Electrical Stimulation for Preventing Disuse Changes of Musculoskeletal System ; Role of Various Physical Modalities.

缺乏运动导致肌肉骨骼系统功能能力的降低（“废用改变”）。如果有一个补充，以其他生物物理方式代替减少的机械应力，这可能是一个很大的帮助，病人卧床休息或固定，以防止废用的变化。在此假设下，我们进行了一系列实验，以确定物理刺激方式（即电或低能级激光）是否可以减少动物模型中固定关节造成的挛缩量。近年来，电增强骨愈合的成功将其应用于骨以外的其他组织，以及修复过程以外的其他方面。评估和比较两组间固定引起的骨、软骨和软组织的变化。试样主要采用生物力学分析进行粘弹性分析。骨密度测定或组织形态测定等其他检查也被采用。结果很有希望，在实验样本和对照组之间有几个统计上显著的差异。然而，组织对这些刺激的反应差异很大，很难确定每个目标组织的最佳条件，需要进一步积累由固定和物理模式引起的组织反应的数据。除了这些动物实验外，我们还对对照临床试验中的电刺激进行了荟萃分析，以寻找支持性的临床证据。

Physical inactivity causes a reduction m functional ability ("disuse changes") of musculoskeletal system. If there is a supplement to substitute decreased mechanical stress with other biophysical modalities, it could be a great help for the patient under bed rest or immobilization to prevent disuse changes. Under this hypothesis we have performed a series of experiments in order to find wether stimulation of physical modality (i.e. electricity or low-1evel laser) could decrease the amount of joint contracture made by immobilization in animal model or not. Recent success of electrical enhancement for bone healing expands its application to other tissues than bone, and to other aspects than repair process.Immobilization-induced changes of bone and cartilage as well as soft tissues in the dissected knee joint were assessed and compared between the groups. The specimen were examined mainly using biomechanical analysis for viscoelastic properties. Other examinations with bone densitometry or histomorphometry were also used. The results were promising with several statistically significant differences between the experiment specimen and the controls. However the tissue responses to these stimulation varied widely and it was hard to identify an optimal condition for each target tissue, Further accumulation of data on tissue responses caused by immobilization and by physical modalities will be needed.Apart from these animal experiments, a meta-analysis on electrical stimulation in controlled clinical trials was also performed to find supportive clinical evidence.