Department of Rehabilitation Medicine, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
Graduate School, Medical School of Chinese PLA, Beijing, China.
Phys Ther. 2022 May 5;102(5). doi: 10.1093/ptj/pzab300.
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.
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.
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.
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.
本研究旨在探讨不同时长的静态渐进性拉伸(SPS)对创伤后膝关节挛缩的影响,包括关节活动度(ROM)、步态分析、肌成纤维细胞增殖和胶原调节。
建立创伤后膝关节挛缩模型,雄性 Wistar 大鼠随机分为 20 分钟 SPS 治疗组、30 分钟 SPS 治疗组(S30)、40 分钟 SPS 治疗组、未治疗组、固定组和对照组。在治疗干预的第 1、2、4 周,测量和比较关节 ROM 和步态。用苏木精和伊红及 Masson 三色染色的膝关节标本观察病理结构的变化。用关节囊后部胶原密度和细胞计数评估关节囊纤维化和炎症。用免疫组织化学法检测 I 型胶原和α-平滑肌肌动蛋白的表达。
S30 组改善最明显;ROM、站立时间、平均强度、印迹面积和步长分别为 115(SD=5)度、0.423(SD=0.074)秒、156.020(SD=7.952)、2.116(SD=0.078)cm2 和 11.758(SD=0.548)cm。与其他组相比,S30 组肌成纤维细胞、成纤维细胞和炎症细胞数量减少,胶原增殖显著受到抑制。
S30 显著改善了创伤后大鼠膝关节挛缩,降低了 I 型胶原和α-平滑肌肌动蛋白的表达,减少了肌成纤维细胞和炎症细胞的数量,抑制了关节囊的纤维化和炎症变化,增加了关节活动度。本研究为创伤后膝关节挛缩的最佳标准治疗方法提供了基础证据,可能对人类具有重要意义。