Hamaue Yohei, Nakano Jiro, Sekino Yuki, Chuganji Sayaka, Sakamoto Junya, Yoshimura Toshiro, Okita Minoru, Origuchi Tomoki
Y. Hamaue, PT, MSc, Department of Locomotive Rehabilitation Science, Unit of Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, and Department of Rehabilitation, Juzenkai Hospital, Nagasaki, Japan.
J. Nakano, PT, PhD, Unit of Physical and Occupational Therapy, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan.
Phys Ther. 2015 Jul;95(7):1015-26. doi: 10.2522/ptj.20140137. Epub 2015 Feb 5.
Cast immobilization induces mechanical hypersensitivity, which disturbs rehabilitation. Although vibration therapy can reduce various types of pain, whether vibration reduces immobilization-induced hypersensitivity remains unclear.
The purpose of this study was to investigate the preventive and therapeutic effects of vibration therapy on immobilization-induced hypersensitivity.
The experimental design of the study involved conducting behavioral, histological, and immunohistochemical studies in model rats.
Thirty-five Wistar rats (8 weeks old, all male) were used. The right ankle joints of 30 rats were immobilized by plaster cast for 8 weeks, and 5 rats were used as controls. The immobilized rats were divided randomly into the following 3 groups: (1) immobilization-only group (Im, n=10); (2) vibration therapy group 1, for which vibration therapy was initiated immediately after the onset of immobilization (Im+Vib1, n=10); and (3) vibration therapy group 2, for which vibration therapy was initiated 4 weeks after the onset of immobilization (Im+Vib2, n=10). Vibration was applied to the hind paw. The mechanical hypersensitivity and epidermal thickness of the hind paw skin were measured. To investigate central sensitization, calcitonin gene-related peptide (CGRP) expression in the spinal cord and dorsal root ganglion (DRG) was analyzed.
Immobilization-induced hypersensitivity was inhibited in the Im+Vib1 group but not in the Im+Vib2 group. Central sensitization, which was indicated by increases in CGRP expression in the spinal cord and the size of the area of CGRP-positive neurons in the DRG, was inhibited in only the Im+Vib1 group. Epidermal thickness was not affected by vibration stimulation.
A limitation of this study is that the results were limited to an animal model and cannot be generalized to humans.
The data suggest that initiation of vibration therapy in the early phase of immobilization may inhibit the development of immobilization-induced hypersensitivity.
石膏固定会引发机械性超敏反应,干扰康复进程。尽管振动疗法可减轻多种类型的疼痛,但振动是否能减轻固定引起的超敏反应仍不明确。
本研究旨在探讨振动疗法对固定诱导的超敏反应的预防和治疗效果。
该研究的实验设计包括对模型大鼠进行行为学、组织学和免疫组化研究。
使用35只Wistar大鼠(8周龄,均为雄性)。30只大鼠的右踝关节用石膏固定8周,5只大鼠作为对照。将固定的大鼠随机分为以下3组:(1)单纯固定组(Im,n = 10);(2)振动疗法组1,在固定开始后立即开始振动疗法(Im + Vib1,n = 10);(3)振动疗法组2,在固定开始4周后开始振动疗法(Im + Vib2,n = 10)。对后爪施加振动。测量后爪皮肤的机械性超敏反应和表皮厚度。为研究中枢敏化,分析脊髓和背根神经节(DRG)中降钙素基因相关肽(CGRP)的表达。
Im + Vib1组中固定诱导的超敏反应受到抑制,但Im + Vib2组未受抑制。仅在Im + Vib1组中,脊髓中CGRP表达增加以及DRG中CGRP阳性神经元区域大小增加所表明的中枢敏化受到抑制。表皮厚度不受振动刺激影响。
本研究的一个局限性是结果仅限于动物模型,不能推广至人类。
数据表明在固定早期开始振动疗法可能会抑制固定诱导的超敏反应的发展。