RESUMO
Quadriceps contracture is a condition where the muscle-tendon unit is abnormally shortened. The treatment prognosis is guarded to poor depending on the progress of the disease. To improve the prognosis, we investigated the effectiveness of therapeutic ultrasound and NMES in treating quadriceps contracture in an immobilized rat model. Thirty-six Wistar rats were randomized into control, immobilization alone, immobilization and spontaneous recovery, immobilization and therapeutic ultrasound, immobilization and NMES, and immobilization and therapeutic ultrasound and NMES combination groups. The continuous therapeutic ultrasound (frequency, 3 MHz, intensity 1 W/cm2) and NMES (TENS mode, frequency 50 Hz; intensity 5.0 ± 0.8 mA) were performed on the quadriceps muscle. On Day 15, immobilization-induced quadriceps contracture resulted in a decreased ROM of the stifle joint, reduction in the sarcomere length, muscle atrophy, and muscle fibrosis. On Day 43, therapeutic ultrasound, NMES, and combining both methods improved muscle atrophy and shortening and decreased collagen type I and III and α-SMA protein. The combination of therapeutic ultrasound and NMES significantly reduced the mRNA expression of IL-1ß, TGF-ß1, and HIF-1α and increased TGF-ß3. Therefore, the combination of therapeutic ultrasound and NMES is the most potent rehabilitation program for treating quadriceps contracture.
RESUMO
Quadriceps contracture is an abnormal pathological shortening of the muscle-tendon unit. To improve the prognosis of quadriceps contracture, improvement of its diagnostic method is needed. In this study, we evaluated the diagnostic utility of ultrasound shear wave elastography in a rat model of quadriceps contracture induced by immobilization. Fifty Wistar rats were randomly divided into control and immobilization groups. During up to 4 weeks of joint immobilization, the quadriceps elastic modulus, muscle hardness, creatinine phosphokinase levels, joint range of motion, histopathologic parameters, and levels of fibrosis-associated mRNA expression were measured every week in the immobilization and control groups and compared. In the immobilization group, the elastic modulus gradually but significantly increased (p < 0.05) throughout the immobilization period. However, muscle hardness and serum creatinine phosphokinase levels only increased at 1 and 2 weeks after the start of immobilization, respectively. Muscle atrophy and shortening progressed throughout the immobilization group. Collagen type I and III, α-SMA protein, and mRNA expression of IL-1ß and TGF-ß1 significantly increased (p < 0.05) throughout in the immobilization group. Ultrasound shear wave elastography is the most useful method for clinical assessment of muscle contracture.
RESUMO
Muscle contracture is an abnormal pathologic process resulting in fibrosis and muscle atrophy, which can lead to limitation of joint motion. To establish a diagnostic method to detect muscle contracture and a method to control its progression, we investigated an appropriate method to create an animal model of quadriceps contracture using rats. Eighteen Wistar rats were divided into three groups, and bilateral hindlimbs were immobilized with either a cast (Group I), a Velcro hook-and-loop fastener (Group V), or steel wire (Group S) with the knee and ankle joints in extension position for two weeks. Five rats in a control group (Group C) were not immobilized. After two weeks, the progression of quadriceps contracture was assessed by measuring the range of joint motion and pathohistological changes. Muscle atrophy and fibrosis were observed in all immobilization groups. The knee joint range of motion, quadriceps muscle weight, and muscle fiber size decreased only in Group S compared to the other immobilization groups. Stress on rats due to immobilization was less in Group S. These results indicate that Group S is the superior quadriceps contracture model. This model aids research investigating diagnostic and therapeutic methods for muscle contracture in humans and animals.
