Active exercise on immobilization-induced contractured rat knees develops arthrogenic joint contracture with pathological changes
Active exercise on immobilization-induced contractured rat knees develops arthrogenic joint contracture with pathological changes
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DOI：
10.1152/japplphysiol.00438.2017
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发表时间：
2018-02-01
影响因子：
3.3
通讯作者：
Yamaoka, Kaoru
中科院分区：
文献类型：
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作者：
Kaneguchi, Akinori;Ozawa, Junya;Yamaoka, Kaoru
本研究探讨了大鼠膝关节在屈曲位固定3周后，在再活动过程中跑步机行走对关节活动范围（ROM）和组织病理学的影响。固定器拆除后，大鼠被分为无干预（RM）组和一组被迫走在跑步机上每天12米/分钟60分钟（步行组）。在7天再活动期的第一天和最后一天，测量膝屈肌切开术前（m-ROM）和后（a-ROM）的被动膝伸展ROM，m-ROM主要反映肌源性因素，a-ROM反映关节源性因素。对膝关节进行组织学分析，并检测后关节囊中炎症或纤维化相关介质的基因表达。固定后建立m-ROM和a-ROM限制。与制动组相比，RM组和WALK组的m-ROM在再动员期后均显著增加。相反，与IM组相比，RM组和WALK组的a-ROM在再动员期后降低。重要的是，WALK组的a-ROM小于RM组。在1天和7天后，无干预的再动员诱导了后关节囊的炎症和纤维化反应。跑步机行走促进了这些反应，也增加了纤维化相关的TGF-β 1和胶原蛋白I型和III型基因的表达。制动后的自由活动改善了肌源性挛缩，关节源性挛缩恶化。跑步机行走通过放大炎症和纤维化反应进一步加重关节挛缩。因此，制动后立即积极锻炼可能不会改善制动引起的关节挛缩。新&值得注意的是在临床实践中，它被广泛接受，促进关节运动是有效地改善制动引起的关节挛缩。然而，主动运动是否能改善关节挛缩尚不清楚。在这项研究中，我们发现踏车行走进一步促进了再动员诱导的关节源性挛缩的进展。据我们所知，这是第一个研究表明，积极的运动对制动引起的关节挛缩没有有利的影响。
This study investigated the effects of treadmill walking during remobilization on range of motion (ROM) and histopathology in rat knee joints, which were immobilized for 3 wk in a flexed position. After fixator removal, rats were divided into a no-intervention (RM) group and a group forced to walk on a treadmill daily at 12 m/min for 60 min (WALK group). Passive knee extension ROMs were measured before (m-ROM) and after (a-ROM) knee flexor myotomy on the first and last day of a 7-day remobilization period, with m-ROM mainly reflecting myogenic factors and a-ROM reflecting arthrogenic factors. Knee joints were histologically analyzed and gene expression of inflammatory or fibrosis-related mediators in the posterior joint capsule were examined. m-ROM and a-ROM restrictions were established after immobilization. m-ROM significantly increased following the remobilization period both in RM and WALK groups compared with that of immobilized (IM) group. Conversely, a-ROM decreased following the remobilization period in both RM and WALK groups compared with that of IM group. Importantly, a-ROM was smaller in the WALK group than the RM group. Remobilization without intervention induced inflammatory and fibrotic reactions in the posterior joint capsule after 1 and 7 days. Treadmill walking promoted these reactions and also increased the expression of fibrosis-related TGF-beta 1 and collagen type I and III genes. While free movement after immobilization improved myogenic contracture, arthrogenic contracture worsened. Treadmill walking further aggravated arthrogenic contracture through amplified inflammatory and fibrotic reactions. Thus active exercise immediately after immobilization may not improve immobilization-induced joint contracture.NEW & NOTEWORTHY In clinical practice, it is widely accepted that facilitation of joint movements is effective in improving immobilization- induced joint contracture. However, whether active exercises improve arthrogenic contracture is not known. In this study, we revealed that treadmill walking further promoted remobilizationinduced progression of arthrogenic contracture. To our knowledge, this is the first study demonstrating no favorable effect of active exercise on immobilization-induced arthrogenic contracture.