器械辅助的交叉纤维按摩可加速膝关节韧带愈合。

Instrument-assisted cross-fiber massage accelerates knee ligament healing.

作者信息

Loghmani M Terry, Warden Stuart J

机构信息

Departmento of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA.

出版信息

J Orthop Sports Phys Ther. 2009 Jul;39(7):506-14. doi: 10.2519/jospt.2009.2997.

DOI:10.2519/jospt.2009.2997

PMID:19574659

Abstract

STUDY DESIGN

Controlled laboratory study.

OBJECTIVES

To investigate the effects of instrument-assisted cross-fiber massage (IACFM) on tissue-level healing of knee medial collateral ligament (MCL) injuries.

BACKGROUND

Ligament injuries are common and significant clinical problems for which there are few established interventions. IACFM represents an intervention that may mediate tissue-level healing following ligament injury.

METHODS

Bilateral knee MCL injuries were created in 51 rodents, while 7 rodents were maintained as ligament-intact, control animals. IACFM was commenced 1 week following injury and introduced 3 sessions per week for 1 minute per session. IACFM was introduced unilaterally (IACFM-treated), with the contralateral, injured MCL serving as an internal control (nontreated). Thirty-one injured animals received 9 ACFM treatments, while the remaining 20 injured animals received 30 treatments. Ligament biomechanical properties and morphology were assessed at either 4 or 12 weeks postinjury.

RESULTS

IACFM-treated ligaments were 43.1% stronger (P<.05), 39.7% stiffer (P<.01), and could absorb 57.1% more energy before failure (P<.05) than contralateral, injured, nontreated ligaments at 4 weeks postinjury. On histological and scanning electron microscopy assessment, IACFM-treated ligaments appeared to have improved collagen fiber bundle formation and orientation within the scar region than nontreated ligaments. There were minimal differences between IACFM-treated and contralateral, nontreated ligaments at 12 weeks postinjury, although IACFM-treated ligaments were 15.4% stiffer (P<.05).

CONCLUSION

IACFM-accelerated ligament healing, possibly via favorable effects on collagen formation and organization, but had minimal effect on the final outcome of healing. These findings are clinically interesting, as there are few established interventions for ligament injuries, and IACFM is a simple and practical therapy technique. J Orthop Sports Phys Ther 2009;39(7):506-514, Epub 24 February 2009. doi:10.2519/jospt.2009.2997.

摘要

研究设计

对照实验室研究。

目的

探讨器械辅助交叉纤维按摩（IACFM）对膝关节内侧副韧带（MCL）损伤组织水平愈合的影响。

背景

韧带损伤是常见且严重的临床问题，针对此类问题的既定干预措施较少。IACFM是一种可能介导韧带损伤后组织水平愈合的干预措施。

方法

在51只啮齿动物身上制造双侧膝关节MCL损伤，同时将7只啮齿动物作为韧带完整的对照动物。损伤后1周开始进行IACFM，每周进行3次，每次1分钟。IACFM单侧进行（IACFM治疗组），对侧受伤的MCL作为内部对照（未治疗组）。31只受伤动物接受9次ACFM治疗，其余20只受伤动物接受30次治疗。在损伤后4周或12周评估韧带的生物力学特性和形态。

结果

在损伤后4周，IACFM治疗的韧带比同侧受伤未治疗的韧带强度高43.1%（P<0.05），刚度高39.7%（P<0.01），在断裂前能多吸收57.1%的能量（P<0.05）。在组织学和扫描电子显微镜评估中，IACFM治疗的韧带在瘢痕区域内的胶原纤维束形成和排列似乎比未治疗的韧带有所改善。在损伤后12周，IACFM治疗的韧带与同侧未治疗的韧带之间差异最小，尽管IACFM治疗的韧带刚度高15.4%（P<0.05）。

结论

IACFM可能通过对胶原形成和组织的有利作用加速韧带愈合，但对愈合的最终结果影响最小。这些发现具有临床意义，因为针对韧带损伤的既定干预措施较少，而IACFM是一种简单实用的治疗技术。《矫形与运动物理治疗杂志》2009年；39(7):506 - 514，2009年2月24日在线发表。doi:10.2519/jospt.2009.2997 。