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IASTM Flashcards

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1
Q

what is IASTM?

A

a skilled intervention that includes the use of specialized tools to manipulate the skin, myofascia, muscles, and tendons by various direct compressive stroke techniques

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2
Q

what are the benefits of using IASTM over STM?

A

provide mechanical advantage to the clinician

allows deeper tissue penetration

more specific treatment

provides vibration feedback sense

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3
Q

t/f: vibration feedback may facilitate the DPT’s ability to detect altered tissue properties like detecting an adhesion

A

true

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4
Q

what is the most common among work-related MSK injuries among PTs?

A

back injuries

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5
Q

what is the 2nd most common among work-related MSK injuries among PTs?

A

hand/thumb

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6
Q

what are risk factors for hand/thumb injuries for PTs?

A

manual therapy

repetitive workloads

treating many pts/day

working while injured

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7
Q

what materials can the instruments be made of?

A

metal, plastic, ceramic

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8
Q

where does IASTM originate from?

A

James Cyriax’s idea of transverse friction massage

Gua sha

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9
Q

what was the purpose behind James Cyriax’s “digital cross friction”?

A

soften/break-up scar tissue

proper laying down of scar tissue

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10
Q

what is the difference bw gua sha and IASTM?

A

Gua sha aims to “scrap/scratch” until blemish appears to relive blood stagnation and reduce pain, but in IASTM blemishes like petechiae is considered a precaution/contraindication and we stop when we see this

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11
Q

what are the proposed mechanisms of action of IASTM?

A

mechano-transduction

tissue healing

mechanical

neuro-physiological effects

fluid dynamics

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12
Q

what is the mechano-transduction MOA of IASTM?

A

cells response to mechanical load

load used therapeutically to stimulate tissue repair and remodeling

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13
Q

what is the tissue healing MOA of IASTM?

A

stimulate CT remodeling through re-absorption of excessive fibrosis

induce repair and regeneration of collagen secondary to fibroblast recruitment

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14
Q

what is the mechanical MOA of IASTM?

A

release and breakdown of scar tissue adhesions, fibrotic nodules, and fascial restrictions (improves ROM and mobility)

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15
Q

what is the neuro-physiological MOA of IASTM?

A

high concentration of mechanoreceptors in fascia causes relaxation and pain reduction in local and surrounding tissues through CNS afferent stim and efferent responses

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16
Q

t/f: a neurophysiological effect of IASTM is improved NCV in pts with CTS

A

true

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17
Q

what are the indications for use of IASTM?

A

tendinopathies

postural abnormalities

myofascial pain syndromes

entrapment syndromes

scar tissue/adhesions

edema reduction

lengthen ms fibers

inhibit hypertonic muscles

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18
Q

what tendinopathies can we using use IASTM to treat?

A

epicondylitis

trigger finger

Achilles tendinopathy

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19
Q

why would we use IASTM to treat postural abnormalities?

A

bc they are often caused by muscle stiffness/tightness

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20
Q

what myofascial pain syndromes can we treat with IASTM?

A

fibromyalgia

PF

ITB

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21
Q

what entrapment syndromes can be treated with IASTM?

A

CTS

TTS

TOS

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22
Q

t/f: other options like exercise for muscle pumping action, compression, cold, or ES would better choices to treat acute edema than IASTM

A

true

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23
Q

t/f: IASTM for tissue lengthening is only used for pathological pts

A

false, it can be used in healthy individuals like athletes too

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24
Q

what does the research say about IASTM?

A

mixed reviews

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25
what are the precautions for IASTM? (long ass list)
petechiae HTN meds: NSAIDs, steroids, narcotics herbal supplements pt age, flu, or flu-like sx cancer acute inflammatory conditions post injection (ie steroids) unhealed closed or non-complicated fx congestive heart disease, circulatory disorders kidney dysfxn body art DM allergies to metal, emolients, latex (professional wearing gloves) abnormal sensations (ie numbness) pregnancy pacemaker or insulin pumps (treatment around devices) autimmune disorders, RSD, or chronic regional pain syndrome polyneuropathy RA, ankylosing spondylitis burn scars varicose veins osteoporosis lymphedema pt intolerance, hypersensitivity, high pain sensation due to injury meds: anti-coagulants, hormone replacement, fluoroquinolone antibiotics
26
what are the contraindications to IASTM? (long ass list)
acute or severe cardiac, liver, or kidney disease acute injury or infection (viral or bacterial), fever, or contagious condition skin rash, open wounds, blisters, local tissue inflammation, or tumors osteoporosis (advanced) unhealed or unstable bone fx hematoma, myositic ossificans neuro conditions resulting in loss or altered sensation (ie MS) metabolic conditions (ie DM=poor skin integrity) or high-risk pregnancy connective tissue disorders (ie EDS, Marphan’s) (hypermobility in these pts=more risk for injury) meds that thin blood or alter sensations chronic pain conditions (ie RA) (LT steroids affect tissue integrity) severe pain felt by pt recent surgery or injury epilepsy (unstable) direct pressure over face, eyes, arteries, veins (varicose veins) or nerves direct pressure over bony prominences or regions (ie lumbar vertebrae) thrombophlebitis or osteomyelitis peripheral vascular disease or insufficiency, varicose veins unhealed surgical site bleeding disorders (hemophilia) congestive heart disease, circulatory disorders insect bite of unexplained origin HTN (uncontrolled) cancer or malignancy treatment over surgical hardware petechiae (severe) or ecchymosis
27
what is involved in IASTM treatment?
exam/eval warm up pt ed tx assessment specific exercises prescription
28
what can we do for a warm-up b4 IASTM?
active exercise diathermy HP US
29
what should we tell a pt during pt ed?
tell them what to expect, what you are doing, and why you are doing it
30
what things can we use to assess efficacy of tx?
VAS ROM fxnal activity
31
what is involved in Graston tx?
exam warmup IASTM tx post-tx stretching strengthening ice
32
when would you use light to moderate tx?
over acute injuries to move fluid hypersensitivity Ms fascilitation
33
when would we use more firm tx?
chronic conditions tendinopathy fibroblast proliferations breaking cross links
34
what angle should we keep the instrument at during tx?
30-60 deg angle bw the edge of the instrument and the skin
35
what is the dosage for IASTM?
no specific dosing has been established, so it is generally accepted to limit tx time using one tool in one direction and depth to 30 sec
36
should we grip the tool hard?
NO! lightly grip it with a neutral wrist
37
when doing IASTM tx, we should using sweeping motions from prox to dist or dist to prox?
either one
38
t/f: when doing IASTM tx, we should treat the entire kinetic chain (above and below)
true
39
what is the general tx sequence with IASTM?
clean hands b4 and after tx inspect and clean the body area to be treated apply a small amount of emollient do your tx and monitor for changes in the pt's status complete tx and clean the body area clean the instruments and hands
40
when selecting a tool size, what size instrument should be used for a larger surface area?
a larger instrument
41
when selecting a tool size, what size instrument should be used for a smaller surface area?
a smaller instrument
42
what convexity of the tool should we choose for a broader tx area?
concave
43
what convexity of the tool should we choose for a more focused tx area?
convex
44
what bevel has an edge with less slope and angle?
a double bevel
45
what bevel is more intense?
a single bevel
46
what bevel is only found on multi-curve tools?
double bevel
47
what bevel allows strokes to be applied in both directions?
a double bevel
48
what bevel allows strokes to be applied in one direction only?
a single bevel
49
when treating the Achilles, should we start with a double or single bevel?
double bevel and work to a single bevel with low reactivity
50
what bevel direction do we almost always use?
upward facing
51
what is an upward facing bevel used for?
mobilizing tissue
52
when is the only times we would use downward facing bevel?
for desensitization or lymphatic drainage
53
what phase involves soft tissue evaluation, gentle tx to desensitize the area and to gauge the pt response?
phase 1
54
what phase involves IASTM with the tissue on stretch?
phase 2
55
what phase involves IASTM while the PT is performing active exercise?
phase 3
56
what phase involves IASTM with the tissue on slack?
phase 1
57
what phase involves IASTM with light pressure?
phase 1
58
what are potential side effects of IASTM?
pain petechiae bruising
59
what should we do if we see petechiae or bruising appearing?
discontinue further IASTM treat and manage the area to ensure healing
60
what is the purpose of the scanning/sweeping stroke?
for adhesions in a Unidirectional prox to dist/dist to prox manner vibration feedback feeling for "gritty" sensation
61
what is the purpose of the fanning stroke?
to scan for and treat adhesions in different planes while fixing one side of the instrument to the skin while pivoting the other side like opening a fan
62
what is the purpose of the brushing stroke?
to desensitize areas with very light pressure strokes in all directions
63
what is the purpose of the strumming stroke?
to use small strokes on localized adhesions in all directions to break them up similar to transverse friction massage
64
what is the purpose of the J stroke?
to use a sweeping curve ending in a sharp curve like a "J" to often treat around boney prominances
65
what is the purpose of the framing stroke?
to sue short strokes framing a bone or boney prominence
66
how do we perform the scapular release technique?
using the handlebar tool pt in SL get the bevel up under the scap and apply tension like the scap mob
67
what is GIRD?
GH IR deficit
68
what is the difference bw pathological and anatomical GIRD?
anatomical GIRD is a loss of about 18 deg (??) pathological GIRD is at least a 5 deg loss of IR compared to ER usually due to a bony, ms, or capsule problem
69
how can we have pts stretch for GIRD?
hor abd sleeper stretch
70
what musculature can we treat with IASTM for GIRD?
post delts/post musculature traps, lats, supra/infra, teres major/minor
71
how can we modify the sleeper stretch?
have them lying back more if they can't do the normal sleeper stretch

DPT 608 (20 decks)

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