The experimental study for the explication of mechanism and therapy on the joint contracture

关节挛缩机制及治疗阐明的实验研究

• 批准号: 12832036
• 负责人: OKITA Minoru
• 金额: $ 2.3万
• 依托单位: NAGASAKI UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12832036/
• 关键词: Contracture; Soleus muscle; Immobilization; Muscle fiber; Collagen fiber; Hyaluronan; Passine tension; 固定期間; 伸張運動

Study 1 : The experimental study for the explication of mechanism on the joint contractureImmobilization is often associated with a decrease in muscle elasticity. This condition is called muscle contracture, but the mechanism is not yet clear. We examined changes in ankle joint mobility, passive tension, sarcomere length, collagen fibril arrangement in the endomysium, and hyaluronic acid in muscular tissue 1, 2, 4, 8, and 12 weeks after immobilization of rat soleus muscles in shortened position. Ankle joint mobility decreased with the duration of immobilization. Passive tension on immobilized muscles had increased. Sarcomere length had shortened 1 week after immobilization, but did not show further change 2, 4, 8, and 12 weeks after immobilization. Collagen fibril arrangement in the endomysium 1 and 2 weeks after immobilization was longitudinal to the axis of the muscle fibers, whereas 4, 8, and 12 weeks after immobilization it was circumferential.Hyaluronic acid in muscular tissue had … More increased 1 week after immobilization but remained at the same level at weeks 2, 4, 8, and 12. Histochemically, hyaluronic acid in the endomysium of immobilized muscular tissue was stained more strongly and widely than that in the control tissue. Increased hyaluronic acid in muscular tissue may induce muscle stiffness, but the significance of how hyaluronic acid is related to the mechanism of muscle contracture was not clear. The findings suggest mat muscle contracture started 1 week after immobilization and increased with the length of immobilization. Consequently, muscle contracture is affected by the shortening muscle fibers during the early stage of immobilization, after which the collagen adapts by the fibril arrangement in the endomysium becoming more circumferential. This change in collagen fibril arrangement may cause advanced muscle contracture in the late stage of immobilization.Study 2 : The experimental study for the explication of therapy on the joint contracture1) To determine whether prolonged stretching is preventing for joint contracture in mice. It was found that progression of joint contracture can not be prevented in periods of stretch lasting 10 min, and can prevent in periods of stretch lasting 20 min or more. But the progression of joint contracture can not completely prevented in periods of stretch lasting 30 min.2) To determine whether prolonged stretching is ameliorating for disuse muscle atrophy in immobilized rat soleus muscles. Eighteen male Wistar rats were divided randomly into control (n=3) and immobilization (n=15) groups. The immobilization groups rats were immobilized on ankle joint for 4 weeks, animals were divided into three groups : immobilization alone (group I, n=3), stretch training for 30 min/day for 1or 3 weeks after remobilization (group S, n=6), and spontaneous recovery (non stretch training) for 1 or 3 weeks after remobilization (group NS, n=6). After 1 week of remobilization, muscle fiber diameters for type I fibers in group S had increased significantly compared with group NS. After 3 weeks of remobilization, muscle fiber diameters for types I and II fibers in group S had increased significantly compared with group NS. Our findings suggest that prolonged stretching induces recovery from disuse muscle atrophy after joint contracture. Less

研究1：关节收缩机制的实验研究：再活动常与肌肉弹性下降有关。这种情况被称为肌肉挛缩，但其机制尚不清楚。我们检测了大鼠比目鱼肌短位固定后1、2、4、8和12周踝关节活动度、被动张力、肌节长度、肌内膜胶原纤维排列和肌肉组织透明质酸的变化。踝关节活动度随固定时间的延长而降低。固定肌肉的被动张力增加。肌节长度在固定后1周缩短，但在固定后2、4、8和12周没有进一步的变化。固定后1、2周，肌内膜胶原纤维沿肌纤维轴向排列，而固定后4、8、12周，肌内膜胶原纤维沿肌纤维轴向排列。肌肉组织中的透明质酸在固定后1周增加，但在第2、4、8和12周保持相同水平。组织化学上，固定肌组织肌内膜的透明质酸染色比对照组织更强烈和广泛。肌肉组织中透明质酸的增加可能引起肌肉僵硬，但透明质酸与肌肉挛缩机制的关系尚不清楚。研究结果表明，垫肌挛缩开始于固定后1周，并随着固定时间的延长而增加。因此，在固定的早期，肌肉挛缩受到肌肉纤维缩短的影响，之后胶原通过肌内膜中的纤维排列变得更周向来适应。这种胶原纤维排列的改变可能在固定后期引起晚期肌肉挛缩。研究二：阐明关节挛缩治疗的实验研究1)确定长时间拉伸是否对小鼠关节挛缩有预防作用。结果发现，在拉伸时间为10 min时，不能阻止关节挛缩的进展，而在拉伸时间为20 min或更长时，可以阻止关节挛缩的进展。但持续30分钟的拉伸不能完全阻止关节挛缩的进展。2)确定延长拉伸是否能改善固定化大鼠比目鱼肌废用性肌萎缩。18只雄性Wistar大鼠随机分为对照组（n=3）和固定组（n=15）。固定组大鼠踝关节固定4周，将大鼠分为单纯固定组（I组，n=3）、活动后1 ~ 3周每天30分钟拉伸训练组（S组，n=6）、活动后1 ~ 3周自发恢复组（NS组，n=6）。再活动1周后，S组ⅰ型肌纤维直径较NS组显著增加。再活动3周后，S组ⅰ型和ⅱ型肌纤维直径较NS组显著增加。我们的研究结果表明，长时间的拉伸可以诱导关节挛缩后废用性肌肉萎缩的恢复。少

项目成果

佐伯 彩, 沖田 実, 吉村俊朗, 中野治郎: "弛緩位ならびに伸張位での固定がラットヒラメ筋におよぼす影響"理学療法学. 27巻. 63-68 (2000)

Aya Saeki、Minoru Okita、Toshiro Yoshimura、Jiro Nakano：“放松和拉伸位置固定对大鼠比目鱼肌的影响”物理治疗科学卷 27. 63-68 (2000)。

沖田 実, 吉村俊朗, 中野治郎, 佐伯 彩: "拘縮の病態とストレッチング"理学療法探求. 3巻. 29-36 (2000)

Minoru Okita、Toshiro Yoshimura、Jiro Nakano、Aya Saeki：“挛缩和拉伸的病理学”物理治疗研究卷 3. 29-36 (2000)。

Okita M: "Morphological canges in muscle fibers and myofascias on the joint contracture"Journal of the Japan Bobath Association. 23-1. 55-60 (2000)

Okita M：“关节挛缩中肌纤维和肌筋膜的形态变化”，日本 Bobath 协会杂志。

沖田 実: "踵歩きギプス療法-heel gait cast-(穐山富太郎編)第1章-II「拘縮の病態」を執筆"医歯薬出版. 174 (2002)

冲田稔：“足跟步态石膏治疗（秋山富太郎编辑）第 1-II 章“挛缩的病理学”撰写”石药出版社 174（2002 年）。

中田 彩, 沖田 実, 中居和代, 中野治郎, 他: "持続的伸張運動の実施時間の違いが関節拘縮の進行抑制効果におよぼす影響-マウスにおける実験的研究-"理学療法学. 29巻. 1-5 (2002)

Aya Nakata、Minoru Okita、Kazuyo Nakai、Jiro Nakano 等人：“不同持续时间的连续伸展运动对抑制关节挛缩进展的效果 - 小鼠实验研究 -”《物理治疗科学》，第 29 卷 .1-5。 (2002)