European Fascia Research Project Report

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    The design and assembly of a system for electrostimulation and muscle mechanics measurement of fibres using a universal testing machine is presented here. Most of the elements used in the design are easy to procure, except for the force measurement machine; however, this machine is of common use in biomaterials laboratories. The designed device is versatile enough to adapt to almost any universal testing machine under low levels of load with high reliability and reproducibility. The proposed design is useful for scientists involved in muscle mechanics research, wishing to develop their own apparatus in a relatively economic and reliable way.
  • Article
    The purpose of this study is to provide better understanding of the mechanical response of the lumbodorsal fascia to dynamic and static traction loadings. Since the fascia shows a viscoelastic behaviour, tests in which time is a variable were used, namely hysteresis and stress relaxation. Load-strain and load-time curves obtained from the hysteresis and stress-relaxation tests point out three different phenomena. First, an increase in stiffness is noticed when ligaments are successively stretched, i.e. strains produced by successive and identical loads decrease. Second, if a sufficient resting period is allowed between loadings, stiffening is reversed and strains tend to recover initial values. The third phenomenon, observed in stress-relaxation tests as time progresses, is ligament contraction in stretched and isometrically held samples. This third phenomenon may be explained by the possibility that muscle fibres capable of contracting spontaneously could be present in lumbodorsal fascia ligaments.
    • J Staubesand
    Staubesand J et al 1997 La structure fine de l´aponévrose jambière. Phlébologie 50(1): 105-113
  • Singapore 18 Using a 6% tissue elongation over 15 minutes followed by rest, we got the following average weight changes (compared with the state before the stretch; n=21): at end of stretch: –11.8%; after 30 min. rest: -0.3%; after 1 hr
    • M-W Ho
    Ho M-W 1999 The rainbow and the worm -The physics of organisms. World Scientific Publ., Singapore 18 Using a 6% tissue elongation over 15 minutes followed by rest, we got the following average weight changes (compared with the state before the stretch; n=21): at end of stretch: –11.8%; after 30 min. rest: -0.3%; after 1 hr.: 0%; after 2 hrs.:+2.1%; after 3 hrs.: +3.6% 19 Ralphs JR et al. 2002 Actin stress fibres and cell-cell adhesion molecules in tendons. Matrix Biol 21 : 67-74
    • L Gaggini
    • M Beech
    Gaggini L, Beech M 1998 How Rolfing® produces change. Rolf Lines 26(5): 30-34
  • matrix regulation: basis for a holistic theory in medicine
    • A Pischinger
    Pischinger A 1991 Matrix & matrix regulation: basis for a holistic theory in medicine. Medicina Biologica, Brussels. 16 Oschman J 2003 Energy medicine in therapeutics and human performance. Butterworth-Heinemann/Elsevier, Amsterdam 17
  • Article
    Of 935 consecutive patients referred with shoulder pain, 50 fitted the criteria for primary frozen shoulder. Twelve patients who failed to improve after conservative treatment and manipulation had excision of the coracohumeral ligament and the rotator interval of the capsule. The specimens were examined histologically, using special stains for collagen. Immunocytochemistry was performed with monoclonal antibodies against leucocyte common antigen (LCA, CD45) and a macrophage/synovial antigen (PGMI, CD68) to assess the inflammatory component, and vimentin and smooth-muscle actin to evaluate fibroblasts and myofibroblasts. Our histological and immunocytochemical findings show that the pathological process is active fibroblastic proliferation, accompanied by some transformation to a smooth muscle phenotype (myofibroblasts). The fibroblasts lay down collagen which appears as a thick nodular band or fleshy mass. These appearances are very similar to those in Dupuytren's disease of the hand, with no inflammation and no synovial involvement. The contracture acts as a check-rein against external rotation, causing loss of both active and passive movement.
  • Article
    Human tissue specimens were examined for the presence of neural end-organs under light and electron microscopy. To define the innervation of the thoracolumbar fascia in problem back pain patients who have articular abnormality defined through pain-provocation discography or facet blocks. Previous investigators have defined the presence of innervation in control (no back pain) tissue specimens. Tissue specimens were harvested during surgery from 24 back pain patients who had not undergone previous lumbar surgery. Specimens were fixed immediately in the operating room and later processed and studied under light and electron microscopy. Structural and ultrastructural studies failed to identify specific neural end-organs in any of the specimens. Serendipidously, microscopic changes suggestive of ischemia or inflammation in this tissue were found. These findings suggest that the thoracolumbar fascia may be deficiently innervated in problem back pain patients.
    • Chaitow
    Chaitow L 2004 Signposts (Editorial), Journal of Bodywork and Movement Therapies 8(2):77-79
  • Article
    The anterior cruciate ligament is a complex tissue composed of structural proteins, proteoglycans, and cells. The histology of the human anterior cruciate ligament is characterized by the specific distribution and density of the fibroblast phenotype as well as by the unique organization of the structural proteins. A notable finding of this study was the identification of three histologically different zones along the anteromedial bundle as it coursed from the femoral to the tibial attachment. Two of the zones, the fusiform and ovoid, were located in the proximal one-quarter of the bundle; the third zone, the spheroid, occupied the distal three quarters of the bundle fascicles. The fusiform cell zone was characterized by a high number density of longitudinally oriented cells with a fusiform-shaped nucleus, longitudinal blood vessels, and high crimp length. The cytoplasm of the cells in this zone appeared to be intimately attached to the extracellular collagen and followed the crimp waveform of the fibers. Fusiform cells were noted to stain positively for the alpha-smooth muscle actin isoform in this region, particularly at areas of crimp disruption. The ovoid cell zone was characterized by a high number density of cells with an ovoid-shaped nucleus, longitudinal vessels, and a high crimp length. In this zone as well, the cytoplasm of the cells appeared to follow the waveform of the adjacent collagen. Ovoid cells were noted to stain positively for the alpha-smooth muscle actin isoform in this region. The spheroid cell zone was characterized by a low density of spheroid cells, few blood vessels, and short crimp length. Cells were noted within and among fascicles, as well as within lacunae. In selected areas, as many as 50% of the cells in this region stained positively for the alpha-smooth muscle actin isoform. This is also the first report of cells expressing the alpha-smooth muscle actin isoform in the intact human anterior cruciate ligament. This specific type of contractile actin, initially identified only in smooth-muscle cells, pericytes, and myofibroblasts, was seen in cells with various morphologies and predominantly in cells located at areas of crimp disruption. Further work is necessary to elucidate the role of the various fibroblast phenotypes in the maintenance of the human anterior cruciate ligament.
  • Article
    Balance performance in unstable sitting and trunk muscle response to quick force release were measured in 16 patients with chronic low back pain and 14 matched healthy control subjects. To determine whether patients with low back pain will exhibit poorer postural control, which will be associated with longer average muscle response times. Larger postural sway during standing and delayed trunk muscle response times for patients with low back pain have been reported in several independent studies. Unstable sitting test was accomplished by attaching different sized hemispheres to the bottom of a seat. Subjects performed trials with eyes open and closed while the displacements of the center of pressure were measured with a force plate underneath the seat. Response to a quick force release was recorded from 12 major trunk muscles with surface electromyography. Subjects performed isometric trunk exertions in a semi-seated position when the resisted force was suddenly released with an electromagnet. Average muscle response times and balance performance were correlated using a linear regression analysis. Patients with low back pain demonstrated poorer balance performance than healthy control volunteers, especially at the most difficult levels. Patients also had delayed muscle response times to quick force release. Average muscle onset times together with age and weight correlated significantly with balance performance with closed eyes (R(2) = 0.46), but not with eyes opened (R(2) = 0.18). Patients with chronic low back pain demonstrated poorer postural control of the lumbar spine and longer trunk muscle response times than healthy control volunteers. Correlation between these two phenomena suggests a common underlying pathology in the lumbar spine.
  • Article
    The expression of the gene for a muscle actin in certain nonmuscle cells and the contraction of these connective tissue cells has been associated with several important physiological and pathological processes; the contraction of healing skin wounds and the contracture in Dupuytren's disease being two notable examples. Studies in recent years have shown that a much wider variety of connective tissue cells than previously considered, including cells in many of the musculoskeletal tissues, e.g., chondrocytes and osteoblasts, can express the gene for alpha-smooth muscle actin and can display contractile behavior. These findings suggest that muscle actin-enabled cell contraction may also be playing important roles in the other connective tissues comprising the musculoskeletal system, namely, tendon, ligament, meniscus, intervertebral disc, articular cartilage, and bone.
  • Article
    The myofibroblast has been shown to have a key role in tissue reconstruction after injury and pathological changes characterized by fibrosis. Force generation by the myofibroblast depends on the isometric contraction of stress fibers containing alpha-smooth muscle actin, and is mediated through Rho/Rho-kinase. The force is transmitted by vinculin and tensin-containing "supermature" focal adhesions, which connect stress fibers with the extracellular matrix. Force production and transmission by the myofibroblast are modulated by the coordinated action of cytokines, extracellular matrix components and mechanical tension. Regulation of these phenomena will be important for therapeutic strategies aimed at influencing fibrocontractive diseases.
  • Article
    Whereas several studies reported a close relationship between changes in the somatotopic organization of primary somatosensory cortex and phantom limb pain, the relationship between alterations in the motor cortex and amputation-related phenomena has not yet been explored in detail. This study used steady-state movement-related cortical potentials (MRCPs) combined with neuroelectric source imaging to assess the relationship of changes in motor cortex and amputation-related phenomena such as painful and non-painful phantom and residual limb sensations, telescoping, and prosthesis use. Eight upper limb amputees were investigated. A significant positive relationship between reorganization of the motor cortex (distance of the MRCP source location from the mirrored source for hand movement) and phantom limb pain was found. Non-painful phantom sensations as well as painful and non-painful residual limb sensations were unrelated to motor cortical reorganization. A higher amount of motor reorganization was associated with less daily prosthesis use, which also tended to be related to more severe phantom limb pain. These results extend previous findings of a positive relationship between somatosensory reorganization and phantom limb pain to the motor domain and suggest a potential positive effect of prosthesis use on phantom limb pain and cortical reorganization.
  • The current understanding of mechanisms of tinnitus generation is continuing to advance. This review is intended to outline new knowledge in the areas of neuroanatomy, physiology, psychophysics, and brain imaging that are revealing novel mechanisms of tinnitus development. Advances in these areas will open new avenues for effective treatment of tinnitus. Application of high-pulse train electrical stimulation to the cochlea may be effective in restoring the normal pattern of spontaneous activity from the periphery that is interpreted by the auditory brainstem as coding for silence. Clinical and laboratory evidence for a significant interaction between the somatosensory and auditory systems has important implications for understanding and treating tinnitus. Application of principles of neuroplasticity and novel imaging techniques has expanded our understanding of tinnitus through analogous approaches to phantom limb pain. Finally, a novel receptor type recently located in auditory neurovascular structures has opened a new field of study of inflammatory mechanisms contributing to tinnitus. Our understanding of the mechanisms that lead to a phantom auditory perception, and the associated debilitating consequences of this sensory experience, is continuing to improve. Tinnitus appears to be significantly affected in complex ways by somatosensory, limbic, and motor influences. Effective treatments will certainly emerge from these new areas of research.