The effects of instrument-assisted soft tissue mobilization on respiratory function, posterior chain mobility, and functional capacity in individuals with chronic obstructive pulmonary disease: a randomized controlled trial

Objective Investigate the effects of instrument-assisted soft tissue mobilization (IASTM) applied to the lower extremities on respiratory function, chest mobility, posterior chain mobility, and functional capacity in individuals with chronic obstructive pulmonary disease (COPD) and hamstring shortness.Methods This prospective randomized controlled trial included 44 patients with COPD (mean age: 55.09 ± 8.42 years; 43.1% female). The participants were randomly assigned to the IASTM group, and the control group (CG). The IASTM group received IASTM applied to the lower extremity in addition to respiratory exercises, while the CG received respiratory exercises alone. Both groups performed respiratory exercises 5 days per week for 4 weeks. In addition to the respiratory exercises, participants in the IASTM group received one session of IASTM (40 min) per week for 4 weeks. The participants were evaluated for respiratory function (spirometry), thoracic mobility (chest circumference measurement), hamstring mobility (popliteal angle test), posterior chain mobility (fingertip-to-floor test), and functional capacity (6-min walk test (6MWT)).Results Between-group comparisons revealed significantly greater improvement in chest mobility at the axillary, and xiphoid levels (η2 = 0.234 (95% CI 0.031–0.407); η2 = 0.225, (95% CI 0.027; 0.398); popliteal angle test (right-left) (η2 = 0.529 (95% CI 0.291; 0.654); η2 = 0.640 (95% CI 0.432; 0.738); fingertip-to-floor test (η2 = 0.500 (95% CI 0.257; 0.632) in the IASTM group compared to the CG (p < .05). In addition, there were significant increases in FEV1 (η2 = 0.110 (95% CI 0.001; 0.274), FEF25–75 (η2 = 0.176 (95% CI 0.005; 0.349)), FEV1/FVC (η2 = 0.158 (95% CI 0.001; 0.330)) in the IASTM group compared to the CG (p < .05).Conclusion IASTM applied to the lower extremities, when added to breathing exercises, is beneficial in enhancing respiratory function, chest mobility, posterior chain mobility in individuals with COPD and hamstring shortness. Although statistically significant, the between-group difference in respiratory function was small, and its clinical relevance remains unclear.