Mustaklem Basil, Loghmani Mary Terry, Waterfill Abigail K, Caron Mackenzie, Glore Daren A, Meyer Nathaniel R, Shelton Luke D, Day Elicza A, Marciano Carmela, Gepfert Addison, Wakefield Connor C, Brown Hailey, Street Sierra, Sasse Madeline M, Snyder Jacob, Hiland Taylor, Hum Julia M, Eland David C, Chu Tien-Min Gabe, Lowery Jonathan W
Wood College of Osteopathic Medicine, Marian University, Indianapolis, IN, USA.
Bone & Muscle Research Group, Marian University, Indianapolis, IN, USA.
J Osteopath Med. 2025 Mar 13. doi: 10.1515/jom-2024-0247.
Sarcopenia is a disease characterized by low muscle mass and function that places individuals at greater risk of disability, loss of independence, and death. Current therapies include addressing underlying performance issues, resistance training, and/or nutritional strategies. However, these approaches have significant limitations, and chronic inflammation associated with sarcopenia may blunt the anabolic response to exercise and nutrition. This presents an unmet need for treatment strategies that promote gains in muscle function. One such possibility is soft tissue manipulation (STM), which is a noninvasive, nonpharmacological mechanotherapy employed by osteopathic physicians, physiotherapists, and massage therapists, wherein soft tissues are subjected to mechanical forces delivered by hand or by an instrument. However, the molecular effects of STM in sarcopenia remain largely unknown.
In the present study, we utilized a rat model of sarcopenia due to disuse atrophy and examined the effects of STM on recovery of muscle mass and regulation of pro-/anti-inflammatory cytokines.
Ten-week-old male Brown Norway rats were subjected to 2-week hindlimb suspension (HLS) and then allowed to re-ambulate for 8 days with or without instrument-assisted soft tissue manipulation (IASTM) applied to the right hindlimb. Muscle weights were determined for treated and nontreated hindlimbs, and membrane-based cytokine arrays were performed on treated tissue and serum.
Following suspension, IASTM enhanced the effectiveness of re-ambulation (Re-A) on muscle mass recovery in both treated and contralateral limbs. This was associated with changes in numerous cytokines in treated skeletal muscle and sera. Several factors we observe to be regulated were also shown to be regulated by STM in other studies, including ciliary neurotrophic factor (CNTF), IL-1β, IL-2, IL-3, IL-13, ICAM-1, and tumor necrosis factor alpha (TNF-α), whereas others are reported for the first time.
Our study adds further support for the role of manual therapy in musculoskeletal health and details molecular-level effects in both target tissue and circulation. STM may hold promise for recovering muscle mass and function related in conditions of atrophy such as age-related sarcopenia.
肌肉减少症是一种以肌肉质量和功能低下为特征的疾病，会使个体面临更高的残疾、失去独立生活能力和死亡风险。目前的治疗方法包括解决潜在的身体机能问题、进行抗阻训练和/或采取营养策略。然而，这些方法存在显著局限性，与肌肉减少症相关的慢性炎症可能会削弱对运动和营养的合成代谢反应。这表明对于促进肌肉功能提升的治疗策略存在未满足的需求。一种可能性是软组织手法治疗（STM），这是一种由整骨医生、物理治疗师和按摩治疗师采用的非侵入性、非药物性机械疗法，通过手或器械对软组织施加机械力。然而，STM对肌肉减少症的分子影响在很大程度上仍不为人知。
在本研究中，我们利用废用性萎缩导致的肌肉减少症大鼠模型，研究了STM对肌肉质量恢复和促炎/抗炎细胞因子调节的影响。
将10周龄雄性挪威棕色大鼠进行2周的后肢悬吊（HLS），然后在右后肢接受或不接受器械辅助软组织手法治疗（IASTM）的情况下，让其重新行走8天。测定治疗和未治疗后肢的肌肉重量，并对治疗组织和血清进行基于膜的细胞因子阵列分析。
悬吊后，IASTM增强了重新行走（Re-A）对治疗侧和对侧肢体肌肉质量恢复的效果。这与治疗后的骨骼肌和血清中多种细胞因子的变化有关。我们观察到受调节的几个因子在其他研究中也显示受STM调节，包括睫状神经营养因子（CNTF）、白细胞介素-1β（IL-1β）、白细胞介素-2（IL-2）、白细胞介素-3（IL-3）、白细胞介素-13（IL-13）、细胞间黏附分子-1（ICAM-1）和肿瘤坏死因子-α（TNF-α），而其他一些因子则是首次报道。
我们的研究进一步支持了手法治疗在肌肉骨骼健康中的作用，并详细阐述了其在靶组织和循环中的分子水平影响。STM可能有望恢复与萎缩相关的肌肉质量和功能，如与年龄相关的肌肉减少症。
