Meyer C, Martinez O, Kim J, Brandao R
Orthopedic Foot and Ankle Center, Worthington, Ohio, United states

Introduction
Scar tissue has the ability to form around muscles, joints, tendons, and ligaments and lead to poor outcomes. Astym is a type of Instrument-assisted soft tissue mobilization (IASTM) used for soft tissue treatment. The purpose of this study was to review the current literature on ASTYM in foot and ankle pathology.

Materials & Methods
A literature search was performed utilizing google scholar, Cochrane Library, and PubMed databases to identify articles using the terms Astym OR Achilles OR Fascia OR Ankle OR Foot until August 2024. Articles were included if they were in peer reviewed journals, patients were 18 years or older, and included objective patient outcome criteria specifically to the foot and ankle.

Results
Five articles were included in this review. Three of the studies were case reports. Two studies were prospective randomized control trials with level 2 evidence. There was an average of two patient outcome measures per study. The average age of the patients included in this review was 41 years. Average improved change in ankle motion pre and post treatment was 5.5 degrees. Pain scores pre and post treatment decreased from 5.1 to 0.5 respectively. Functional scores pre and post treatment improved from 57.3 to 79.5 respectively. Meta Analysis of two included studies revealed a pain reduction by 1.93 points per NPRS scale.

Conclusion
This review offers one of the only studies to focus on use of ASTYM therapy on foot and ankle pathology alone. Our metanalysis suggests that providers can expect a small amount of pain reduction on a scaled manner which may be valuable addition to outpatient therapy. Incorporation of ASTYM into rehabilitation protocols has the ability to improve range of motion, pain and function for patients with tendinopathy.