Mechanotherapy

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Mechanotherapy is a type of medical therapeutics in which treatment is given by manual or mechanical means. Mechanotherapy is a general term for physical therapy modalities that exploit mechanobiology principles for tissue rehabilitation and regeneration using the application of specific mechanical forces. The terms was defined in 1890 as “the employment of mechanical means for the cure of disease”. Mechanotherapy employs mechanotransduction to stimulate tissue repair and remodelling. [1]

Contents

History

The American College of Mechano-Therapy operated in Chicago between roughly 1905 and 1920. It was founded by William C. Schulze, an 1897 graduate of Rush Medical College and practicing MD licensed in Illinois, Minnesota, and Wisconsin. [2] Schulze was born in Germany in 1870. He incorporated the American College of Mechano-Therapy in 1907 and served as its president. Purporting to be the “largest eclectic school of drugless healing in the world,” the college offered a training course via correspondence. Though heavily criticized by the medical establishment, mechanical methods of healing nonetheless were increasingly popular in North America in the early part of the 20th century. [3]

The American College of Mechano-Therapy published several books, such as "Text-book of Osteopathy" (1910) or "Clinical Lectures on Mechano-therapy" (1915). [4] [5]

Exercise

Mechanotherapy is used as term for exercise prescription to promote healing and rehabilitation. [1] Mechanotherapy is a useful term for exercise which is prescribed for rehabilitation because tissue repair is driven by the physiological process of mechanotransduction.

Uses

Tendon

Tendon, as a tissue, is mechanoresponsive. Various academic studies show that tendons can respond well to controlled loading, post-injury. [6] [7] Loading of a tendon results in up regulation of insulin-like growth factor, [8] [9] in addition to other cytokines and growth factors. [10] This up regulation results in proliferation at the cellular level and remodelling of the tendon matrix.

Muscle

The clinical justification for the use of mechanotherapy in muscle injury is formed from initial animal studies. [11] Generally, a rest period is undertaken to allow stabilisation of scar tissue, which is followed by controlled loading.

Loading of muscle leads to up regulation of a number of load-induced pathways, including mechanogrowth factor (MGF). MGF expression results in activation of satellite cells and hypertrophy. [12] Loading in this setting can increase rate and completeness of regeneration, improve myotubule alignment, and minimise myotubule atrophy. [11]

Bone

One of the integral components of bone are osteocytes, which act as the primary mechanosensors. Evidence suggests that mechanotherapy can be useful in the rehabilitation of bone fractures. [13] Loading bone during rehabilitation can result in significantly increased strength and range of motion, compared with immobilized patients. [13]

Massage

Another related use of the term Mechanotherapy is the original term for therapeutic massage. It was developed as an independent branch of manual medicine in Sweden in the early 20th century. It quickly became popular in the U.S. and many chiropractic colleges in the U.S. in the first half of the 20th century also offered separate degree programs in mechanotherapy. Mechanotherapists received a Doctor of Mechanotherapy (DM) degree and were licensed to practice in many states and practiced in many more states without a license. A DM degree is a graduate professional degree that indicates proficiency in mechano- or massage therapy. Mechanotherapists do not claim to be physicians or to diagnose or treat diseases.

Related Research Articles

<span class="mw-page-title-main">Tendon</span> Type of tissue that connects muscle to bone

A tendon or sinew is a tough band of dense fibrous connective tissue that connects muscle to bone. It sends the mechanical forces of muscle contraction to the skeletal system, while withstanding tension.

<span class="mw-page-title-main">Rotator cuff</span> Group of muscles

The rotator cuff is a group of muscles and their tendons that act to stabilize the human shoulder and allow for its extensive range of motion. Of the seven scapulohumeral muscles, four make up the rotator cuff. The four muscles are:

<span class="mw-page-title-main">Tendinopathy</span> Inflammation of the tendon

Tendinopathy is a type of tendon disorder that results in pain, swelling, and impaired function. The pain is typically worse with movement. It most commonly occurs around the shoulder, elbow, wrist, hip, knee, or ankle.

<span class="mw-page-title-main">Achilles tendon</span> Tendon at the back of the lower leg

The Achilles tendon or heel cord, also known as the calcaneal tendon, is a tendon at the back of the lower leg, and is the thickest in the human body. It serves to attach the plantaris, gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone. These muscles, acting via the tendon, cause plantar flexion of the foot at the ankle joint, and flexion at the knee.

A sprain is a soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint and are important for joint stability and proprioception, which is the body's sense of limb position and movement. Sprains may be mild, moderate, or severe, with the latter two classes involving some degree of tearing of the ligament. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. An equivalent injury to a muscle or tendon is known as a strain.

<span class="mw-page-title-main">Tennis elbow</span> Condition in which the outer part of the elbow becomes sore and tender

Tennis elbow, also known as lateral epicondylitis is an enthesopathy of the origin of the extensor carpi radialis brevis on the lateral epicondyle. It causes pain and tenderness over the bony part of the lateral epicondyle. Symptoms range from mild tenderness to severe, persistent pain. The pain may also extend into the back of the forearm. It usually has a gradual onset, but it can seem sudden and be misinterpreted as an injury.

<span class="mw-page-title-main">Achilles tendinitis</span> Medical condition of the ankle and heel

Achilles tendinitis, also known as Achilles tendinopathy, is soreness of the Achilles tendon. It is accompanied by alterations in the tendon's structure and mechanical properties. The most common symptoms are pain and swelling around the back of the ankle. The pain is typically worse at the start of exercise and decreases thereafter. Stiffness of the ankle may also be present. Onset is generally gradual.

Manual therapy, or manipulative therapy, is a treatment primarily used by physical therapists and occupational therapists to treat musculoskeletal pain and disability. It mostly includes kneading and manipulation of muscles, joint mobilization and joint manipulation. It is also used by Rolfers, massage therapists, athletic trainers, osteopaths, and physicians.

<span class="mw-page-title-main">Spinal adjustment</span> Chiropractic technique

Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment. Despite anecdotal success, there is no scientific evidence that spinal adjustment is effective against disease.

<span class="mw-page-title-main">Achilles tendon rupture</span> Medical condition where the tendon at the back of the ankle breaks

Achilles tendon rupture is when the Achilles tendon, at the back of the ankle, breaks. Symptoms include the sudden onset of sharp pain in the heel. A snapping sound may be heard as the tendon breaks and walking becomes difficult.

<span class="mw-page-title-main">Patellar tendinitis</span> Human disease

Patellar tendinitis, also known as jumper's knee, is an overuse injury of the tendon that straightens the knee. Symptoms include pain in the front of the knee. Typically the pain and tenderness is at the lower part of the kneecap, though the upper part may also be affected. Generally there is no pain when the person is at rest. Complications may include patellar tendon rupture.

<span class="mw-page-title-main">Strain (injury)</span> Injury due to slight tearing of a muscle or tendon

A strain is an acute or chronic soft tissue injury that occurs to a muscle, tendon, or both. The equivalent injury to a ligament is a sprain. Generally, the muscle or tendon overstretches and partially tears, under more physical stress than it can withstand, often from a sudden increase in duration, intensity, or frequency of an activity. Strains most commonly occur in the foot, leg, or back. Immediate treatment typically used to include four steps abbreviated as R.I.C.E. before the role of inflammation was found to be helpful.

<span class="mw-page-title-main">Mechanotransduction</span> Conversion of mechanical stimulus of a cell into electrochemical activity

In cellular biology, mechanotransduction is any of various mechanisms by which cells convert mechanical stimulus into electrochemical activity. This form of sensory transduction is responsible for a number of senses and physiological processes in the body, including proprioception, touch, balance, and hearing. The basic mechanism of mechanotransduction involves converting mechanical signals into electrical or chemical signals.

Heat therapy, also called thermotherapy, is the use of heat in therapy, such as for pain relief and health. It can take the form of a hot cloth, hot water bottle, ultrasound, heating pad, hydrocollator packs, whirlpool baths, cordless FIR heat therapy wraps, and others. It can be beneficial to those with arthritis and stiff muscles and injuries to the deep tissue of the skin. Heat may be an effective self-care treatment for conditions like rheumatoid arthritis.

<span class="mw-page-title-main">Anterior cruciate ligament injury</span> Ligament injury near the knee

An anterior cruciate ligament injury occurs when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn. The most common injury is a complete tear. Symptoms include pain, an audible cracking sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours. In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged.

<span class="mw-page-title-main">Contracture</span> Permanent shortening of a muscle or joint

In pathology, a contracture is a shortening of muscles, tendons, skin, and nearby soft tissues that causes the joints to shorten and become very stiff, preventing normal movement. A contracture is usually permanent, but less commonly can be temporary, or resolve over time but reoccur later in life.

<span class="mw-page-title-main">RICE (medicine)</span> Medical acronym

RICE is a mnemonic acronym for the four elements of a treatment regimen that was once recommended for soft tissue injuries: rest, ice, compression, and elevation. It was considered a first-aid treatment rather than a cure and aimed to control inflammation. It was thought that the reduction in pain and swelling that occurred as a result of decreased inflammation helped with healing. The protocol was often used to treat sprains, strains, cuts, bruises, and other similar injuries. Ice has been used for injuries since at least the 1960s, in a case where a 12-year-old boy needed to have a limb reattached. The limb was preserved before surgery by using ice. As news of the successful operation spread, the use of ice to treat acute injuries became common.

Alternative veterinary medicine is the use of alternative medicine in the treatment of animals. Types alternative therapies used for veterinary treatments may include, but are not limited to, acupuncture, herbal medicine, homeopathy, ethnomedicine and chiropractic. The term includes many treatments that do not have enough evidence to support them being a standard method within many veterinary practices.

<span class="mw-page-title-main">Shoulder impingement syndrome</span> Medical condition

Shoulder impingement syndrome is a syndrome involving tendonitis of the rotator cuff muscles as they pass through the subacromial space, the passage beneath the acromion. It is particularly associated with tendonitis of the supraspinatus muscle. This can result in pain, weakness, and loss of movement at the shoulder.

Mechanobiology is an emerging field of science at the interface of biology, engineering, chemistry and physics. It focuses on how physical forces and changes in the mechanical properties of cells and tissues contribute to development, cell differentiation, physiology, and disease. Mechanical forces are experienced and may be interpreted to give biological responses in cells. The movement of joints, compressive loads on the cartilage and bone during exercise, and shear pressure on the blood vessel during blood circulation are all examples of mechanical forces in human tissues. A major challenge in the field is understanding mechanotransduction—the molecular mechanisms by which cells sense and respond to mechanical signals. While medicine has typically looked for the genetic and biochemical basis of disease, advances in mechanobiology suggest that changes in cell mechanics, extracellular matrix structure, or mechanotransduction may contribute to the development of many diseases, including atherosclerosis, fibrosis, asthma, osteoporosis, heart failure, and cancer. There is also a strong mechanical basis for many generalized medical disabilities, such as lower back pain, foot and postural injury, deformity, and irritable bowel syndrome.

References

  1. 1 2 Khan, K. M.; Scott, A. (2009-04-01). "Mechanotherapy: how physical therapists' prescription of exercise promotes tissue repair". British Journal of Sports Medicine. 43 (4): 247–252. doi:10.1136/bjsm.2008.054239. ISSN   1473-0480. PMC   2662433 . PMID   19244270.
  2. ↑ "William C. Schulze, M.D., D.C. (1870-1936): From Mail-Order Mechano-Therapists to Scholarship and Professionalism Among Drugless Physicians, by Joseph C. Keating, Jr., Ph.D., Professor Los Angeles College of Chiropractic, and William S. Rehm, D.C., Past President Association for the History of Chiropractic, 1995
  3. ↑ "American College of Mechano-Therapy Collection". McGill Library Archival Catalogue. Retrieved 2018-02-15.
  4. ↑ Mechano-Therapy, American College of (1910). Text-book of Osteopathy. American College of Mechano-Therapy.
  5. ↑ Clinical Lectures on Mechano-therapy. American College of Mechano-Therapy. 1915.
  6. ↑ Öhberg, L.; Lorentzon, R.; Alfredson, H. (2004-02-01). "Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up". British Journal of Sports Medicine. 38 (1): 8–11. doi:10.1136/bjsm.2001.000284. ISSN   1473-0480. PMC   1724744 . PMID   14751936.
  7. ↑ Boyer, Martin I.; Goldfarb, Charles A.; Gelberman, Richard H. (2005-06-01). "Recent progress in flexor tendon healing. The modulation of tendon healing with rehabilitation variables". Journal of Hand Therapy. 18 (2): 80–85, quiz 86. doi:10.1197/j.jht.2005.02.009. ISSN   0894-1130. PMID   15891963.
  8. ↑ Banes, A. J.; Tsuzaki, M.; Hu, P.; Brigman, B.; Brown, T.; Almekinders, L.; Lawrence, W. T.; Fischer, T. (1995-12-01). "PDGF-BB, IGF-I and mechanical load stimulate DNA synthesis in avian tendon fibroblasts in vitro". Journal of Biomechanics. 28 (12): 1505–1513. doi:10.1016/0021-9290(95)00098-4. ISSN   0021-9290. PMID   8666590.
  9. ↑ Scott, Alexander; Cook, Jill L.; Hart, David A.; Walker, David C.; Duronio, Vincent; Khan, Karim M. (2007-03-01). "Tenocyte responses to mechanical loading in vivo: a role for local insulin-like growth factor 1 signaling in early tendinosis in rats". Arthritis and Rheumatism. 56 (3): 871–881. doi:10.1002/art.22426. ISSN   0004-3591. PMID   17328060.
  10. ↑ Olesen, Jens L.; Heinemeier, Katja M.; Gemmer, Carsten; Kjaer, Michael; Flyvbjerg, Allan; Langberg, Henning (2007-01-01). "Exercise-dependent IGF-I, IGFBPs, and type I collagen changes in human peritendinous connective tissue determined by microdialysis". Journal of Applied Physiology. 102 (1): 214–220. doi:10.1152/japplphysiol.01205.2005. ISSN   8750-7587. PMID   16973813.
  11. 1 2 Järvinen, Tero A. H.; Järvinen, Teppo L. N.; Kääriäinen, Minna; Aärimaa, Ville; Vaittinen, Samuli; Kalimo, Hannu; Järvinen, Markku (2007-04-01). "Muscle injuries: optimising recovery". Best Practice & Research. Clinical Rheumatology. 21 (2): 317–331. doi:10.1016/j.berh.2006.12.004. ISSN   1521-6942. PMID   17512485.
  12. ↑ Goldspink, Geoffrey (2003-01-01). "Gene expression in muscle in response to exercise". Journal of Muscle Research and Cell Motility. 24 (2–3): 121–126. doi:10.1023/a:1026041228041. ISSN   0142-4319. PMID   14609023. S2CID   24520913.
  13. 1 2 Challis, Murray J.; Jull, Gwendolen J.; Stanton, Warwick R.; Welsh, Mark K. (2007-01-01). "Cyclic pneumatic soft-tissue compression enhances recovery following fracture of the distal radius: a randomised controlled trial". The Australian Journal of Physiotherapy. 53 (4): 247–252. doi: 10.1016/s0004-9514(07)70005-3 . ISSN   0004-9514. PMID   18047459.
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