Development of a biotensegrity focused therapy for the treatment of pelvic organ prolapse: A retrospective case series

Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle

BACKGROUND

Myofascial Pain Syndrome (MPS) is a common, overlooked, and underdiagnosed condition and has significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease.

METHODS

Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews.

FINDINGS

799 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence.

CONCLUSIONS

MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue ("fascial armoring"). Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. A "global percutaneous needle fasciotomy" that respects tensegrity principles may treat MPS/fibromyalgia more effectively. "Functional-somatic syndromes" can be seen as one entity (myofibroblast-generated-tensegrity-tension), sharing a common rheuma-psycho-neurological mechanism.

Multi-Directional Shape Change Analysis of Biotensegrity Model Mimicking Human Spine Curvature

This paper presents a numerical strategy for the shape change analysis of spine biotensegrity models in multi-directional modes. The formulation of incremental equilibrium equations and optimization problem for shape change analysis via the forced elongation of cables to achieve the target coordinates of the monitored nodes of spine biotensegrity models are presented. The distance between the monitored nodes and the target coordinates is chosen as the objective function which is minimized subject to inequality constraints on member axial forces and cable forced elongation. Three spine biotensegrity models were analyzed to validate the effectiveness of the proposed method. The deformation characteristics of the Class-1 four-stage biotensegrity models mimicking the natural curvature of the human spine were investigated. A highly successful rate in achieving the target coordinates was observed in a total of 258 analysis cases, with percentages of 99.9%, 99.9% and 98.9% for shape change analysis involving uni-, bi- and tri-directional modes, respectively. The results show that the spine biotensegrity models have more flexibility in undergoing bending in comparison with axial deformation. With the established shape change strategy, the flexibility and versatility of the movement of spine biotensegrity models can be further studied for potential application in the shape change control of deployable structures together with the use of IoT.