Effect of spinal cord injury at C6–C7 on global upper-limb coordination during grasping: Manipulability approach

Clinical and Animal Studies of Waist and Knee Scraping Therapy for Knee Osteoarthritis

BACKGROUND

Knee osteoarthritis (KOA) is a degenerative condition with knee pain as the main clinical manifestation. Scraping is one of the commonly used traditional Chinese medicine treatment methods, which activates blood circulation, removes blood stasis, reduces inflammation, and so on. Although scholars have proposed that the synergistic treatment of the waist and knee for KOA is superior to simple knee treatment, there is no relevant reference literature on the application of scraping therapy. Therefore, this study aims to explore the effectiveness and potential mechanisms of waist and knee scraping therapy for treating KOA through clinical and animal studies in order to promote its clinical application.

OBJECTIVE

To explore the clinical efficacy of waist and knee scraping therapy in the treatment of KOA from clinical study and increase animal study on this basis to preliminarily explore its mechanism, providing an objective basis for better treatment of KOA.

METHODS

The clinical study recruited 90 KOA patients and divided them into a control group, a knee scraping group, and a waist and knee scraping group using a random number table method. All patients were evaluated for clinical efficacy, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), and Traditional Chinese Medicine Syndrome Score. The KOA rat model was established using the Hulth method. The rats were randomly divided into a control group, KOA group, waist scraping group, knee scraping group, and waist and knee scraping group. During the intervention process of rats, the pain sensitivity threshold was measured, and HE staining was performed on the synovium and cartilage. The protein and mRNA expression levels of TNF-α, IL- 1β, IL-6, PGP9.5, SP and TRPA1, TRPV4, SP, and NGF were measured by Western blot and real-time PCR.

RESULTS

In the clinical study, the clinical efficacy of the 2 scraping groups was significantly higher than that of the control group. The clinical efficacy of the waist and knee scraping group on the 60th day of treatment was significantly higher than that of the knee scraping group. In terms of improving WOMAC scores, all 3 groups had significance; The function and total score of the waist and knee scraping group on the 28th day of treatment, as well as the pain, function, and total score on the 60th day, were lower than those of the knee scraping group. In terms of improving pain while standing, pain when walking on flat ground, and total score, the scraping group had significant differences. The score of heavy limbs in the waist and knee scraping group was lower than that in the knee scraping group. In an animal study, during the 4th week after modeling, there were differences in the pain sensitivity threshold between the KOA group and the waist scraping group compared to the control group, while there were differences in the pain sensitivity threshold between the knee scraping group and the waist and knee scraping group compared to the KOA group. The expression levels of various proteins and genes in the KOA group and waist scraping group increased compared to the control group; The knee scraping group and the waist and knee scraping group were lower than those in the KOA group.

CONCLUSION

Scraping therapy can significantly alleviate knee joint pain and stiffness, improve joint function, and improve clinical efficacy, and the short-term and long-term effects of waist and knee scraping therapy are more significant. The scraping therapy has a definite therapeutic effect on KOA rats, which can improve the threshold of cold hyperalgesia and mechanical hyperalgesia, and the waist and knee scraping therapy is more obvious. This may be related to reducing inflammatory reactions in synovial and ganglion tissues.

A manipulability analysis of human walking

From the literature of biomechanics, it is now clear that humans use elevating, lowering and delayed-lowering strategies in order to maintain stability during perturbed walking. The main purpose of this study is to provide insights into the role of manipulability in selection of these strategies. A 37 degrees of freedom (DoFs) model of the human body is developed to evaluate the manipulability indices during walking. The model is considered as a tree-like structure and its forward kinematics equations and the Jacobian are derived based on the Denavit-Hartenberg (DH) convention. A hybrid genetic algorithm (HGA) is then employed to map the experimental kinematics of a human to the model. The kinematic and dynamic manipulability indices of the swing phase of walking are evaluated concentrating on early, mid and late swing phases. The results indicate that the manipulability indices can characterize well the selection of elevating, lowering and delayed-lowering strategies at different stages of the swing phase. The results kinematically describe the reason of selecting delayed-lowering strategy at mid-swing phase that was not obvious in previous studies. Moreover, the results show that at mid-swing phase of walking the kinematic maneuverability is lower than that of the early and late swing phases.