Instrument-Assisted Soft Tissue Mobilization And Percussion Massage Therapy In Cervical Disc Herniation: A Randomized Controlled Study

Cervical disc herniation (CDH) is a prevalent musculoskeletal condition marked by chronic neck pain, impaired proprioception, kinesiophobia, and functional limitations, often requiring multimodal conservative management. Myofascial interventions, particularly Instrument-Assisted Soft Tissue Mobilization (IASTM) and Vibration Therapy (VT), have emerged as supportive approaches within conservative physiotherapy programs. This randomized controlled trial aimed to evaluate the comparative effectiveness of two emerging myofascial interventions (IASTM and VT) on pain, disability, fear of movement, and proprioceptive function in individuals with CDH. In this double-blinded randomized controlled trial, 57 individuals diagnosed with CDH were randomly assigned to three groups (n = 19): Conventional Therapy (CT), CT combined with VT, and CT combined with IASTM. Interventions were administered over a 3-week period. Primary outcomes included pain (Visual Analog Scale) and neck disability (Neck Disability Index); secondary outcomes were kinesiophobia (Tampa Scale for Kinesiophobia) and JPS (Laser Pointer Assisted Test). All groups demonstrated significant within-group improvements across all outcome measures (p < 0.001). Compared to the CT group, the VT and IASTM groups exhibited significantly greater improvements in pain, kinesiophobia, and JPS parameters (p < 0.001). No statistically significant differences were found between the VT and IASTM groups. IASTM and VT provide additional clinical benefits over conventional therapy alone in the management of CDH, particularly in reducing pain and kinesiophobia and enhancing proprioceptive function. Both interventions may be effectively integrated into conservative rehabilitation protocols targeting sensorimotor dysfunction in CDH.