To examine the effect of the posture of immobilization upon the tensile properties in injured Achilles tendon of rat for an initial period of immobilization.
Forty-two Sprague-Dawley rats were used in the present study. Eighteen rats received a total tenotomy of the right Achilles tendon to mimic total rupture and were divided into three groups comprising of 6 rats each. Ankles of group A were immobilized at 60° of plantarflexion. Ankles of group B were immobilized at neutral position. Whereas, those of group C were immobilized at 60° of dorsiflexion. Other 18 rats received hemitenotomy to mimic partial rupture and were divided into three groups. The remaining 6 rats were kept free as control. After 14 days, we dissected the tendons and analyzed maximum force, stiffness, and energy uptake during pulling of the tendons until they ruptured. The tendons of 6 rats in each group and control were reserved for histology. Picrosirius staining was done for the analysis of collagen organization.
In total tenotomy, tensile properties were significantly different between the control and the intervention groups (p<0.05). Group C showed relatively higher values than the groups A and B with respect to tensile properties (p>0.05). In partial tenotomy, tensile properties were significantly different between the control and the intervention groups (p<0.05). Group C showed significantly higher value than other intervention groups in terms of maximum force and energy uptake (p<0.05). The semiquantitative histologic grading scores were assigned for collagen organization. The scores for dorsiflexion posture were higher than the ones for plantarflexion.
Dorsiflexion posture in partial ruptured Achilles tendon showed better functional recovery than other immobilized postures. In total ruptured case, the tensile properties showed increasing tendency in dorsiflexion posture.
Citations
Objective: To evaluate the effects of local triamcinolone (TAC) injection and weight bearing on healing process of the injured Achilles tendon.
Method: The right Achilles tendons in 54 rats, Sprague- Dawley (about 200 g), were each sutured after transection and allocated into three groups according to the amount of the local injection of TAC (none, 0.25 mg, and 1.25 mg respectively), and subsequently each group divided into three subgroups by the type of weight bearing {normal weight bearing (NWB), treadmill exercise (7∼8 m/min, 10 min/day) from day 7 for 7 days, and hind limb immobilization respectively}. On 15th day rats were sacrificed, and then diameters of both injured and uninjured tendon, numbers of fibroblasts on injured tissues and
the percentage of matured fibroblasts by microscopy were evaluated.
Results: The diameter of the hypertrophied neotendon in groups injected with TAC 1.25 mg was significantly decreased, but not in the others. There were no differences in numbers of fibroblast. As the amount of TAC increased in groups done with NWB and treadmill exercise, the percentages of matured fibroblasts significantly decreased.
Conclusion: The local TAC injection on acute tendon injuries had deleterious effects on healing process of tendon, and follow- up study about the types of weight bearing is needed. (J Korean Acad Rehab Med 2002; 26: 215-222)
Objective: The aims of this study were to know the effects of long time bed immobilization on the heart rate variability and to know the correlation between the heart rate variability and other anthropometric parameters.
Method: The subjects of this study were 60 normal sedentary persons as control group and 22 patients who had been immobilized for a long time because of musculoskeletal problems without any systemic diseases. The heart rate variabilities were measured through the R-R interval variation at rest, deep breathing and valsalva maneuver. These values were compared between control and patient group and were analysed for correlation with age, weight, height, body mass index (BMI), amounts of smoking (pack years), spans of immobilization and physical activity scale (PAS).
Results: The mean heart rate variability of patients were 0.132⁑0.072, 0.216⁑0.109, and 0.289⁑0.171 in rest, deep breathing and valsalva maneuver respectively which were lower than the corresponding 0.176⁑0.085, 0.314⁑0.146, and 0.322⁑0.174 of normal control group. The heart rate variabilities were negatively correlated with age, BMI and amounts of smoking but positively correlated with the height. The physical activity scale of preimmobilization state was negatively correlated with resting heart rate variability but was positively correlated with heart rate variability during deep breathing and valsalva maneuvering state.
Conclusion: The long bed immobilization significantly decreased the heart rate variability and the heart rate variability could be used as a useful tool to measure the effects of immobilization on the heart.
Objective: To investigate the functional facilitation effect on an affected side of spastic hemiplegic cerebral palsy by immobilizing the intact side with a cast.
Method: Five hemiplegic cerebral palsies, who had been treated by general rehabilitation therapy during previous 6 months and showed no functional improvement were studied. Their intact arms were immobilized by scotch short arm casts for 6 weeks. And, the therapeatic effects of this method were evaluated by the Box and Block Test of manual dexterity, Erhardt Developmental Prehension Assesment and Brain Perfusion SPECT.
Results: 1. Box and Block test: Before the cast immobilization method, hemiplegic cerebral palsies could transfer a mean of 5.4⁑3.36 cubic rods from one to the other side, and after the treatment a mean of 8.0⁑1.41 cubic rods with the affected arm.
2. Erhardt Developmental Prehension Assesment: Before the treatment, the grasp motion of round rod, cubic rod, and button suited in a mean of 5.1⁑3.0 months, and after the treatment, suited in a mean of 8.2⁑0.66 months.
3. Brain Perfusion SPECTs did not change before and after the cast immobilization method.
4. There was no adverse effect resulting from the cast immobilization method on an intact side.
Conclusion: We concluded that the cast immobilization method on an intact side could be a new beneficial rehabilitation method for the treatment of spastic hemiplegic cerebral palsies.
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