Cao Thanh V, Hicks Michael R, Zein-Hammoud Manal, Standley Paul R
From the Department of Basic Medical Sciences at the University of Arizona College of Medicine in Phoenix (Mr Cao and Drs Zein-Hammoud and Standley) and the Department of Molecular and Cell Biology at Arizona State University in Tempe (Dr Hicks).
From the Department of Basic Medical Sciences at the University of Arizona College of Medicine in Phoenix (Mr Cao and Drs Zein-Hammoud and Standley) and the Department of Molecular and Cell Biology at Arizona State University in Tempe (Dr Hicks)
J Am Osteopath Assoc. 2015 Feb;115(2):72-82. doi: 10.7556/jaoa.2015.018.
Myofascial release (MFR) is one of the most commonly used manual manipulative treatments for patients with soft tissue injury. However, a paucity of basic science evidence has been published to support any particular mechanism that may contribute to reported clinical efficacies of MFR.
To investigate the effects of duration and magnitude of MFR strain on wound healing in bioengineered tendons (BETs) in vitro.
The BETs were cultured on a deformable matrix and then wounded with a steel cutting tip. Using vacuum pressure, they were then strained with a modeled MFR paradigm. The duration of MFR dose consisted of a slow-loading strain that stretched the BETs 6% beyond their resting length, held them for 0, 1, 2, 3, 4, or 5 minutes, and then slowly released them back to baseline. To assess the effects of MFR magnitude, the BETs were stretched to 0%, 3%, 6%, 9%, or 12% beyond resting length, held for 90 seconds, and then released back to baseline. Repeated measures of BET width and the wound's area, shape, and major and minor axes were quantified using microscopy over a 48-hour period.
An 11% and 12% reduction in BET width were observed in groups with a 9% (0.961 mm; P<.01) and 12% (0.952 mm; P<.05) strain, respectively. Reduction of the minor axis of the wound was unrelated to changes in BET width. In the 3% strain group, a statistically significant decrease (-40%; P<.05) in wound size was observed at 24 hours compared with 48 hours in the nonstrain, 6% strain, and 9% strain groups. Longer duration of MFR resulted in rapid decreases in wound size, which were observed as early as 3 hours after strain.
Wound healing is highly dependent on the duration and magnitude of MFR strain, with a lower magnitude and longer duration leading to the most improvement. The rapid change in wound area observed 3 hours after strain suggests that this phenomenon is likely a result of the modification of the existing matrix protein architecture. These data suggest that MFR's effect on the extracellular matrix can potentially promote wound healing.
肌筋膜释放术（MFR）是软组织损伤患者最常用的手动治疗方法之一。然而，目前发表的基础科学证据很少，无法支持任何可能有助于MFR报告临床疗效的特定机制。
研究MFR应变的持续时间和大小对体外生物工程肌腱（BET）伤口愈合的影响。
将BET培养在可变形基质上，然后用钢切割尖端造成损伤。然后使用真空压力，以模拟的MFR模式对其施加应变。MFR剂量的持续时间包括缓慢加载应变，将BET拉伸至超过其静止长度6%，保持0、1、2、3、4或5分钟，然后缓慢释放回基线。为了评估MFR大小的影响，将BET拉伸至超过静止长度0%、3%、6%、9%或12%，保持90秒，然后释放回基线。在48小时内，使用显微镜对BET宽度以及伤口的面积、形状和长短轴进行重复测量并量化。
在分别施加9%（0.961毫米；P<0.01）和12%（0.952毫米；P<0.05）应变的组中，观察到BET宽度分别减少了11%和12%。伤口短轴的减少与BET宽度的变化无关。在3%应变组中，与非应变组、6%应变组和9%应变组在48小时时相比，在24小时时观察到伤口大小有统计学显著下降（-40%；P<0.05）。MFR持续时间越长，伤口大小下降越快，早在应变后3小时就观察到了这种情况。
伤口愈合高度依赖于MFR应变的持续时间和大小，较小的大小和较长的持续时间导致的改善最大。应变后3小时观察到的伤口面积快速变化表明，这种现象可能是现有基质蛋白结构改变的结果。这些数据表明，MFR对细胞外基质的作用可能潜在地促进伤口愈合。
