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The Graston Technique® is a common treatment that combines a warm-up, Instrument Assisted Soft Tissue Mobilization (IASTM), stretching, and strengthening protocols. The treatment is commonly chosen by clinicians to treat musculoskeletal injuries. The purpose of this study was to determine how the Graston Technique® is used in clinical practice by certified athletic trainers to compare to recommendations made by the Graston Technique®. Factors such as time, expense, lack of training in the Graston Technique®, availability of resources, and an overall lack of evidence-based recommendations may have influenced inconsistencies in clinical practice. Although the technique is not always performed according to recommendations, these findings suggest both clinicians and patients report objective and subjective improvements when treating musculoskeletal pathologies regardless of the techniques used.

Indiana University-Purdue University Indianapolis (IUPUI) / Instrument assisted soft tissue mobilization (IASTM) is a form of massage using rigid manufactured or cast devices. The delivered force, which is a critical parameter in massage during IASTM, has not been measured or standardized for most clinical practices. In addition to the force, the angle of treatment and frequency play an important role during IASTM. As a result, there is a strong need to characterize the delivered force to a patient, angle of treatment, and stroke frequency. This thesis proposes two novel mechatronic designs for a specific instrument from Graston Technique(Model GT3), which is a frequently used tool to clinically deliver localize pressure to the soft tissue. The first design is based on compression load cells, where 4-load cells are used to measure the force components in three-dimensional space. The second design uses a 3D load cell, which can measure all three force components force simultaneously. Both designs are implemented with IMUduino microcontroller chips which can also measure tool orientation angles and provide computed stroke frequency. Both designs, which were created using Creo CAD platform, were also analyzed thorough strength and integrity using the finite element analysis package ANSYS. Once the static analysis was completed, a dynamic model was created for the first design to simulate IASTM practice using the GT-3 tool. The deformation and stress on skin were measured after applying force with the GT-3 tool. Additionally, the relationship between skin stress and the load cell measurements has been investigated. The second design of the mechatronic IASTM tool was validated for force measurements using an electronic plate scale that provided the baseline force values to compare with the applied force values measured by the tool. The load cell measurements and the scale readings were found to be in agreement within the expected degree of accuracy. The stroke frequency was computed using the force data and determining the peaks during force application. The orientation angles were obtained from the built-in sensors in the microchip.