Effectiveness of IASTM Vs Stretching in improving tissue flexibility among Athletes: A Systematic Review and Meta-Analysis

Abstract

Background:
Flexibility is critical for optimal athletic performance and injury prevention. While traditional stretching methods are commonly used to enhance tissue extensibility, Instrument-Assisted Soft Tissue Mobilization (IASTM) has emerged as a promising alternative. However, evidence comparing their relative effectiveness remains inconclusive.

Objective:
To compare the effectiveness of IASTM versus stretching in improving tissue flexibility and reducing muscle stiffness among athletes.

Methods:
A systematic literature search was conducted through PubMed, ScienceDirect, and Google Scholar up to October 2024. Randomized controlled trials involving athletes aged 15 years and above, comparing IASTM with stretching, and measuring outcomes such as range of motion (ROM) or muscle stiffness were included. Methodological quality was assessed using the Cochrane RoB 2 tool. Meta-analysis was performed using Review Manager 5.4.

Results:
Eight studies met the inclusion criteria, and seven were included in the meta-analysis. IASTM demonstrated superior improvement in flexibility, with a pooled mean difference (MD = −1.03; 95 % CI [−1.46, −0.60]; p < 0.001), indicating a significant advantage over stretching. Individual studies reported ROM gains of up to 21.8% and significant reductions in passive stiffness with IASTM. However, substantial heterogeneity was observed (I² = 94%).

Conclusion:
IASTM appears more effective than stretching in enhancing flexibility and reducing muscle stiffness in athletes. However, due to limited sample size and methodological variations, further high-quality studies are recommended to establish long-term efficacy and standardized protocols.

Keywords: IASTM; Stretching; Flexibility; Range of Motion.

PROSPERO Registration: CRD42024610293