force quantification of iastm device

Final Project ME 597

Force Quantification ofIASTM and Validation

through Test Rig

1Mechanical Engineering


Table of Contents

Abstract.......................................................................................................

Project Requirements.......................................................................................

Previous Study...............................................................................................

Introduction..................................................................................................

Test Rig.....................................................................................................11Mathematical Formulation and Vector Analysis..........................................................................

Result...........................................................................................................................................

Sample Calculations....................................................................................................................

Graphical plots.............................................................................................................................

Procedure for Test Rig.................................................................................................................

FEA analysis................................................................................................................................

Bill of Material............................................................................................................................

Conclusions................................................................................................29

Acknowledgements.......................................................................................30

References..................................................................................................31Appendix

Appendix A..............................................................................................................................

Appendix B..............................................................................................................................



Abstract

The overarching purpose of this proposed research project was to develop, compare and

evaluate design concepts for a clinically-applicable system to quantify the force delivered

during instrument-assisted soft tissue mobilization (IASTM) for the treatment of common

clinical conditions. In this report we lay stress on the sensor used to measure the forces and

design of a test rig that will apply a series of pre-determined forces and compare them

against the forces measured by the IASTM device. The setup of the text rig consists of a

simple belt-pulley mechanism that is used to apply the force on the Instrument. The weights

are hung on the belt through the hook and the force is transferred to the instrument via

tension in the belt. The force on the instrument is measured/calculated by vector analysis

and put in a tabulated form for further use by other individuals. The test rig was designed by

using Pro-Engineer and the force analysis were done using simulation software i.e. ANASYS

Workbench. There is a pressing need to quantify the force delivered during massage.

Although this form of manual therapy has been used in a widespread manner for millennia,

its therapeutic potential, optimal dosing and underlying biological mechanisms are not well

established due, in part, to the lack of force quantification.



Project Requirements:

The main requirement of this project was to quantify the force measured by the

force sensor used in the IASTM device for clinical purposes.

Different sensors were selected based on their properties and specifications meeting

our requirements.

However to validate the force measured by the sensor, we need a test rig to

successfully validate the reading of the forces from the force sensor installed in the

instrument.

There are different test rig available in the market that work electronically with their

precisions and calibrations. But we need a device that is built mechanically and does

not involve any electrical components that need calibrations.

We also need the test rig to hold the instrument securely and will be able to validate

the readings from the sensor at given angle range.

The test rig should also be able to withstand the given loads without failure.

Working on that path a test rig was designed and analyzed which is the main aim of

this report is described as we read the report.



Previous Study

Massage therapies have been used for thousands of years to improve human health and

well-being. In fact, such therapies make up approximately 45% of the total physiotherapy

treatments provided for muscle ailments 1. It is a general belief that massage reduces

muscle tension, excitability, and stress hormones, as well as increases the blood flow and

parasympathetic activities 2–6. Clinical research has provided modest evidence that

massage therapies are effective in promoting muscle recovery from injury 6–9, alleviating

lymphedema 10–12, and relieving lower back pain 13–15.

Figure 1

Massage practitioners believe that lengthwise strokes parallel to the natural tissue surface

plays a significant role in relieving the patient’s symptoms by unblocking tissue energy

blockages and reintroducing the optimal flow of energy. Due to the effectiveness of

massage, there has been a concomitant increase in the development of robotic massage

systems and investigations to explain the mechanisms of massage actions beyond

qualitative observations and personal experiences. In an effort to accurately deliver

mechanical forces and to mimic manual massage, several systems have been developed.



Figure 2

There are various experiments and studies that talk about the force quantization for IASTM.

Those experiments either quantify a relative smaller force or the device setup is not user

friendly or feasible at all. But there has been no such study upon the validation of the forces

measured by the force sensors installed on the instrument using a test rig.



Introduction

Instrument Assisted Soft Tissue Mobilization or Simply IASTM is a new range of tool which

enables clinicians to efficiently locate and treat individuals diagnosed with soft tissue

dysfunction. The technique itself is said to be a modern evolution from Traditional Chinese

Medicine called Gua Sha[1].However Gua Sha was not used to treat Musculoskeletal

conditions but was traditionally applied along meridiens to move the bad chi out through

the skin. IASTM is a procedure that is rapidly growing in popularity due to its effectiveness

and efficiency while remaining non-invasive, with its own indications and limitations.

IASTM is performed with ergonomically designed instruments that detect and treat fascial

restrictions, encourage rapid localization and effectively treat areas exhibiting soft tissue

fibrosis, chronic inflammation, or degeneration. As in any Manual therapy treatment,

supplementation with exercises and additional modalities e.g. joint mobilization designed to

correct biomechanical deficiencies by addressing musculoskeletal strength and muscle

imbalances throughout the entire kinetic chain should be used in conjunction with IASTM.

Though doctors of chiropractic (DCs) have always used their hands to increase blood flow

and break up restrictions in injured soft tissue, fingers alone can’t detect restrictions at

deeper levels or treat the full range of restrictions. Because of this, several companies have

now developed handheld tools to perform instrument-assisted soft-tissue mobilization

IASTM has two main functions: to break up abnormal densities in tissue, such as scar tissue,

and to reinitiate first-stage healing in the body. “When a body is injured, it sends blood,

specifically the healing substances found in white blood cells, to the wounded area to begin

laying down new collagen tissues and repairing the injury—building scar tissue.

The introduction of controlled microtrauma to affected soft tissue structure causes the

stimulation of a local inflammatory response. Microtrauma initiates reabsorption of

inappropriate fibrosis or excessive scar tissue and facilitates a cascade of healing activities

resulting in remodeling of affected soft tissue structures. Adhesions within the soft tissue

which may have developed as a result of surgery, immobilization, repeated strain or other

mechanisms, are broken down allowing full functional restoration to occur.


http://www.physio-pedia.com/Instrument_Assisted_Soft_Tissue_Mobilization#cite_note-0


Limitations of IASTM

Though IASTM is a very effective treatment modality, there are certainly situations in which

you wouldn’t want to use it. You wouldn’t want to use instruments on a patient with a skin

infection or an open wound or a bone fracture. It is recommended to avoid recent suture

sites and not using IASTM on patients with uncontrolled hypertension, kidney dysfunction,

hematoma or osteomyelitis.

Adopting a more delicate approach when using instruments on patients who are taking

anticoagulant medications and on patients with varicose veins, cancer, rheumatoid arthritis

or acute inflammatory conditions. Additionally, IASTM may not be the first-choice modality

for a very recent injury. In this case, the body’s already working on its first-stage healing.

The Graston Technique

The Graston Technique is a form of manual therapy known as soft-tissue instrument-assisted

mobilization. It is one of a number of manual therapy approaches that uses instruments with a

specialized form of massage/scraping the skin gently. The therapy is designed to help the

practitioner identify areas of restriction and attempt to break up scar tissue. The Graston Technique

is often practiced by chiropractors, osteopathic physicians, physical therapists, occupational

therapists, and some licensed massage therapists and athletic trainers.

Graston Technique Goals

The general goals of the therapy are to reduce the patient's pain and increase function through a

combination of:

Breaking down the scar tissue and fascia restrictions that are usually associated with some

form of trauma to the soft tissue (e.g., a strained muscle or a pulled ligament, tendon, or

fascia).

Reducing restrictions by stretching connective tissue in an attempt to rearrange the

structure of the soft tissue being treated (e.g., muscle, fascia, tendons, and ligaments).

Promoting a better healing environment for the injured soft tissue.



There also appears to be a neurologic benefit to treating patients with the Graston Technique

Instruments. This response is similar to that involved with other manual therapies. The literature

suggests that when a patient is given manual or instrument assisted soft tissue mobilization (IASTM)

therapy, certain nerve fibers are activated. Additionally, the body's position sense organs, such as

mechanoreceptors and proprioceptors, seem to respond to these forms of treatment.

GT-3 (Tongue Depressor)

Figure 3

Graston is the leading technique when it comes to IASTM. It has developed a set of six

stainless steel instruments of various shapes and sizes. You would want an instrument with

a beveled edge to go deeper into the tissue, and you would use an instrument with a flat

edge if you were working more on the surface.

So you've read all about GT4 and how it’s typically the first instrument, well GT3 is usually

the next in line. As you can see, it looks very different to GT4- it works completely differently

too! The actual treatment surface is much smaller, and this is GT3's secret- it allows a very

precise manipulation of the soft tissue. Think of GT3 as like a pencil; precise, good feedback

of subtle lesions, whereas GT4 would be more like a paint roller.



GT3 is typically an go to instrument for trigger points or taught bands, uses the single

beveled edge to precisely work through the lesion in attempt to restore the original

morphology a to the tissue.

Some other common uses for GT3:

Knee ligaments

Carpal tunnel syndrome

TMJ dysfunction

Tennis/golfers elbow

Post-surgical scarring

Biceps tendinopathy

As with all GT instruments, GT3 can sometimes be a little uncomfortable when used on

really angry (tender) lesions but any discomfort is only for a short period of time (30 seconds

to a minute) whereas using the traditional thumb or knuckle method takes 5-10 minutes

with considerably more discomfort and bruising. This is why Graston Technique is so

effective- quicker treatment time, less pain and most importantly better results!



Test Rig

Figure 4

In order to evaluate the force sensing IASTM device, a test rig is designed as shown in

figure4. Test rig is a box type structure with top and bottom supported by the four vertical

beams. The Instrument is held at the base of the test rig and the base slides along the length

of the rig by rotating the handle which in-turn through nut and bolt mechanism

moves/slides the base to the desired position. The Instrument can be rotated at the desired

angle by notch attached to the base of the rig.

A simple belt pulley mechanism is used to apply a load on the Instrument (sensor) via

tension in the belt. The tension in the belt is caused by hooks attached at both ends of the

belt and the hooks contain the known amount of weight. The given weights produce a net

downward force which is calculated by vector analysis. The horizontal component of the

tension forces cancel each other while the vertical components add up and gives the

resulting force that acts on the Instrument and then read by the sensors in the instrument.

The pulleys slide along the vertical beams to achieve force equilibrium at all given angles.

The pulleys can slide along the beams independent of each other to give more fidelity.



Components of Test Rig

Fixture

Figure 5

The fixture provides mechanical structure to the test rig. The four columns/beam support

the upper and the lower plate to make the test rig a rigid structure. The top and the bottom

plate are aluminum plates with 15" x 12" x 0.5". The four columns are made of steel.

The sliders marked as red support the two pulleys and slide in the provided slots on the

beam. The sliders are used to adjust the height of the pulleys.

Belt and Pulleys

Figure 6

The belt and pulley mechanism play the role of transferring the force from the given weights

to the instrument via tension produced in the pulley. The weights are hung on the pulley

through hooks which fit into the reinforced rings made on the lower part of the belt. The

pulley is of 2" diameter and the thickness of the belt is 0.094" and is made of PVC.



Base

Figure 7

The Instrument is secured tightly in the clamp (marked as yellow in the figure) and the

clamp rest on the base of the test rig. The base has internal teeth so that it can slide along

the length of the fixture via nut and bolt mechanism. The clamp can be rotated at desired

angles to measure forces at different angles. The dimension of the base are 4" x 2"x 1" and

is made of aluminum.

Hook

Figure 8

The hook carries the weight and is hooked on to the lower half of the belt into the

reinforcement rings. The weight is transferred to the belt via hooks.



Instrument (GT3)

Figure 9

This is the instrument which with its new design has the force sensor installed in it. It will be

secured to the text rig via clamp on the base. The material used for research purpose is

plastic.



Mathematical Formulation and vector analysis

The test rig is laid down in mathematical terms as geometric equalities. The instrument has

to be inclined at an angle from the center for force measurement and validation. Using the

belt pulley mechanism with the instrument inclined at some angle from the center would

give incorrect value of the forces.

Figure: 10

In order to overcome this problem and to achieve force equilibrium at all angles, the angle

of contact (β) between the belt and the instrument is made equal. This is done by fixing the

height of the pulley on one side with known height from the base. The other pulley is then

slided to the new height to bring the equilibrium of forces at that angle.

Exercising the geometrical formulations and exploiting them to get the relationships

between the angles of rotation of the instrument from the central axis.

This whole mathematical proof is done so that we have the equilibrium of forces being

maintained at all angles and positions of the Instrument to get the net force acting on it. The

proof is as follows:



Starting with ∆ GJK

cos (α)= JKGK

⇒ GK=JK∗Cosec (α )

Now in ∆ AEG

cos (α)= AEAG & AG=AK−GK

⇒ AE=AK∗cos (α )−JK

In ∆ AMK

sin(α )=MKAK

MK=AK∗sin(α ) & Y=QK−MK

⇒ Y=QK−AK∗sin(α)

Now in ∆ AES

tan(θ)= AESE & SE=Y=QK−AK∗sin(α)

⇒ (θ)=tan−1( AESE )From the geometrical formulations

β=((900−θ )+α )

Now in ∆ ABC

Angle ACB = (θ−2α) & tan(θ−2α)= ABBC

⇒ AB=BC∗tan(θ−2α )

AD=AB+r

H 2=AM−AD



Figure: 11

Vector analysis of the Tension forces:

The horizontal components acts opposite to each other and gets cancelled as seen in the

above figure while the vertical components of the tension forces adds up and is the

resultant force acting on the instrument which is equal to:

F=T∗Cosβ+T∗Cosβ

⇒ F=2∗T∗Cosβ

Calculating the value of β from the above geometrical expressions and plugging in the

equation to give the value of force that is exerted on the instrument. This calculated force

value should be the output value from the sensor placed in the instrument.



Results:

Using MATLAB the iteration were ran and the resultant force and the corresponding

change in the H2 to maintain equilibrium of forces were tabulated:

L=15 inches, dimensions are in inches, N is the displacement of base from the center axis.

α =0 α =5 α =10 α =15 α =20 α =25

H1=3

H2(N=0)H2(N=1)H2(N=2)H2(N=3)H2(N=4)H2(N=5)

3.0000 4.0673 5.1740 6.3742 7.7355 9.3574

3.8235 4.7584 5.7647 6.8963 8.2276 9.8771

4.4737 5.2678 6.1568 7.1920 8.4504

10.0612

5.0000 5.6472 6.4064 7.3247 8.4780 9.9995

5.4348 5.9303 6.5502 7.3361 8.3598 9.7526

5.8000 6.1402 6.6135 7.2548 8.1297 9.3625

H1=4

H2(N=0)H2(N=1)H2(N=2)H2(N=3)H2(N=4)H2(N=5)

4.0000 5.1042 6.3032 7.6692 9.3094

11.4095

4.5882 5.5665 6.6619 7.9462 9.5329

11.6254

5.0526 5.8925 6.8642 8.0361 9.5215

11.5286

5.4286 6.1217 6.9559 7.9944 9.3453

11.2131

5.7391 6.2795 6.9666 7.8564 9.0490

10.7383

6.0000 6.3833 6.9162 7.6460 8.6627

10.1441H1=

5H2(N=0)H2(N=1)H2(N=2)H2(N=3)H2(N=4)H2(N=5)

5.0000 6.1919 7.5520 9.1923

11.3088 14.3028

5.3529 6.4094 7.6419 9.1565

11.1421 13.9851

5.6316 6.5412 7.6295 8.9942

10.8116 13.4437

5.8571 6.6126 7.5460 8.7450

10.3706 12.7547

6.0435 6.6397 7.4109 8.4336 9.8515

11.9633

6.2000 6.6334 7.2373 8.0762 9.2754

11.0979H1=

6H2(N=0)H2(N=1)H2(N=2)H2(N=3)H2(N=4)H2(N=5)

6.0000 7.3343 8.9402

11.0096 13.9333 18.6877

6.1176 7.2894 8.7167

10.5672 13.1754 17.3450

6.2105 7.2153 8.4603

10.0909 12.3955 16.0479

6.2857 7.1208 8.1812 9.5922

11.6015 14.7785

6.3478 7.0114 7.8860 9.0777

10.7978 13.5270

6.4000 6.8909 7.5788 8.5517 9.9873

12.2880H1=

7H2(N=0)H2(N=1)H2(N=2)H2(N=3)H2(N=4)H2(N=5)

7.0000 8.5356

10.4927 13.2154 17.5304 26.1184

6.8824 8.2089 9.9010

12.2322 15.8260 22.5122

6.7895 7.9162 9.3652

11.3588 14.3867 19.7950

6.7143 7.6472 8.8669

10.5558 13.1068 17.5522

6.6522 7.3953 8.3951 9.8008

11.9303 15.5922

6.6000 7.1561 7.9426 9.0800

10.8246 13.8145

H1=8

H2(N=0)H2(N=1)H2(N=2)H2(N=3)H2(N=4)H2(N=5)

8.0000 9.8004

12.2403 15.9492 22.7639 41.4576

7.6471 9.1707

11.2122 14.2275 19.4252 31.4810

7.3684 8.6457

10.3547 12.8411 16.9652 25.6487

7.1429 8.1928 9.6094

11.6616 14.9898 21.5877

6.9565 7.7918 8.9420

10.6186 13.3100 18.4464

6.8000 7.4293 8.3309 9.6704

11.8237 15.8436



Sample Calculations

Let’s assume we put the weights equal to 30lbf and the equivalent Tension force produce in the belt is given by

T=m*g= 30lbf

Now the Length of the Pulley is taken as 15 inches.

Height of the fixed pulley is taken = 4 inches.

The base is shifted from the center by 3 inches.

The instrument is inclined at an angle of 15 degrees = 0.26 radian from the center.

Now, from the above mathematical equations,

(θ )=1.4660

β=((900−θ )+α )

β=0.364 Radians

The force experienced by the instrument is given by

⇒ F=2∗T∗Cosβ

⇒ F=2∗30∗.934

⇒ F=56.04 lbf



Graphical Plots:

The data from the above table is taken and plotted in 3 dimensions to get better understanding of the movement of the Instrument and the changed height of the second pulley.

Figure 12

The above figure plots the angle of inclination (α) of the Instrument with the central axis and the corresponding change in the height. The values are monitored when the base of the test rig is slided every 1 inch (n) away from the inclination of the instrument.

Figure 13

The above figure plots the angle of inclination (α) of the Instrument with the central axis and angle between the belt and tip of the instrument. The values are monitored when the base of the test rig is slided every 1 inch (n) away from the inclination of the instrument.



Figure 14

The above figure is a surface mesh of the values obtained over the whole range of motion of

the instrument. The maximum angle of inclination of the instrument with the central axis is

taken as 35 degrees.

From the figure it is evident that for the whole range of motion as mentioned above the

maximum height that the second pulley will be changed is 15 inches. This is in fact

accordance with our test rig dimensions.



Procedure for using the test rig:

1. Make sure the test rig is at a levelled base and not uneven.

2. Bring the Instrument and place it on the base of the rig and make sure it is tightly

held by the screw onto the clamp.

3. Look at the angle divider placed in front of the base to see what angle is the clamp

that holds the instrument is at.

4. Bring it to the desired angle at which the force measurement is to be done.

5. Check the reading at which the base is on by looking at the scale placed on the

bottom plate of the rig.

6. If the angle at which the force is measured is above 20 degree (.349 radians), slide

the base by turning the handle and try to bring the tip of the instrument in the

center of the test rig.

7. Read the position at which the slide has been brought on the scale and note it.

8. Now carefully slide the pulleys and bring them to a spot where the belt touches the

tip of the instrument.

9. Adjust the height H1 of the pulley so that you see the belt covering the tip of the

instrument.

10. Put the key and lock the height so that the pulley does not slides anymore in either

direction.

11. Note the height H1 on the scale that is present on the vertical beam of the rig.

12. Now use the look-up sheet and locate your noted values and find the corresponding

H2 value of the second pulley.

13. Now use the second scale that is present on the other vertical beam to bring the H2

to the value mention in the look-up sheet.

14. Use the second key to secure the pulley at H2.

15. Make sure everything is tight and does not move/slides.

16. Now place the weights onto the hooks attached to the belt.

17. Place equal amount of weight on both sides of the pulley.

18. Read the look-up table for the force value associated with the weight that is hung

onto the belt.



19. The force reading in the look-up table should be equal to the reading displayed by

the sensor.

20. Repeat Steps 3-18 for different angle of inclination of the Instrument.



FEA Analysis

For the static analysis, the maximum allowable loading conditions that could be seen for the device were applied to assure that the stress levels and deflections were within acceptable ranges for the application

Figure 15

The above figure shows the equivalent elastic strain that is produced in the fixture. A Static load of 50lbf is applied on both the sliders of the test rig. The elastic strain is concentrated at the edges of the base plate, but is in the acceptable range and therefor will not cause failure.

Figure 16



The equivalent stress is also concentrated on the edges of the base plate and is in the

accepted range and will not cause failure. The Maximum Stress is around 1000 psi and is

below the yield strength of Aluminum.

Figure 17

The above stress analysis shows the deformation in the fixture due to the applied load of

50lbf. The maximum deformation can be seen in the sliders of the fixture which is evident

from the fact that sliders hold the belt and pulley mechanism through which the load is

applied to the instrument. The maximum deflection is 0.0004 inches which is almost equal

to zero, but if considered can be reduced by increasing the diameter of the slider.



Forces Transferred to the Instrument

Figure 18

The static force analysis of the instrument are done to check whether the tension produced

in the belt is equal to the applied force on the Instrument. It can be seen that the tension

produced is in fact equal to the applied load on the instrument.

Figure 19



Magnified version of the above result so that the distribution of the forces can be monitored closely.

Figure 20

The above figure shows the distribution of the tension throughout the length of the belt. It

can call upon the weak point of the belt material which can be reinforced to reduce risk of

failure. Also the loads on the pulley can be analyzed to change the dimensions of the pulley

so that it can sustain the maximum loading conditions.



Bill of Material

Component Dimension Vendor Price Quantity

Link for Vendor

3003 - H14 Aluminum Plate

12" x 18" x 1/4" Plate

Speedymetals .com

$33.76/plate

2 http://www.speedymetals.com/pc-97-8358-14-3003-h14-aluminum-plate.aspx

6061-T6 Aluminum, Extruded Pipe

1.900" OD {A} x 1.610" ID {B} x .145"

Speedymetals .com

$0.63/ inch

1 http://www.speedymetals.com/pc-4437-8370-1-12-sch-40-pipe-6061-t6-aluminum-extruded.aspx

Steel rods: 3/4" cold finished 1018

3/4" Speedymetals .com

$0.32/ inch

2 http://www.speedymetals.com/pc-31-8227-18r75.aspx

Steel Rods: 1/2" cold finished 1018

1/2" Speedymetals .com

$0.15/ inch

4 http://www.speedymetals.com/pc-27-8227-18r5.aspx

Conveying PVC

2-ply, Thickness=0.094"

Thomasnet.com

Awaited

1 http://www.thomasnet.com/productsearch/productline/120500-1312-3001990-/dunham-rubber-belting-corp/general-conveying-pvc/

Pulley 2" diameter

IHS Engineering 360

Awaited

2 http://www.globalspec.com/specsearch/partspecs?partId={DE1FA627-0854-4D70-A19C-E95CF5BDF321}&comp=211&vid=96896&sqid=13446679


http://www.globalspec.com/specsearch/partspecs?partId=%7BDE1FA627-0854-4D70-A19C-E95CF5BDF321%7D&comp=211&vid=96896&sqid=13446679



http://www.thomasnet.com/productsearch/productline/120500-1312-3001990-/dunham-rubber-belting-corp/general-conveying-pvc/



http://www.speedymetals.com/pc-27-8227-18r5.aspx





Conclusion

The Proposed Test rig has been designed and analyzed through simulation. The test rig is

designed with all mechanical components with no electrical equipment’s to play role in

force validation. The vector components of tension forces have been balanced by changing

the height of the pulley. The change in height values are tabulated and should be used for

force measurement at different angle of orientation of the instrument. The deformed

geometry, stress distribution, and modal frequencies, were analyzed with ANSYS workbench

and found to be well within acceptable ranges which demonstrate that the structure of the

test rig is stable and can withstand the maximum loads without failure.

The Test rig will work successfully with given range of angles and might behave differently at

higher angles due to geometrical constraints. The next step would be building and

fabricating the test rig so that it can be used later in the force quantification and validation

of IASTM.



Acknowledgements

This work was done under ME 597 Individual project as a part of fulfillment for the MSME

degree. Special thanks to Dr. Sohel Anwar for his constant supervision and for mentoring

the project. Thanks to Dr. Loghmani and Dr. Stanley Chien for their critic views and thoughts

on the working of this project. Also, thanks to Ahmed, graduate student, IUPUI that helped

me in making this project a successful one.



References

1. ↑ http://en.wikipedia.org/wiki/Gua_sha2. ↑ Fowler, S, Wilson, J, and Sevier, TL, IfckLRnnovative approach forfckLRthe treatment

offckLRcumulative trauma disorders,fckLRWorkfckLR. 2000; 15:9-143. ↑ Sevier, TL, Helfst, RH, Stover, SA, andfckLRWilson, JK. Clinical trends on

tendinitis.fckLRWorkfckLR. 2000; 14:123-2264. ↑ Sevier, TL, Gehlsen, JK, Wilson, JK,fckLRStover SA, and Helfst RH. TraditionalfckLRphysical

therapy versus augmented softfckLRtissue mobilization (ASTM) in thefckLRtreatment of lateral epicondylitis.fckLRMed Sci Sports ExercfckLR. 1995; 27:S52

5. Material about IASTM reviewed from http://www.physiopedia.com/Instrument_Assisted_Soft_Tissue_Mobilization . https://www.acatoday.org/content_css.cfm?CID=5272

6. An Engineering Approach for Quantitative Analysis of the Lengthwise Strokes in Massage Therapies by Hansong Zeng, Department of Biomedical Engineering, Timothy A. Butterfield, Division of Athletic Training, Department of Rehabilitation Sciences.


http://www.physiopedia.com/Instrument_Assisted_Soft_Tissue_Mobilization

http://www.physio-pedia.com/Instrument_Assisted_Soft_Tissue_Mobilization#cite_ref-3



http://en.wikipedia.org/wiki/Gua_sha



Appendix A

This appendix contains the MATLAB code to calculate the height and angle required to bring the force equilibrium for the tension forces to act on the instrument.

clear allclcalpha =(0:5:35).*pi/180;A=zeros(64,8);JK=3; %% This is the height of the first pulley and is kept fixed%%T=15; %%This the force that is applied by the weights%%d=(1:8);for i=1:7 a=6.5;L=15; %%This is the distance between the two pulleys%%for n = 1:8Y=((L/2+(n-1))-(a.*sin(alpha)));AE=(a*cos(alpha)-JK);theta= atan(AE./Y);beta=(pi/2-theta)+alpha;BC=(L-Y);AB=BC.*tan((theta-2*alpha));AD=(AB+1);DF=((AE-AD)+1);RU=JK+DF;flse(n,:)=RU;flse1(n,:)=beta;endA((i*n+1:(i+1)*n),:)=flse(1:n,:);C((i*n+1:(i+1)*n),:)=flse1(1:n,:);JK=JK+1;end B=A(9:end,:);D=C(9:end,:);createfigure(alpha,d,B(1:8,1:8))grid onxlabel('alpha')zlabel('change in 2nd pulley height(H2)')ylabel('n')title('alpha vs n vs H2')createfigure(alpha,d,D(1:8,1:8))grid ontitle('alpha vs n vs beta')xlabel('alpha')zlabel('beta')



ylabel('n')meshgrid(d);meshgrid(alpha);figure;surf(alpha,d,B(1:8,1:8))title('alpha vs n vs beta')xlabel('alpha')zlabel('beta')ylabel('n')% surf(alpha,d,B(1:8,1:8))force=2*T.*cos(D);

Appendix B

This is a function that was developed to obtain the graphs and surface maps that would help validate our force analysis graphically.

function createfigure(X1, Y1, ZMatrix1)%CREATEFIGURE(X1, Y1, ZMATRIX1)% X1: vector of x data% Y1: vector of y data% ZMATRIX1: matrix of z data % Create figurefigure1 = figure; % Create axesaxes1 = axes('Parent',figure1,... 'Position',[0.0854973821989531 0.112155172413793 0.775 0.810258620689655]);view(axes1,[120.5 26]);grid(axes1,'on');hold(axes1,'all'); % Create multiple lines using matrix input to plot3plot31 = plot3(X1,Y1,ZMatrix1,'Parent',axes1);set(plot31(1),'Color',[0 1 1],'DisplayName','n=7');set(plot31(2),'Color',[0.87058824300766 0.490196079015732 0],... 'DisplayName','n=6');set(plot31(3),'Color',[1 1 0],'DisplayName','n=5');set(plot31(4),'Color',[0 1 0],'DisplayName','n=4');set(plot31(5),'Color',[0.749019622802734 0 0.749019622802734],... 'DisplayName','n=3');set(plot31(6),'Color',[1 0 0],'DisplayName','n=2');set(plot31(7),'DisplayName','n=1','Color',[0 0 0]);set(plot31(8),'DisplayName','n=0'); % Create titletitle('alpha vs n vs beta'); % Create xlabelxlabel('alpha'); % Create zlabelzlabel('beta');



% Create ylabelylabel('n'); % Create legendlegend1 = legend(axes1,'show');set(legend1,... 'Position',[0.853859851825394 0.639236956800407 0.117801047120419 0.331896551724138]);
