Date of Award

Spring 2023

Document Type


Degree Name

Master of Science (MS)


Athletic Training

Committee Chairperson

Alison Gardiner-Shires, PhD, LAT, ATC

Committee Member

Nicole Cattano, PhD, LAT, ATC

Committee Member

Christina Seffrin, MS, LAT, ATC



To determine the overall effectiveness of instrument-assisted soft tissue mobilization (IASTM) in improving range of motion (ROM), pain, strength, and patient-reported function in the lower extremity to provide recommendations for use. We also examined the influence of IASTM on unhealthy and healthy participants, body parts treated, and products used.

Data Sources:

We searched the Academic Search Premier, Alt Healthwatch, CINAHL Complete, Cochrane Library, MEDLINE with full text, NLM PubMed, Physical Education Index, SPORTDiscus with full text, and the Web of Science databases for articles using the Boolean String advantEDGE OR astym OR graston OR iastm OR “instrument assist* soft tissue mobil*” OR “augment* soft tissue mobil*” OR “myofascial release” OR “instrument assist* massage” OR “augment* massage” OR “instrument assist* cross fiber massage”.

Study Selection:

Included articles were RCT’s that measured ROM, pain, strength, or patient-reported function, examined the lower extremity, and compared IASTM treatment with at least 1 other group.

Data Extraction:

Twenty-five articles met the inclusion criteria. Three independent reviewers assessed study quality using the PEDro scale. Sixteen articles were included in the meta-analysis.

Data Synthesis:

The average PEDro score for studies of uninjured participants was 7.5 (range = 4 to 9) and for studies of injured participants was 5.44 (range = 3 to 8).


IASTM remains an effective modality to improve lower extremity range of motion in healthy subjects and effective in reducing pain associated with some pathologies. More evidence exists to support the effectiveness of IASTM for improving strength.