The effect of therapeutic ultrasound and instrument assisted soft tissue mobilization on muscle contraction of the lumbar multifidus measured by ultrasound imaging

Context: Therapeutic ultrasound and Instrument Assisted Soft Tissue Mobilization (IASTM) are widely used physical therapy interventions used in a variety of orthopedic pathologies. The immediate effects of both interventions on muscle size and contractibility have not yet been established. There is limited clinical research regarding the immediate physiological effects of therapeutic ultrasound (US) or IASTM on muscle tissue.;Objective: To determine the immediate effects that therapeutic ultrasound and the IASTM Technique have on muscle contraction of the L5 multifidus in healthy individuals as measured by diagnostic ultrasound imaging.;Design: Quasi-Experimental Design.;Setting: Data collection took place in the Florida Gulf Coast University Physical Therapy Lab.;Participants: 25 healthy individuals (11 male, 14 female) ages 18-45 years. No history of current or previous episodes of low back pain, no prior spinal surgeries, and no history or diagnosed spinal deformities, neuromuscular conditions, joint disease, malignant tissue, or currently pregnant.;Interventions: Participants were treated with 10 minutes of therapeutic ultrasound on the right L5 multifidus with the following parameters: 1-MHz continuous ultrasound at an intensity of 2.0 W/cm2. During the final 2 minutes of the ultrasound treatment, participants were also treated with the Graston on the left L5 multifidus.;Main Outcome Measures: Cross sectional area of the left and right L5 multifidus were measured in both a relaxed and contracted state prior to and following treatment. Three images were taken in each state and the average cross sectional area was used for data analysis.;Results: This study found no significant differences in the cross sectional area differences of the L5 multifidus muscles in the relaxed muscle and contracted muscle before and immediately following therapeutic US and IASTM using the Graston Technique.;Conclusion: Although the results of this study found no significant difference in the immediate effects of both therapeutic US and IASTM on the cross sectional area of the lumbar multifidus muscles during relaxed and muscle contraction as measured using diagnostic US, further research is recommended to examine the long term physiological effects of these treatment interventions on the lumbar multifidus muscles after various increments of time following treatment.