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This study established expert consensus on instrument-assisted soft-tissue mobilization (IASTM) precautions and contraindications. It provides a foundational guide for clinicians to safely apply IASTM, ensuring best practices in patient care.

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Area of Science:

  • Physical Therapy
  • Rehabilitation Medicine
  • Musculoskeletal Interventions

Background:

  • Instrument-assisted soft-tissue mobilization (IASTM) is a widely used myofascial intervention by healthcare professionals.
  • A significant gap exists in understanding expert consensus on IASTM treatment precautions and contraindications.
  • Previous research has not established a consensus among IASTM experts regarding safety guidelines.

Purpose of the Study:

  • To determine instrument-assisted soft-tissue mobilization (IASTM) precautions and contraindications.
  • To achieve consensus among international IASTM experts on these safety parameters.

Main Methods:

  • A modified three-round Delphi survey was administered to 24 international IASTM experts.
  • Experts evaluated 81 medical conditions and treatment considerations for IASTM safety.
  • Consensus was defined as >70% agreement, with items ranked using a strength of agreement scale (Grades A-D).

Main Results:

  • All 24 experts completed all three rounds, with 100% final approval of the item list.
  • A consensus was reached on numerous precautions and contraindications for IASTM.
  • Contraindications comprised the largest category (n=16, Grades A-C), followed by combined precautions/contraindications (n=8, Grade D).

Conclusions:

  • This study is the first to document expert consensus on IASTM precautions and contraindications using a strength of agreement scale.
  • The findings provide a crucial guide for clinicians to safely implement IASTM.
  • This research serves as a foundational step towards establishing best-practice recommendations for IASTM application.