Evidence map›Paper›PMID 42522020›Full record

Observational studyChiropractic & manual therapies2026

Visual monitoring in real-time improves consistency of 3D IASTM force applied to humans.

M Terry Loghmani, Rachael Powell, George J Eckert, Sarah Morgan, Abhinaba Bhattacharjee, Stanley Chien, Sohel Anwar

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Chiropractic & manual therapies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04923633 (The Reproducibility and Consistency of Instrument-assisted Soft Tissue Manipulation), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04923633 completednot on this map

The Reproducibility and Consistency of Instrument-assisted Soft Tissue Manipulation

TypeobservationalSponsorIndiana UniversityRan2021 to 2022Enrolled106ConditionsMassageArmsQuantifiable Soft Tissue Manipulation (QSTM)
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

M Terry LoghmaniSchool of Health and Human Sciences, Department of Graduate Health Professions, Doctorate of Physical Therapy Program, Indiana University, 1050 Wishard Blvd., IN, 46202, Indianapolis, USA. mloghman@iu.edu.ORCID http://orcid.org/0000-0003-2286-0733
Rachael PowellSchool of Health and Human Sciences, Department of Graduate Health Professions, Doctorate of Physical Therapy Program, Indiana University, 1050 Wishard Blvd., IN, 46202, Indianapolis, USA.
George J EckertSchool of Medicine, Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, 46202, USA.
Sarah MorganSchool of Health and Human Sciences, Department of Graduate Health Professions, Doctorate of Physical Therapy Program, Indiana University, 1050 Wishard Blvd., IN, 46202, Indianapolis, USA.
Abhinaba BhattacharjeeSchool of Mechanical Engineering, Purdue University, Indianapolis, IN, 46202, USA.
Stanley ChienSchool of Electrical & Computer Engineering, Purdue University, Indianapolis, IN, 46202, USA.
Sohel AnwarSchool of Mechanical Engineering, Purdue University, Indianapolis, IN, 46202, USA.

Funding

Development of Innovative Medical Device Technology for Quantifying Forces during Soft Tissue Manipulation Assessment and InterventionR41AT011494 · NCCIH · HEALTH SMART TECHNOLOGIES, INC. · PI ANWAR, SOHEL, LOGHMANI, MARY TERRY · 2021 to 2021
$256k
NCCIH NIH HHS R41 AT011494NCCIH NIH HHS R41AT011494
6 · The paper itself

Abstract

backgroundInstrument-assisted soft tissue manipulation (IASTM) is widely used, yet clinicians mostly rely on their subjective perception of applied force which can lead to variability. No studies have determined intra- and inter-examiner reliability of three-dimensional (3D) IASTM force-motions applied to humans. The objective of this study was to evaluate whether real-time visual monitoring enhances consistency of applied IASTM force.

methodsThis study was an observational reliability study with blinded assessors. 45 healthy adults were enrolled between June to December 2021. Clinicians (two novice, two experienced) applied 1-inch IASTM linear strokes using two quantifiable soft tissue manipulation (QSTM) smart devices (localized; dispersive) to lumbar and calf regions under two conditions: (1) applying self-perceived "medium" force without visual monitoring, and (2) applying force guided by real-time visual monitoring from a graphic visual interface (GVI). Triaxial (3D) average peak force (primary variable), stroke frequency, and angle were measured. Linear mixed models and variance components evaluated repeatability and reproducibility within and between clinicians and across two sessions.

resultsVisual monitoring substantially reduced variability in average peak force across clinicians, regions, devices, and sessions. Standard deviations (SDs) were significantly larger and ranges meaningfully broader without monitoring compared to with monitoring. Monitoring improved intra- and inter-examiner consistency by ≥ 30% in nearly all conditions, with medium to very large effect sizes. Effects on stroke frequency were mixed, and influence on angle minimal.

conclusionsVisual monitoring in real-time significantly improved the consistency of 3D IASTM force applications on humans. Optimal reliability is foundational to practice fidelity, training, and more rigorous investigation of dose-force response relationships in manual therapy.

trial registrationThe study was prospectively registered at ClinicalTrials.gov (Identifier: NCT04923633).

Indexed as

Musculoskeletal ManipulationsAdultFemaleHumansMaleMiddle AgedReproducibility of ResultsYoung AdultDigital technologyInstrument-assisted soft tissue manipulation (IASTM)Manual TherapyPhysical therapyQuantifiable soft tissue manipulationReliability

Identifiers

PMID42522020
PMCPMC13418447

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.