Talk to me about ASTYM (Full Version)

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alodato -> Talk to me about ASTYM (April 8, 2008 12:29:48 PM)

Who has taken the course and what are your thoughts?

Likes/Dislikes?

Do you find that it is clinically relevant for soft tissue issues?

Thanks for any input!




TexasOrtho -> RE: Talk to me about ASTYM (April 8, 2008 1:37:45 PM)

What is it?



proud -> RE: Talk to me about ASTYM (April 8, 2008 1:55:45 PM)

quote:

ORIGINAL: TexasOrtho

What is it?


It's mostly a chiroptractic shtick....a gimmick.

Thousands of dollars in training and certification to rub a metal object along soft tissue....

Or....you could just take the end of a stainless steel knife and rub... tell the patient that it's a "special" device used to break adhesions and Volia....ASTYM.....



Kaden -> RE: Talk to me about ASTYM (April 8, 2008 5:21:12 PM)

I work with some clinicians that use ASTYM and I like some of the theory behind the system.  Basically advocating poor healing of tendinous and muscular structures requiring "re-organization"  The technique is basically like aggressive soft tissue work or MFR so I say why not just use your hands and do myofascial/soft tissue work or some frictions if needed.

The only plus I can see is that it would be less stressful on the therpists body to do the technique but paying a few thousand to decrease stress on my hands and shoulders seems a high price.

Another disadvantage is the inability to feel what you are working on and re-asses.  Would be like using a machine to do a posterior glide of the GH joint - how do you grade that and even know what would be going on.



PainFree -> RE: Talk to me about ASTYM (April 8, 2008 5:33:32 PM)

Proud,

ASTYM is exclusively marketed to physical therapists, occupational therapists and the like.  I do not believe a chiropractor can take a class through the ASYTM organization. 

From the ASTYM website:

The ASTYM system is available from certified rehabilitation professionals around the country. These include physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, and athletic trainers. Each clinician certified in the ASTYM system has undergone intensive training in this therapy approach. This training combined with the clinician’s other education and healthcare expertise provides the ideal opportunity for the patient to achieve maximum benefit from the System.




rwillcott -> RE: Talk to me about ASTYM (April 8, 2008 6:30:53 PM)

Beware of any treatment approach referred to as the 'System'




proud -> RE: Talk to me about ASTYM (April 8, 2008 6:55:51 PM)

quote:

ORIGINAL: Kaden

I work with some clinicians that use ASTYM and I like some of the theory behind the system.  Basically advocating poor healing of tendinous and muscular structures requiring "re-organization"  The technique is basically like aggressive soft tissue work or MFR so I say why not just use your hands and do myofascial/soft tissue work or some frictions if needed.

The only plus I can see is that it would be less stressful on the therpists body to do the technique but paying a few thousand to decrease stress on my hands and shoulders seems a high price.

Another disadvantage is the inability to feel what you are working on and re-asses.  Would be like using a machine to do a posterior glide of the GH joint - how do you grade that and even know what would be going on.


Kaden,

This is truth....without my infused sarcasm.

I can accomplish the same thing( I think) without tiny mystical instruments.

Painfree,

Are you sure?:

http://www.chiroweb.com/archives/24/11/18.html

There are several brands on the market. Graston markets primarily to DC's and ATC's. Regardless, they all supposedly require some bizzare certification and the cost is ridiculous.

Either way...it's like I said. It's a shtick....a gimmick that ropes in the gullible( plenty of gullible "professionals" to go around I guess).



Kaden -> RE: Talk to me about ASTYM (April 8, 2008 7:12:33 PM)

Proud,

I agree with your take and I too feel I can do the same thing with my hands.  Like most gimmicks we see in the clinic it is simply taking something we all use every day, usually via our hand and coming up with a nice looking device to do the same thing. 

The problem is you can't charge a whole heck of a lot for some ASTYM tools but you sure can for an extensive course to learn "their system"



PainFree -> RE: Talk to me about ASTYM (April 8, 2008 7:30:01 PM)

Proud,

I feel certain that ASTYM is marketed to PT's.  Graston, on the other hand, is similiar and is marketed to DC's.  Guasha has been around forever and can accomplish the same thing IMO.  One can search some common patent sites and see the basis to these treatments and save themselves 1000's of dollars.



jsalva -> RE: Talk to me about ASTYM (April 9, 2008 12:57:38 PM)

I have taken the ASTYM certification course, and currently use it with pt's. They do not allow DC's to take the course, but there are offshoots used by DC's (Graston/ART). The technique is based on the theory that many musculo-skeletal issues are more 'osis than 'itis, and that there are patters of tissue disfunction due to compesatory movement patterns rather than a localized "injury".

The ASTYM (augmented soft tissue mobilization) works simlar to TFM, but will allow you to treat an entire extremity in several minutes. You are able to feel areas of tissue fibrosis (even more than with your fingers...at least my fingers), and pts can feel the difference as well. I have seen positive results with many Dx, but it is just a TOOL and will never replace other manual techniques.

ASTYM ( http://www.astym.com/ ) does have outcome studies to show effectiveness and I believe they are working on other research.

John



TC PT -> RE: Talk to me about ASTYM (April 9, 2008 7:51:50 PM)

I too am ASTYM certified, and regularly use the treatment. The hospital that our clinic functions under paid for this certification, which certainly wasn't inexpensive. They also pay yearly membership dues, and have purchased the tools we use. The course took nearly 3 full days to complete. I feel the course was over-priced and too lengthy for the information provided. I think it could have been done in about half the time it took. The basic tenets of the treatment are similar to some ancient Chinese medicine techniques so it's hardly cutting edge or original.

That said, I can attest to it's effectiveness based solely on my and my coworkers' clinical experiences. No, it isn't effective for every patient but, it often works in cases that have been resistant to numerous other forms of treatment. It works especially well in support of ther manual techniques. It also comes in handy when a physician referral asks specifically for it....happens a lot around here due to word of mouth. ASTYM also places a high degree of importance in tracking outcomes and doing research. Those two factors as much as anything else they've done have improved their credibility in my opinion.

Something I found surprising when I first started to use this technique was the ability to feel the tools resonate in my hands in way that allowed better soft-tissue assessment than my hands alone could offer. I like to think that over the last 17 years as a PT I've developed very good palpation skills...something that I believe comes with practice on all body types and tissues. The tools aren't necessarily a better way to assess the soft tissues than skilled hands but, they add to what you can percieve with the hands alone.

I believe this technique could be used effectively by any competent PT who understands the principles, using tools they could either fashion themselves or, adapt utensils used for other purposes. My message is that this treatment isn't 'chiropractic schtik' as someone suggested earlier. What it is, is another tool to use to help people feel and function better. Which is what we do, right?



proud -> RE: Talk to me about ASTYM (April 9, 2008 8:18:20 PM)

quote:

ORIGINAL: TC PT

I too am ASTYM certified, and regularly use the treatment. The hospital that our clinic functions under paid for this certification, which certainly wasn't inexpensive. They also pay yearly membership dues, and have purchased the tools we use. The course took nearly 3 full days to complete. I feel the course was over-priced and too lengthy for the information provided. I think it could have been done in about half the time it took. The basic tenets of the treatment are similar to some ancient Chinese medicine techniques so it's hardly cutting edge or original.

That said, I can attest to it's effectiveness based solely on my and my coworkers' clinical experiences. No, it isn't effective for every patient but, it often works in cases that have been resistant to numerous other forms of treatment. It works especially well in support of ther manual techniques. It also comes in handy when a physician referral asks specifically for it....happens a lot around here due to word of mouth. ASTYM also places a high degree of importance in tracking outcomes and doing research. Those two factors as much as anything else they've done have improved their credibility in my opinion.

Something I found surprising when I first started to use this technique was the ability to feel the tools resonate in my hands in way that allowed better soft-tissue assessment than my hands alone could offer. I like to think that over the last 17 years as a PT I've developed very good palpation skills...something that I believe comes with practice on all body types and tissues. The tools aren't necessarily a better way to assess the soft tissues than skilled hands but, they add to what you can percieve with the hands alone.

I believe this technique could be used effectively by any competent PT who understands the principles, using tools they could either fashion themselves or, adapt utensils used for other purposes. My message is that this treatment isn't 'chiropractic schtik' as someone suggested earlier. What it is, is another tool to use to help people feel and function better. Which is what we do, right?


The tools is the shtick...not the rationale.

In fact the rationale is somewhat grounded in what is know scientifically( tendinosis).

But rest assured....there are more PT's than not that don't understand the distinction between 'osis' and 'itis'. It's sad.

So it makes sense that PT's that apply what is known to these patients would have better outcomes overall that the local PT clown who is mobilizing cranial sutures to fix a patellar tendinosis.

But this in no way validates the use of the tiny instruments. I'd be willing to bet that if an RCT was completed in which the tiny instruments were compared against traditional manual therapy with the same patient population....the results would be the same.

It's a gimmick.



rwillcott -> RE: Talk to me about ASTYM (April 9, 2008 8:29:22 PM)

"It also comes in handy when a physician referral asks specifically for it....happens a lot around here due to word of mouth."

Of course, the doctor recommended it therefore it must work.

Rob



TC PT -> RE: Talk to me about ASTYM (April 9, 2008 8:41:50 PM)

The "business" portion of making money from a specific treatment method or piece of equipment is not what I'm talking about. That will always be around, and I don't like that aspect of ASTYM either. Like it or not people will find ways to make something 'theirs' and charge money for it.

You can call the tools a gimmick if you like (I wouldn't disagree), but you'll not convince me, nor the successfully treated patients, that the treatment is a gimmick.  



TC PT -> RE: Talk to me about ASTYM (April 9, 2008 8:47:12 PM)

quote:

ORIGINAL: rwillcott

"It also comes in handy when a physician referral asks specifically for it....happens a lot around here due to word of mouth."

Of course, the doctor recommended it therefore it must work.

Rob

I don't think I said nor, did I infer that it must work because anyone recommended it. I believe it works based on the clinical results I've observed.

If the treatment isn't effective after 2-3 sessions the ASTYM is deleted from the treatment plan.




proud -> RE: Talk to me about ASTYM (April 9, 2008 8:53:04 PM)

Never called the treatment a gimmick. The rationale is somewhat sound.

The tools and thus the purveyor's of the "technique" are gimmick salesmen/women. And those that spend the money to be certified to dig the but end of a stainless steal spoon into patients....gullible.



dscouras -> RE: Talk to me about ASTYM (April 10, 2008 4:20:59 AM)

Looks like a get rich quick program for the developers - knock off artists. There are lots of treatments out there that do the same. I would put laser therapy in that boat as well. I wonder how much research out there has been modified or stats used in such a way as to help sell a set of products.

I think that ASTYM, Graston, Laser etc etc are likely used as a way for clinicians to save their joints from future irritations/pains. Also as a tool for convincing clients that there is this new revolutionary treatment that they will be recieving and benefiting from. Everybody wants to feel the excitement of being part of cutting edge research treatments.

I am naive to the following therapy as well, however my first inclination is to think someone go the calling - has anyone heard of network chiropracting - where the clinician touches three to four spots on the spine and viola the person is magically cured?

At the end of the day I think that proper knowledge of injuries/tissues, assessment and treatment trump gimmicks.



AllenB -> RE: Talk to me about ASTYM (April 10, 2008 10:20:15 PM)

I'm on my last rotation and three clinicians (2 PTs and 1 PTA) at the facility are certified and "all about" this ASTYM stuff. As mentioned above, MDs do send referrals specifically requesting ASTYM.

What would you do in the following situation? You're a PT, WITHOUT ASTYM certification, and you get a referral requesting ASTYM specifically. I completely agree with the comments above concerning other methods to achieve the same result. So ......

-Do you use your own method (other manual techniques) to treat the patient and more or less ignore the instructions from the MD?
-Contact the MD (let's assume it's not one you know very well) explaining that you are not certified with ASTYM but you think you can treat the pt appropriately ... bla, bla, bla.
-Run out and get certified immediately because you clearly are a poor PT without this certification and should not treat another pt before doing so (BTW - My current CI seriously might choose this answer)

Thanks.



SJBird55 -> RE: Talk to me about ASTYM (April 10, 2008 10:40:03 PM)

Allen,  when a physician refers, I interpret that to mean that the physician believes that physical therapy intervention may be beneficial for the patient.  The patient schedules an appointment.  The physical therapist evaluates the patient and assesses the condition AND whether physical therapy services are warranted.  The physical therapist discusses treatment options.  The physical therapist creates the plan of care.  The physical therapist sends the plan of care to the referring physician for signature IF required.  The referring physician receives the plan of care, signs it and sends it back.  Viola... done deal. 

Physicians really don't "instruct" us, do they?  If physicians really instructed us, why would we need to do an evaluation?  Why would we need to come up with a plan of care? 



Shill -> RE: Talk to me about ASTYM (April 11, 2008 8:28:11 AM)

I for one have had this very situation.  I viewed the website, saw what they did, and reproduced it.  It aint quantum physics or molecular engineering, its aggressive STM with implements.  I used a tool I thought would work just fine, and I didnt have to pay millions of dollars for it.  Plantar fasciitis was the dx, pt got better (for whatever reason), and all involved were pleased.  The only people who would be disenchanted with this are the people who are out money because I didnt go to their course.  End of story.   



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