Akai M, Usuba M, Sekiguchi H, Hong B, Iwashita K, Shirasaki Y
Department of Rehabilitation for Movement Functions, Research Institute, National Rehabilitation Center, Tokorozawa, Japan.
Prosthet Orthot Int. 2007 Jun;31(2):121-32. doi: 10.1080/03093640500495606.
The purpose of this study was to clarify the relationship between mechanical stress and tissue response of the contracted knee joint in rats and to propose a new design of contracture correction device for clinical use. Wistar rats were operated on to immobilize their knee joints with a procedure causing periarticular bleeding and were kept in flexed position for 40 days. At day 40, the immobilizing wire was removed, and after day 43, the contracted knee joint had been treated with tunable corrective devices secured by an external fixation method to the rear limb. These devices consisted of four types of motor-driving system which provided several different low-load and continuous stretch torques. Measuring the angle of maximum knee extension, its effectiveness was assessed comparing with a lower load and control group of natural recovery course. The device also had a cyclic joint movement within the acquired range of motion and an oval cam mechanism producing a small distraction force to the joint along its long axis. The results showed that an appropriate range of low-load continuous torque was more effective to correct joint contracture. On the basis of the animal experiment, a new computer-controlled, gas-driven contracture correction device was developed for clinical trial. It was concluded that mechanical application in a condition with low and continuous torque is a useful treatment for fixed joint contracture.
本研究的目的是阐明大鼠膝关节挛缩时机械应力与组织反应之间的关系，并提出一种用于临床的新型挛缩矫正装置设计。对Wistar大鼠进行手术，通过一种导致关节周围出血的程序固定其膝关节，并使其保持屈曲位40天。在第40天，移除固定钢丝，在第43天后，对挛缩的膝关节用通过外固定方法固定在后肢上的可调矫正装置进行治疗。这些装置由四种电机驱动系统组成，可提供几种不同的低负荷和持续拉伸扭矩。测量最大膝关节伸展角度，与低负荷自然恢复过程对照组相比评估其有效性。该装置还在获得的运动范围内进行关节循环运动，并具有一个椭圆形凸轮机构，沿关节长轴对关节产生一个小的牵张力。结果表明，适当范围的低负荷持续扭矩对矫正关节挛缩更有效。基于动物实验，开发了一种新型计算机控制、气体驱动的挛缩矫正装置用于临床试验。得出的结论是，在低负荷和持续扭矩条件下进行机械应用是治疗固定性关节挛缩的一种有效方法。
