

  • Namn: Rachael Powell, DPT
  • Telefonnummer: 3173061072
  • E-post: racpowel@iu.edu

Studieorter

    • Indiana
      • Indianapolis, Indiana, Förenta staterna, 46202
        • Indiana University School of Health and Human Sciences
        • Kontakt:
        • Kontakt:
          • Mary T Loghmani, PhD, PT
          • Telefonnummer: 3176910175
          • E-post: mloghman@iu.edu
        • Huvudutredare:
          • Mary T Loghmani, PhD, PT

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 50 år (Vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  1. Male or female
  2. Between the ages of 18-50 years old
  3. Body Mass Index (BMI) ≥ 18.5 kg/m2 but <30 kg/m2
  4. A tight calf with limited ankle dorsiflexion range of motion: < 8-9 cm on weight-bearing lunge test (WBLT) indicating restricted ankle dorsiflexion and/or side to side difference of >1.5 cm due to muscular tightness.

Exclusion Criteria:

  1. Any known musculoskeletal pain conditions, such as nerve impingement (radiculopathies), rheumatoid arthritis, osteoarthritis, or inflammatory conditions that may interfere with study participation.
  2. Ankle joint limitations due to intra-articular, capsular tightness, or post-fracture abnormalities.
  3. Any known cardiovascular, pulmonary, metabolic disease, or other co-morbidities that could interfere with the clinician's ability to perform basic IASTM stroke patterns to the calf or subject participation.
  4. Any narcotics, blood thinners, or other medications that could alter sensation, consciousness, or tendency to bruise/bleed.
  5. Any recent surgeries, medical conditions, or injuries that could interfere with treatment or ability to participate.
  6. Acute injuries, unhealed, acute or unstable conditions.
  7. Any known contraindications to instrument-assisted soft tissue manipulation of the lower extremity, including but not limited to open wounds, active infection, unhealed fracture, deep vein thrombosis, severe vascular disorders, bleeding disorders, anticoagulant therapy associated with increased bleeding risk, or other conditions that, in the judgment of the investigator, would make study participation unsafe.
  8. Current smoking or recreational/illicit drug use.
  9. Individuals who answer "Yes" to any of Questions 1-7 on the Physical Activity Readiness Questionnaire (PAR-Q) will be required to obtain written clearance from their physician or other qualified healthcare provider before participating in study procedures involving physical activity

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Grundläggande vetenskap
  • Tilldelning: Randomiserad
  • Interventionsmodell: Crossover tilldelning
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Higher-force IASTM

Will receive higher-force instrument-assisted massage during one study session as randomized based on individualized dynamic pain threshold

Higher-Force Instrument-assisted soft tissue manipulation (IASTM) is applied to the calf-foot region using a force-sensing research instrument that provides real-time visual feedback to the clinician. A standardized treatment protocol is used, including consistent treatment duration, treatment area, stroke characteristics, and participant positioning. Force is maintained within a predefined higher-force target range based on participant tolerance within their comfort. Lower-Force IASTM is applied to the calf-foot region using the same force-sensing device and standardized treatment protocol. Force is maintained within a predefined lower-force target range to isolate the effects of force dose on study outcomes. The intervention is designed to evaluate force-dose effects while controlling other treatment variables.

Andra namn:
  • QSTM
Experimentell: Lower-force IASTM

Will receive a lower-force instrument-assisted massage during one study session as randomized based on individualized dynamic pain threshold

Higher-Force Instrument-assisted soft tissue manipulation (IASTM) is applied to the calf-foot region using a force-sensing research instrument that provides real-time visual feedback to the clinician. A standardized treatment protocol is used, including consistent treatment duration, treatment area, stroke characteristics, and participant positioning. Force is maintained within a predefined higher-force target range based on participant tolerance within their comfort. Lower-Force IASTM is applied to the calf-foot region using the same force-sensing device and standardized treatment protocol. Force is maintained within a predefined lower-force target range to isolate the effects of force dose on study outcomes. The intervention is designed to evaluate force-dose effects while controlling other treatment variables.

Andra namn:
  • QSTM

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Ankle dorsiflexion range of motion weight-bearing lunge test (WBLT)
Tidsram: Immediately before and after intervention to each leg at each session.

Change in ankle dorsiflexion range of motion measured using the Weight-Bearing Lunge Test (WBLT) immediately following higher-force and lower-force instrument-assisted soft tissue manipulation (IASTM).

Immediately before and after intervention to each leg at each session.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Calf muscle stiffness
Tidsram: Immediately before and after intervention to each leg at each session.

Calf muscle stiffness will be assessed using a handheld tissue stiffness measurement device. Higher values indicate greater resistance of the calf musculature to deformation, whereas lower values indicate reduced tissue stiffness.

Immediately before and after intervention to each leg at each session.
pain pressure threshold
Tidsram: Immediately before and after intervention at each session.

Pressure pain threshold will be assessed using a pressure algometer applied to the calf musculature. The measure represents the minimum pressure at which pressure sensation first becomes painful. Higher values indicate lower pain sensitivity.

Immediately before and after intervention at each session.
Walking speed
Tidsram: Immediately before and after intervention at each session.

Walking speed will be assessed during a standardized walking task and reported as walking velocity. Higher values indicate faster walking performance.

Immediately before and after intervention at each session.
Vertical Jump Performance
Tidsram: Immediately before and after intervention at each session.

Jump height will be recorded using standard equipment, with higher values indicating greater lower-extremity power and performance.

Immediately before and after intervention at each session.
Self-reported Pain Level
Tidsram: Immediately before and after interventions to each leg at each session.

Pain intensity will be assessed using an 11-point Numeric Pain Rating Scale (NPRS), ranging from 0 ("no pain") to 10 ("worst pain imaginable"). Higher scores indicate greater pain intensity.

Immediately before and after interventions to each leg at each session.
Self-reported function level
Tidsram: Before and after interventions at each session.

Function level will be assessed using a Visual Analog Scale (VAS), with higher scores indicating greater self-reported function.

Before and after interventions at each session.

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Self-Reported Anxiety Level
Tidsram: Immediately prior to intervention at each session.

Anxiety level will be assessed using a Visual Analog Scale (VAS), in which participants rate their current level of anxiety on a continuous scale. Higher scores indicate greater self-reported anxiety.

Immediately prior to intervention at each session.
Treatment Outcome Expectancy
Tidsram: Immediately prior to first intervention at first session

Treatment expectancy will be assessed using a participant-reported questionnaire that measures the extent to which participants expect the higher or lower force intervention to improve mobility, physical performance, and related outcomes. Higher scores indicate greater expectations of treatment benefit.

Immediately prior to first intervention at first session
Treatment Pleasantness Rating
Tidsram: Immediately following each intervention session.

Treatment pleasantness will be assessed using a participant-reported rating of the overall comfort and pleasantness of the intervention experience. Higher scores indicate a more favorable treatment experience.

Immediately following each intervention session.

Samarbetspartners och utredare

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Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

6 november 2026

Primärt slutförande (Beräknad)

25 oktober 2027

Avslutad studie (Beräknad)

1 december 2027

Studieregistreringsdatum

Först inskickad

2 november 2026

Först inskickad som uppfyllde QC-kriterierna

2 november 2026

Första postat (Faktisk)

6 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

6 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

2 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • 32736

Plan för individuella deltagardata (IPD)

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OBESLUTSAM

IPD-planbeskrivning

De-identified individual participant data may be shared with other researchers in accordance with participant consent and institutional policies; however, specific plans for data sharing have not yet been determined.

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Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Ja

produkt tillverkad i och exporterad från U.S.A.

Ja

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