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Zhang QB, Huo L, Li M, Zhang R, Zhou T, Wang F, Zhou Y. Role of hypoxia-mediated pyroptosis in the development of extending knee joint contracture in rats. Eur J Med Res 2024; 29:298. [PMID: 38802976 PMCID: PMC11129407 DOI: 10.1186/s40001-024-01890-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
Joint contracture is one of the common diseases clinically, and joint capsule fibrosis is considered to be one of the most important pathological changes of joint contracture. However, the underlying mechanism of joint capsule fibrosis is still controversial. The present study aims to establish an animal model of knee extending joint contracture in rats, and to investigate the role of hypoxia-mediated pyroptosis in the progression of joint contracture using this animal model. 36 male SD rats were selected, 6 of which were not immobilized and were used as control group, while 30 rats were divided into I-1 group (immobilized for 1 week following 7 weeks of free movement), I-2 group (immobilized for 2 weeks following 6 weeks of free movement), I-4 group (immobilized for 4 weeks following 4 weeks of free movement), I-6 group (immobilized for 6 weeks following 2 weeks of free movement) and I-8 group (immobilized for 8 weeks) according to different immobilizing time. The progression of joint contracture was assessed by the measurement of knee joint range of motion, collagen deposition in joint capsule was examined with Masson staining, protein expression levels of HIF-1α, NLRP3, Caspase-1, GSDMD-N, TGF-β1, α-SMA and p-Smad3 in joint capsule were assessed using western blotting, and the morphological changes of fibroblasts were observed by transmission electron microscopy. The degree of total and arthrogenic contracture progressed from the first week and lasted until the first eight weeks after immobilization. The degree of total and arthrogenic contracture progressed rapidly in the first four weeks after immobilization and then progressed slowly. Masson staining indicated that collagen deposition in joint capsule gradually increased in the first 8 weeks following immobilization. Western blotting analysis showed that the protein levels of HIF-1α continued to increase during the first 8 weeks of immobilization, and the protein levels of pyroptosis-related proteins NLRP3, Caspase-1, GSDMD-N continued to increase in the first 4 weeks after immobilization and then decreased. The protein levels of fibrosis-related proteins TGF-β1, p-Smad3 and α-SMA continued to increase in the first 8 weeks after immobilization. Transmission electron microscopy showed that 4 weeks of immobilization induced cell membrane rupture and cell contents overflow, which further indicated the activation of pyroptosis. Knee extending joint contracture animal model can be established by external immobilization orthosis in rats, and the activation of hypoxia-mediated pyroptosis may play a stimulating role in the process of joint capsule fibrosis and joint contracture.
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Affiliation(s)
- Quan-Bing Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, Anhui, China
| | - Lei Huo
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, Anhui, China
| | - Mian Li
- Hefei Institute of Physical Sciences, Chinese Academy of Sciences, Hefei, 230031, Anhui, China
| | - Rui Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, Anhui, China
| | - Ting Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, Anhui, China
| | - Feng Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, Anhui, China
| | - Yun Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, Anhui, China.
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Zhang R, Zhang R, Zhou T, Wang F, Zhou CX, Wang H, Zhang QB, Zhou Y. Preliminary investigation on the effect of extracorporeal shock wave combined with traction on joint contracture based on PTEN-PI3K/AKT pathway. J Orthop Res 2024; 42:339-348. [PMID: 37676080 DOI: 10.1002/jor.25687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/13/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
To investigate the intervention effect of extracorporeal shock wave combined with manual traction on fixation-induced knee contracture and its influence on PTEN-PI3K/AKT signaling pathway. Thirty-six SD male rats were randomly divided into six groups. The left knee joints were not fixed in the control group (C group). Rats in other groups underwent brace fixation in the extended position of the left knee. After 4 weeks of bracing, it is randomly divided into five groups: Model group (M group), natural recovery group (NR group), extracorporeal shock wave treatment group (ET group), manual traction group (MT group), and extracorporeal shock wave combined with manual traction group (CT group). Joint range of motion (ROM) of left knee was carried out to assess joint function. Hematoxylin and eosin (HE) staining and Masson staining were respectively used to assess the cell number and collagen deposition expression. Immunohistochemical staining and Western blot were used to assess protein levels of phosphatase and tensin homolog (PTEN), phosphatidylinositol 3-kinase (PI3K), and protein kinase B (AKT). The combined therapy was more effective than extracorporeal shock wave therapy or manual traction alone against the joint ROM, cell number and the collagen deposition, low-expression of PTEN, and overexpression of PI3K/AKT in the anterior joint capsule of rats with knee extension contracture. Extracorporeal shock wave combined with manual traction can promote the histopathological changes of anterior joint capsule fibrosis, upregulate the protein expression of PTEN and downregulate the protein expression of PI3K/AKT in the fibrotic joint capsule in a rat joint contracture model.
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Affiliation(s)
- Rui Zhang
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Run Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ting Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Feng Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chen Xu Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hua Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, China
| | - Quan Bing Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yun Zhou
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Zhou T, Zhou CX, Zhang QB, Wang F, Zhou Y. LIPUS Alleviates Knee Joint Capsule Fibrosis in Rabbits by Regulating SOD/ROS Dynamics and Inhibiting the TGF-β1/Smad Signaling Pathway. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2510-2518. [PMID: 37714800 DOI: 10.1016/j.ultrasmedbio.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE The aim of the work described here was to investigate the efficacy and potential mechanisms of low-intensity pulsed ultrasound (LIPUS) for the treatment of arthrogenic contracture induced by immobilization in rabbits. METHODS The left knee joint of rabbits was immobilized for 6 wk to establish the model of extending knee joint contracture. The rabbits were divided into a control group (C), a group immobilized for 6 wk (IM-6w), a group remobilized for 1 wk (RM-1w), a group subjected to LIPUS intervention for 1 wk (LIPUS-1w), a group remobilized for 2 wk (RM-2w) and a group subjected to LIPUS intervention for 2 wk (LIPUS-2w). The degrees of arthrogenic contracture and joint capsule fibrosis were assessed, as were the levels of reactive oxygen species (ROS) and the activation status of the TGF-β1/Smad signaling pathway in the joint capsule. RESULTS After immobilization for 6 wk, the degrees of arthrogenic contracture and joint capsule fibrosis increased. The ROS level increased, as evidenced by an increase in malondialdehyde content and a decrease in superoxide dismutase content. In addition, the TGF-β1/Smad signaling pathway was significantly activated. The degrees of knee joint contracture increased in the first week after remobilization and decreased in the second week. Furthermore, joint capsule fibrosis continued to develop during the 2 wk of remobilization, and the ROS level increased, while the TGF-β1/Smad signaling pathway was significantly activated. LIPUS effectively reduced the level of ROS in the joint capsule, which further inhibited activation of the TGF-β1/Smad signaling pathway, thereby improving joint capsule fibrosis and reducing arthrogenic contracture. CONCLUSION The high ROS levels and overactivation of the TGF-β1/Smad signaling pathway may be reasons why immobilization induces knee joint capsule fibrosis. LIPUS can alleviate the degree of knee joint capsule fibrosis induced by immobilization by inhibiting the production of ROS and the activation of the TGF-β1/Smad signaling pathway.
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Affiliation(s)
- Ting Zhou
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center for Translational Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chen Xu Zhou
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center for Translational Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Quan Bing Zhang
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center for Translational Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Feng Wang
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center for Translational Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yun Zhou
- Department of Rehabilitation Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China; Research Center for Translational Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China.
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Zhou CX, Wang F, Zhou Y, Fang QZ, Zhang QB. Formation process of extension knee joint contracture following external immobilization in rats. World J Orthop 2023; 14:669-681. [PMID: 37744718 PMCID: PMC10514713 DOI: 10.5312/wjo.v14.i9.669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/30/2023] [Accepted: 08/21/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Current research lacks a model of knee extension contracture in rats.
AIM To elucidate the formation process of knee extension contracture.
METHODS We developed a rat model using an aluminum external fixator. Sixty male Sprague-Dawley rats with mature bones were divided into the control group (n = 6) and groups that had the left knee immobilized with an aluminum external fixator for 1, 2, and 3 d, and 1, 2, 3, 4, 6, and 8 wk (n = 6 in each group). The passive extension range of motion, histology, and expression of fibrosis-related proteins were compared between the control group and the immobilization groups.
RESULTS Myogenic contracture progressed very quickly during the initial 2 wk of immobilization. After 2 wk, the contracture gradually changed from myogenic to arthrogenic. The arthrogenic contracture progressed slowly during the 1st week, rapidly progressed until the 3rd week, and then showed a steady progression until the 4rd week. Histological analyses confirmed that the anterior joint capsule of the extended fixed knee became increasingly thicker over time. Correspondingly, the level of transforming growth factor beta 1 (TGF-β1) and phosphorylated mothers against decapentaplegic homolog 2 (p-Smad2) in the anterior joint capsule also increased with the immobilization time. Over time, the cross-sectional area of muscle fibers gradually decreased, while the amount of intermuscular collagen and TGF-β1, p-Smad2, and p-Smad3 was increased. Unexpectedly, the amount of intermuscular collagen and TGF-β1, p-Smad2, and p-Smad3 was decreased during the late stage of immobilization (6-8 wk). The myogenic contracture was stabilized after 2 wk of immobilization, whereas the arthrogenic contracture was stabilized after 3 wk of immobilization and completely stable in 4 wk.
CONCLUSION This rat model may be a useful tool to study the etiology of joint contracture and establish therapeutic approaches.
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Affiliation(s)
- Chen-Xu Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Feng Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Yun Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
| | - Qiao-Zhou Fang
- The Second Clinical Medicine College, Anhui Medical University, Hefei 230000, Anhui Province, China
| | - Quan-Bing Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China
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Hu C, Zhang QB, Wang F, Wang H, Zhou Y. The effect of extracorporeal shock wave on joint capsule fibrosis in rats with knee extension contracture: a preliminary study. Connect Tissue Res 2023; 64:469-478. [PMID: 37267052 DOI: 10.1080/03008207.2023.2217254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/04/2023] [Indexed: 06/04/2023]
Abstract
The purpose of this study was to observe the therapeutic effect of extracorporeal shock wave (ESW) on extensional joint contracture of knee joint in rats and its mechanism on articular capsule fibrosis. Thirty-two SD rats were randomly divided into blank control, immobilization, natural recovery, and ESW intervention groups. Except for the control group, the left knee joints of other rats were fixed with external fixation brace for 4 weeks when they were fully extended to form joint contracture. The effect of intervention was assessed by evaluating joint contracture, total cell count and collagen deposition in joint capsule, and protein expression levels of TGF-β1, p-Smad2/3, Smad2/3, p-JNK, JNK, I and III collagen in joint capsule. ESW can effectively reduce arthrogenic contracture, improve the histopathological changes of anterior joint capsule, inhibit the high expression of target protein and the excessive activation of TGF-β1/Smad2/3/JNK signal pathway. Inhibition of excessive activation of TGF-β1/Smad2/3/JNK pathway may be one of the potential molecular mechanisms by which extracorporeal shock wave can play a role.
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Affiliation(s)
- Chao Hu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Quan Bing Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Feng Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hua Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, China
| | - Yun Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Zhang QB, Liu AY, Fang QZ, Wang F, Wang H, Zhou Y. Effect of Electrical Stimulation on Disuse Muscular Atrophy Induced by Immobilization: Correlation With Upregulation of PERK Signal and Parkin-Mediated Mitophagy. Am J Phys Med Rehabil 2023; 102:692-700. [PMID: 36630294 DOI: 10.1097/phm.0000000000002182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The aims of the study are to investigate the effect of electrical stimulation on disuse muscular atrophy induced by immobilization (IM) and to explore the role of PERK signal and Parkin-dependent mitophagy in this process. DESIGN In the first subexperiment, 24 rabbits were divided into four groups, which underwent different periods of IM. In the second subexperiment, 24 rabbits were divided into four groups on average in accordance with different kinds of interventions. To test the time-dependent changes of rectus femoris after IM, and to evaluate the effect of electrical stimulation, the wet weights, cross-sectional area and fat deposition of rectus femoris were assessed in this study, along with the protein levels of atrogin-1, p-PERK, Parkin, and COXIV. RESULTS The wet weights and cross-sectional area decreased, and the fat deposition increased in rectus femoris after IM, along with the elevated protein levels of atrogin-1, p-PERK, Parkin, and decreased protein levels of COXIV. The above histomorphological and molecular changes can be partially ameliorated by electrical stimulation. CONCLUSIONS Immobilization of unilateral lower limb could induce rectus femoris atrophy, which can be partially rectified by electrical stimulation. PERK signal and Parkin-mediated mitophagy may be the mechanisms by which electrical stimulation can play a significant role.
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Affiliation(s)
- Quan-Bing Zhang
- From the Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Q-BZ, FW, YZ); The Center for Scientific Research of the First Affiliated Hospital of Anhui Medical University, Hefei, China (A-YL); The Second Clinical Medicine College of Anhui Medical University, Hefei, China (Q-ZF); Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, China (HW); and Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, China (HW)
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Huang L, Li Q, Shah SZA, Nasb M, Ali I, Chen B, Xie L, Chen H. Efficacy and safety of ultra-short wave diathermy on COVID-19 pneumonia: a pioneering study. Front Med (Lausanne) 2023; 10:1149250. [PMID: 37342496 PMCID: PMC10277738 DOI: 10.3389/fmed.2023.1149250] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Background The ultra-short wave diathermy (USWD) is widely used to ameliorate inflammation of bacterial pneumonia, however, for COVID-19 pneumonia, USWD still needs to be verified. This study aimed to investigate the efficacy and safety of USWD in COVID-19 pneumonia patients. Methods This was a single-center, evaluator-blinded, randomized controlled trial. Moderate and severe COVID-19 patients were recruited between 18 February and 20 April 2020. Participants were randomly allocated to receive USWD + standard medical treatment (USWD group) or standard medical treatment alone (control group). The negative conversion rate of SARS-CoV-2 and Systemic Inflammatory Response Scale (SIRS) on days 7, 14, 21, and 28 were assessed as primary outcomes. Secondary outcomes included time to clinical recovery, the 7-point ordinal scale, and adverse events. Results Fifty patients were randomized (USWD, 25; control, 25), which included 22 males (44.0%) and 28 females (56.0%) with a mean (SD) age of 53 ± 10.69. The rates of SARS-CoV-2 negative conversion on day 7 (p = 0.066), day 14 (p = 0.239), day 21 (p = 0.269), and day 28 (p = 0.490) were insignificant. However, systemic inflammation by SIRS was ameliorated with significance on day 7 (p = 0.030), day 14 (p = 0.002), day 21 (p = 0.003), and day 28 (p = 0.011). Time to clinical recovery (USWD 36.84 ± 9.93 vs. control 43.56 ± 12.15, p = 0.037) was significantly shortened with a between-group difference of 6.72 ± 3.14 days. 7-point ordinal scale on days 21 and 28 showed significance (p = 0.002, 0.003), whereas the difference on days 7 and 14 was insignificant (p = 0.524, 0.108). In addition, artificial intelligence-assisted CT analysis showed a greater decrease in the infection volume in the USWD group, without significant between-group differences. No treatment-associated adverse events or worsening of pulmonary fibrosis were observed in either group. Conclusion Among patients with moderate and severe COVID-19 pneumonia, USWD added to standard medical treatment could ameliorate systemic inflammation and shorten the duration of hospitalization without causing any adverse effects.Clinical Trial Registration: chictr.org.cn, identifier ChiCTR2000029972.
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Affiliation(s)
- Liangjiang Huang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- WHO Collaborating Center for Training and Research in Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Li
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- WHO Collaborating Center for Training and Research in Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sayed Zulfiqar Ali Shah
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mohammad Nasb
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Iftikhar Ali
- Paraplegic Center, Hayatabad, Peshawar, Pakistan
| | - Bin Chen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lingfeng Xie
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- WHO Collaborating Center for Training and Research in Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Chen
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- WHO Collaborating Center for Training and Research in Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Fan Z, Weiguang G, Yubao M, Shuyan Q. Effect of different Intensity Electrotherapy on Functional Recovery
in Patients with Knee Osteoarthritis. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2023. [DOI: 10.1055/a-2047-4009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Objective To explore the effects of different-intensity intermediate
frequency therapy on functional recovery of patients with knee
osteoarthritis.
Methods Three-band electromagnetic waves of constant amplitude
intermediate frequency electrotherapy group (Group A), interference
electrotherapy group (Group B) and modulated intermediate frequency
electrotherapy group (Group C) were used to treat knee osteoarthritis (KOA)
patients, 20 min/time, 1 time/day and 5
days/week for four weeks. Other rehabilitation items were performed the
same way. The rehabilitation therapy were evaluated by VAS score, Timed Up and
Go test and balance ability.
Results After 4 weeks of treatment, the treatment effects of the three
groups were all significant compared with the pre-treatment. Among the three
groups, the treatment effect of Group B was better than that of the other two
groups, and there was no significant difference in the treatment effect between
Group A and Group C.
Conclusion According to thee. g.results, it is possible that the
interference current is of a great action depth, and the
"endogenous" low-frequency modulated intermediate frequency
current possesses the advantages of both low and intermediate frequency, so with
the intermediate frequency current getting through the high resistance of skin,
the current effect of the low and intermediate frequency in the deep part of the
human body can be achieved.
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Affiliation(s)
- Zhijiao Fan
- Rehabilitation Treatment Center of Beijing Rehabilitation Hospital,
Capital Medical University, Beijing, China
| | - Gao Weiguang
- Rehabilitation Department, Hangzhou Wenhui University, Hangzhou,
China
| | - Ma Yubao
- Musculoskeletal Rebabilitation Center of Beijing Rehabilitation
Hospital, Capital Medical University, Beijing, China
| | - Qie Shuyan
- Rehabilitation Treatment Center of Beijing Rehabilitation Hospital,
Capital Medical University, Beijing, China
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Wang L, Cui JB, Xie HM, Zuo XQ, He JL, Jia ZS, Zhang LN. Effects of Different Static Progressive Stretching Durations on Range of Motion, Myofibroblasts, and Collagen in a Posttraumatic Knee Contracture Rat Model. Phys Ther 2022; 102:6481179. [PMID: 34972861 DOI: 10.1093/ptj/pzab300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 07/24/2021] [Accepted: 10/19/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of different durations of static progressive stretching (SPS) on posttraumatic knee contracture in rats, including range of motion (ROM), gait analysis, myofibroblast proliferation, and collagen regulation. METHODS The posttraumatic knee contracture model was established, and male Wistar rats were randomly divided into the 20-minute SPS treatment, 30-minute SPS treatment (S30), 40-minute SPS treatment, untreated, immobilization, and control groups. At Week 1, 2, and 4 of treatment intervention, joint ROM and gait were measured and compared. Knee joint samples stained with hematoxylin and eosin and Masson trichrome were used to observe alterations in pathological structures. Collagen density and cell numbers in the posterior joint capsule were used to assess joint capsule fibrosis and inflammation. Immunohistochemistry was used to detect type I collagen and α-smooth muscle actin expression. RESULTS The S30 group improved the most; ROM, stance, mean intensity, print area, and stride length were 115 (SD = 5) degrees, 0.423 (SD = 0.074) seconds, 156.020 (SD = 7.952), 2.116 (SD = 0.078) cm2, and 11.758 (SD = 0.548) cm, respectively. The numbers of myofibroblasts, fibroblasts, and inflammatory cells decreased, and collagen proliferation was significantly suppressed in the S30 group compared with the other groups. CONCLUSION S30 significantly improved posttraumatic knee contracture in rats, with reduced type I collagen and α-smooth muscle actin expression, decreased the numbers of myofibroblasts and inflammatory cells, suppressed fibrotic and inflammatory changes in the joint capsule, and increased joint mobility. This study provided basic evidence for an optimal standard-of-care treatment approach for posttraumatic knee joint contracture in rats, which may have significance for humans.
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Affiliation(s)
- Lu Wang
- Department of Rehabilitation Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,Graduate School, Medical School of Chinese PLA, Beijing, China.,Department of Rehabilitation Medicine, Beijing Tongren Hospital, Beijing, China
| | - Jian-Bo Cui
- Department of Rehabilitation Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hui-Min Xie
- Department of Rehabilitation Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiu-Qin Zuo
- Department of Rehabilitation Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jia-Le He
- Department of Rehabilitation Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China.,Graduate School, Medical School of Chinese PLA, Beijing, China
| | - Zi-Shan Jia
- Department of Rehabilitation Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Li-Ning Zhang
- Department of Rehabilitation Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China
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Wang F, Li W, Zhou Y, Huang PP, Zhang QB. Radial extracorporeal shock wave reduces myogenic contracture and muscle atrophy via inhibiting NF-κB/HIF-1α signaling pathway in rabbit. Connect Tissue Res 2022; 63:298-307. [PMID: 34014138 DOI: 10.1080/03008207.2021.1920934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE We investigate the underlying biological effects and mechanisms of rESWT on myogenic contracture and muscle atrophy in a rabbit model of extending knee joint contracture. MATERIALS AND METHODS In group control, the knee joint was not fixed. In group I-4w, the knee joint was only fixed for 4 weeks. In groups SR-1 w, SR-2 w, and SR-4 w, the knee joint was fixed for 4 weeks before the rabbits underwent 1, 2, and 4 weeks of self-recovery, respectively. In groups rESWT-1 w, rESWT 2 w, and rESWT-4 w, the knee joint was fixed for 4 weeks before the rabbits underwent 1, 2, and 4 weeks of rESWT, respectively. The myogenic contracture was measured, the cross-sectional area and key protein levels for NF-κB/HIF-1α signaling pathway and myogenic regulatory factors were evaluated. RESULTS During the recovery period, biological findings showed that the levels of myogenic contracture and muscle atrophy were milder in group rESWT by compared with group SR after 2 weeks. Molecular biological analysis showed that MyoD protein levels in the group rESWT was significantly higher than those in the group SR, and importantly, phospho-NF-κB p65 and HIF-1α protein levels in the group rESWT were significantly lower than those in the group SR at the same time point. CONCLUSIONS This is the first study demonstrated that rESWT has the potential to reduce myogenic contracture and muscle atrophy after long-term immobilization in animal model. It is a possible mechanism that changing the low oxygen environment in skeletal muscle through rESWT may inhibit activation of NF-κB/HIF-1α signaling pathway.
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Affiliation(s)
- Feng Wang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Wen Li
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Yun Zhou
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Peng Peng Huang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Quan Bing Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
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Liu AY, Zhang QB, Zhu HL, Xiong YW, Wang F, Huang PP, Xu QY, Zhong HZ, Wang H, Zhou Y. Low-frequency electrical stimulation alleviates immobilization-evoked disuse muscle atrophy by repressing autophagy in skeletal muscle of rabbits. BMC Musculoskelet Disord 2022; 23:398. [PMID: 35484550 PMCID: PMC9047266 DOI: 10.1186/s12891-022-05350-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study aimed to investigate the effect of low-frequency electrical stimulation (LFES) on disuse muscle atrophy and its mechanism in a rabbit model of knee extension contracture. METHODS This study involved two experiments. In the time-point experiment, 24 rabbits were randomly divided into 4 groups: Control 1 (Ctrl1 group), immobilization for 2 weeks (I-2 group), immobilization for 4 weeks (I-4 group), and immobilization for 6 weeks (I-6 group). In the intervention experiment, 24 rabbits were randomly divided into 4 groups: Control 2 (Ctrl2 group), electrical stimulation (ESG group), natural recovery (NRG group), and electrical stimulation treatment (ESTG group). All intervention effects were assessed by evaluating the knee joint range of motion (ROM), cross-sectional area (CSA) of the rectus femoris muscle, and expression of autophagy-related proteins. RESULTS The time-point experiment showed that immobilization reduced the knee ROM, reduced the rectus femoris muscle CSA, and activated autophagy in skeletal muscle. The levels of five autophagy-related proteins [mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), autophagy-related protein 7 (Atg7), p62, and microtubule-associated protein light chain 3B-II (LC3B-II)] were significantly elevated in the skeletal muscle of the I-4 group. The intervention experiment further showed that LFES significantly improved the immobilization-induced reductions in ROM and CSA. Additionally, LFES resulted in a significant decrease in the protein expression of mTOR, p-mTOR, Atg7, p62, and LC3B-II in the rectus femoris muscle. CONCLUSIONS LFES alleviates immobilization-evoked disuse muscle atrophy possibly by inhibiting autophagy in the skeletal muscle of rabbits.
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Affiliation(s)
- A-Ying Liu
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Quan-Bing Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Hua-Long Zhu
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, China.,Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Yong-Wei Xiong
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, China.,Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Feng Wang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Peng-Peng Huang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Qi-Yu Xu
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China
| | - Hua-Zhang Zhong
- Department of Orthopedics, The Second Hospital of Anhui Medical University, Hefei, China
| | - Hua Wang
- Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Hefei, China. .,Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China.
| | - Yun Zhou
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, No.678 Furong Road, Economic and Technological Development Zone, Hefei, 230601, China.
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12
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Electroacupuncture for Temporomandibular Disorders: A Systematic Review of Randomized Controlled Trials. Healthcare (Basel) 2021; 9:healthcare9111497. [PMID: 34828543 PMCID: PMC8624061 DOI: 10.3390/healthcare9111497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 12/02/2022] Open
Abstract
Although electroacupuncture (EA) is an effective treatment for pain relief, there has been no systematic review of EA treatment for temporomandibular disorder TMD. This systematic review aimed to evaluate the efficacy and safety of EA in TMD management. We searched 14 databases until April 2021 for randomized controlled trials (RCTs) evaluating the effects of EA on TMDs. Eleven RCTs with 667 patients that used three acupuncture points (ST6, ST7, and LI4) were included. Two RCTs reported significant effects of EA plus microwave treatment compared with EA treatment alone on the total effectiveness rate (TER) for TMD. Further, two studies reported that compared with ultrashort wave alone, EA plus ultrashort wave had a significant effect on the TER for TMD and visual analog scale. All RCTs did not report adverse events. Our findings demonstrated the positive potential of EA in TMD management. However, there was weak evidence regarding EA use for TMD management given the poor quality and small sample sizes of the included studies. In the future, well-designed RCTs are required. It is necessary to investigate clinical trials and systematic reviews to compare the effectiveness and safety of EA and acupuncture for TMD.
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Xu QY, Zhang QB, Zhou Y, Liu AY, Wang F. Preventive effect and possible mechanisms of ultrashort wave diathermy on myogenic contracture in a rabbit model. Sci Prog 2021; 104:368504211054992. [PMID: 34825614 PMCID: PMC10450593 DOI: 10.1177/00368504211054992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to determine the preventive effect of ultrashort wave diathermy on immobilization-induced myogenic contracture and to explore its underlying mechanisms. Forty-two rabbits were randomly assigned into control (Group C), immobilization (Group I, which was further divided into one week, Group I-1; two weeks, Group I-2; and four weeks, Group I-4, subgroups by the length of immobilization) and ultrashort wave prevention (Group U, which was further divided into one week, Group U-1; two weeks, Group U-2; and four weeks, Group U-4, by time of treatment) groups. Intervention effects were assessed by evaluating rectus femoris cross-sectional area (CSA), knee range of motion, and the protein levels for myogenic differentiation (MyoD) and muscle atrophy F-box (MAFbx-1) in the rectus femoris. Compared with those of Group C, in Groups I and U, total contracture, myogenic contracture, MyoD and MAFbx-1 levels were significantly elevated, and CSA was significantly smaller (p < 0.05). Compared with those of Group I at each time point, MyoD levels were significantly elevated, MAFbx-1 levels were significantly lower, CSA was significantly larger, and myogenic contracture was significantly alleviated in Group U (p < 0.05). In the early stages of contracture, ultrashort wave diathermy reduces muscle atrophy and delays the process of myogenic contracture during joint immobilization; the mechanism of this may be explained as increased expression of MyoD triggered by suppression of the MAFbx-1-mediated ubiquitin-proteasome pathway.
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Affiliation(s)
- Qi-Yu Xu
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Rehabilitation Medicine, Anhui No.2 Provincial People’s Hospital, Hefei, Anhui, China
| | - Quan-Bing Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yun Zhou
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - A-Ying Liu
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Feng Wang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
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14
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Effect of Radial Extracorporeal Shock Wave Combined With Ultrashort Wave Diathermy on Fibrosis and Contracture of Muscle. Am J Phys Med Rehabil 2020; 100:643-650. [DOI: 10.1097/phm.0000000000001599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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15
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Wang F, Zhang QB, Zhou Y, Liu AY, Huang PP, Liu Y. Effect of ultrashort wave treatment on joint dysfunction and muscle atrophy in a rabbit model of extending knee joint contracture: Enhanced expression of myogenic differentiation. Knee 2020; 27:795-802. [PMID: 32201041 DOI: 10.1016/j.knee.2020.02.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/01/2019] [Accepted: 02/05/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the effects of ultrashort wave treatment on joint dysfunction and muscle atrophy in a rabbit model of extending knee joint contracture. METHODS Forty rabbits were randomly divided into eight groups. In group C, the left knee joint was not fixed. In group I-8, the left knee joint was only fixed for eight weeks. In groups R-1, R-2, and R-4, the left knee joint was fixed for eight weeks before the rabbits underwent one, two, and four weeks of self-recovery, respectively. In groups T-1, T-2, and T-4, the left knee joint was fixed for eight weeks before the rabbits underwent one, two, and four weeks of ultrashort wave treatment, respectively. The degree of total contracture and myogenic contracture were measured, the cross-sectional area (CSA) and protein levels for myogenic differentiation (MyoD) of the rectus femoris were evaluated. RESULTS There was a tendency toward a reduced degree of total and myogenic contracture, and also a tendency toward an increased CSA of the rectus femoris and increased protein levels for MyoD after both self-recovery and ultrashort wave treatment. The ultrashort wave was more effective than self-recovery in reducing the total and myogenic contracture, and increasing the CSA and MyoD protein levels of the rectus femoris. CONCLUSIONS Ultrashort wave treatment may ameliorate joint dysfunction and muscle atrophy by upregulating the expression of MyoD protein in a rabbit model of extending knee joint contracture.
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Affiliation(s)
- Feng Wang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Quan Bing Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Yun Zhou
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China.
| | - A Ying Liu
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Peng Peng Huang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
| | - Yi Liu
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, China
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Wang F, Zhang QB, Zhou Y, Chen S, Huang PP, Liu Y, Xu YH. The mechanisms and treatments of muscular pathological changes in immobilization-induced joint contracture: A literature review. Chin J Traumatol 2019; 22:93-98. [PMID: 30928194 PMCID: PMC6488749 DOI: 10.1016/j.cjtee.2019.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 10/15/2018] [Accepted: 01/26/2019] [Indexed: 02/04/2023] Open
Abstract
The clinical treatment of joint contracture due to immobilization remains difficult. The pathological changes of muscle tissue caused by immobilization-induced joint contracture include disuse skeletal muscle atrophy and skeletal muscle tissue fibrosis. The proteolytic pathways involved in disuse muscle atrophy include the ubiquitin-proteasome-dependent pathway, caspase system pathway, matrix metalloproteinase pathway, Ca2+-dependent pathway and autophagy-lysosomal pathway. The important biological processes involved in skeletal muscle fibrosis include intermuscular connective tissue thickening caused by transforming growth factor-β1 and an anaerobic environment within the skeletal muscle leading to the induction of hypoxia-inducible factor-1α. This article reviews the progress made in understanding the pathological processes involved in immobilization-induced muscle contracture and the currently available treatments. Understanding the mechanisms involved in immobilization-induced contracture of muscle tissue should facilitate the development of more effective treatment measures for the different mechanisms in the future.
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Affiliation(s)
- Feng Wang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Quan-Bing Zhang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Yun Zhou
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, 230601, China,Corresponding author.
| | - Shuang Chen
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Peng-Peng Huang
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Yi Liu
- Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, Hefei, 230601, China
| | - Yuan-Hong Xu
- Department of Clinical Laboratory, The First Hospital of Anhui Medical University, Hefei, 230601, China
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