Complex mechanisms of chronic pain in knee osteoarthritis identified by neuroimaging technology / 生理学报

Chronic pain of knee osteoarthritis (KOA) greatly affects the quality of life and functional activities of patients. It is important to clarify the underlying mechanisms of KOA pain and the analgesic effect of different therapies. Neuroimaging technology has been widely used in the basic and clinical research of pain. In the recent years, neuroimaging technology has played an important role in the basic and clinical research of KOA pain. Increasing evidence demonstrates that chronic pain in KOA includes both nociceptive and neuropathic pain. The neuropathic mechanism involved in KOA pain is complex, which may be caused by peripheral or central sensitization. In this paper, we review the regional changes of brain pathophysiology caused by KOA pain based on magnetic resonance imaging (MRI), electroencephalogram (EEG), magnetoencephalogram (MEG), near-infrared spectroscopy (NIRS) and other neuroimaging techniques. We also discuss the central analgesic mechanism of different KOA therapies, with a focus on the latest achievements in the evaluation and prediction of pain. We hope to provide new thoughts for the treatment of KOA pain, especially in the early and middle stages of KOA.

Effects of manual loading on calcitonin gene-related peptide and nerve growth factor in rats with chronic low back pain / 中国骨伤

OBJECTIVE@#To observe the analgesic effect of manipulation loading on chronic low back pain (CLBP) model rats and the expression of inflammatory factors in psoas major muscle tissue, and to explore the improvement of manipulation on local inflammatory microenvironment.@*METHODS@#Thirty two SPF male SD rats weighing 340-360g were randomly divided into blank group, sham operation group, chronic low back pain model group and treatment group, with 8 rats in each group. In the model group, L@*RESULTS@#There was no significant difference in PWT and PWL between the blank group and the sham operation group after modeling (@*CONCLUSION@#Local massage loading has analgesic effect on CLBP rats, at the same time, it can inhibit the content of CGRP and NGF in psoas muscle tissue of CLBP rats, and improve the local inflammatory microenvironment.

Mechanical properties of cervical spine manipulation with fine adjustment / 医用生物力学

Objective To analyze mechanical properties of cervical spine manipulation with fine adjustment, so as to provide mechanical data for popularization of such manipulation in clinic. Methods The founder, a skilled practitioner and a beginner of fine-adjusting manipulation operated the spinal fine-adjusting manipulation on two cervical vertebral segments of healthy subjects, respectively. The force data of thumbs were collected by FingerTPS Wireless System to analyze force differences between two thumbs while the force of right thumb was in its peak value, as well as regular pattern of the thumb force in relation with time. Results Significant differences were found between the maximum force of two thumbs in each subject (P＜0.001). The process of force application (from trough to peak, T1) was longer than that of force reduction (from peak to trough, T2) when all the subjects operated spinal fine-adjusting manipulation, showing significant differences (P＜0.001). Conclusions There exists the main and auxiliary hand during cervical spine manipulation with fine adjustment, which is actually a process of slow force application and rapid force reduction.

Effects of tuina manipulation on the three-dimensional space of cervical vertebral segments of cervical spondylosis patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the mechanisms of tuina manipulation for treating the dislocation of bone in cervical spondylosis (CS) patients by observing the effects of tuina manipulation on the three-dimensional (3D) angles.</p><p><b>METHODS</b>From August to December 2009 20 CS patients were assigned to Group 1 (10 cases, treated with relaxing manipulation) and Group 2 (10 cases, treated with relaxing manipulation and joint regulation). Besides, 10 healthy subjects were recruited as the normal group (treated with relaxing manipulation). Before and after manipulation intervention, all of them were scanned from the base of the skull to the first thoracic vertebra using Philips 64 spiral CT under equal conditions, thus obtaining the volume data. The 0.625 mm thickness was reconstructed using ITK reconstruction software provided by the digital medical laboratory, Software College of Shanghai Jiaotong University. The reconstruction of each cervical skeleton was finished referring to CT data. Changes of the 3D angles were compared among the three groups.</p><p><b>RESULTS</b>The regulation of the 3D C2 vertebra: Results of Group 2 were significantly larger than those of the normal group at X-, Y-, and Z-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X- and Z-axis (P < 0.05). But results of Group 1 were significantly larger than those of the normal group at Z-axis (P < 0.05). The regulation of the 3D C3 vertebra: Results of Group 2 were significantly larger than those of the normal group at X- and Y-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X-axis (P < 0.05). But results of Group 1 were significantly larger than those of the normal group at X-axis (P < 0.05). The regulation of the 3D C4 vertebra: Results of Group 2 were significantly larger than those of the normal group at X- and Y-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X- and Z-axis (P < 0.05). There were no significant difference among the three groups in the 3D spaces of C1, C5, C6, and C7. The larger 3D space was shown in Group 2 than in Group 1 and the normal group.</p><p><b>CONCLUSIONS</b>The relaxing manipulation combined with joint regulation significantly improved the 3D angles of C2, C3, and C4 in CS patients. The mechanism of tuina manipulation for treating the dislocation of bone in CS patients might lie in adjusting the 3D space of the cervical spine, and improving its functions.</p>

Effects of manipulation on mechanical properties of cervical and degree of fatigue in patients with cervical spondylosis / 中国骨伤

<p><b>OBJECTIVE</b>To explore the mechanism of manipulation in treating cervical spondylosis.</p><p><b>METHODS</b>From August 2008 to December 2009, 65 patients with cervical spondylosis were randomly divided into manipulation group and traction group. There were 32 patients in manipulation group, of which 30 cases obtained followed-up, including 10 males and 20 females, ranging in age from 30 to 65 years,with an average of (42.31 +/- 13.23) years; the mean course of diseases was (12.40 +/- 6.23) months, and the average weight was (61.21 +/- 10.23) kg. In traction group, there were 33 patients, 30 cases obtained follow-up, including 11 males and 19 males, ranging in age from 30 to 65 years, with an average of (45.54 +/- 14.35) years; the mean course of diseases was (13.25 +/- 6.06) months and average weight was (62.31 +/- 10.45) kg. Biodex III Isokinetic Testing System and TeleMyo 2400 T Surface EMG was applied to test the mechanical properties and fatigue of neck muscles before and after treatment.</p><p><b>RESULTS</b>The mechanical properties of neck muscles: measuring in the 60 degrees/s and 120 degrees/s angular velocity, there were no significant difference (P > 0.05) in peak torque (PT), average power (AP), peak torque of flexor/extensor peak torque ratio (F/E) before treatment, while manipulation group was improved more than traction group in PT, AP, F/E after treatment (P < 0.05), and there was significant difference (P < 0.05). For the degree of fatigue: there was no significant difference (P > 0.05) in IEMG, MPF compared by two groups before treatment, but the manipulation group was improved more than the traction group in IEMG, MPF after treatment (P < 0.05), and there was significant difference (P < 0.05) on the right side.</p><p><b>CONCLUSION</b>Manipulation can improve contraction forces and work efficiency of neck muscle, coordination ability of flexors and extensors muscles, efficiency of neck muscle, and recover mechanical properties and can alleviate fatigue of neck muscles in patients with cervical spondylosis.</p>

Analysis of the principle of lever about adjustment of spinal "Gucuofeng" with manipulative maneuver / 中国骨伤

Spinal "Gucuofeng" mainly is considered as abnormalities of joint function. Manipulative maneuver have obviously effect in adjustment of spinal "Gucuofeng", and the technical key point is utilization of principle of lever to achieve safe, effective and labor-saving purpose. After clinical practice, the general principle of manipulative maneuver in adjustment of spinal "Gucuofeng" can be summed up as pull stretch traction, first-induced instability, reverse adjustment,withdraw along situation.