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With the common occurrence of knee osteoarthritis, total knee arthroplasty has become an effective method for the treatment of middle and late knee osteoarthritis. Continuous passive movement is an effective auxiliary method for rehabilitation after total knee arthroplasty, but it also has some limitations. This article reviews the research progress of continuous passive movement after total knee arthroplasty.
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OBJECTIVE: To investigate the expression of miRNA-1 in denervated skeletal muscle at different periods, and to explore effects of passive movement on the expression of miRNA-1 and differentiation of myoblasts in denervation-induced skeletal muscle atrophy in rats. METHODS: Twenty-seven Sprague Dawley rats, weighing (200±10) g, were randomly divided into sham-operated group (group A, n=3), denervated group (group B, n=12), and passive movement group (group C, n=12). After the right sciatic nerve was exposed and dissociated, the sciatic nerve of 1 cm in length was removed in groups B and C; resection was not performed in group A. At 1 day after operation, passive flexion and extension movement was performed on the right hind limb in group C. At 6 hours in group A and at 3, 7, 14, and 28 days in groups B and C, 3 rats were sacrificed to measure the wet weight ratio of gastrocnemius muscle, to observe the diameter of the gastrocnemius muscle cell and evaluate the muscle atrophy by HE staining; RT-PCR was used to detect the mRNA expression of miRNA-1 and myocyte differentiation factor (MyoD), and immunohistochemistry to determine the protein expression of MyoD. RESULTS: Atrophy in various degrees was observed in denervated gastrocnemius muscle of groups B and C. The muscle fiber arranged in disorder and the diameter of the muscle cells decreased gradually with the time, without normal structure and morphology. The wet weight ratio and the cell diameter of the gastrocnemius in groups B and C were significantly less than those in group A (P0.05), and had positive correlation at 14 and 28 days (P<0.05); positive correlation was found between the relative expression of MyoD and miRNA-1 mRNA (P<0.05). CONCLUSIONS: Passive movement can prevent amyotrophy by increasing the expression of miRNA-1 and promoting the differentiation of myoblasts.
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Objective To assess any differences in brain activation during active,passive and imaginary movement of the hands using blood oxygen level-dependent functional magnetic resonance imaging (fMRI),and to provide references for the cortical reorganization in patients with brain injuries.Methods Twenty healthy,righthanded,adult volunteers were studied,fMRI was performed during active,passive and imaginary fist clutching.Whole brain analysis and group analysis were applied to get the voxels,the volume of activation,the peak t-score and its coordinates.Results Active and passive movement both produced significant activation in the contralateral sensorimotor cortex,the contralateral supplementary motor area and the ipsilateral cerebellum.The sensorimotor cortex was the most frequently and most strongly activated brain area.Imaginary movement produced significant bilateral activation in the supplementary motor area.Conclusions Active and passive movement induce similar brain activation patterns.This indicates that passive might replace active movement when observing activation of the brain's cortex during the rehabilitation of patients with hemiplegia.
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Objective To study the potential of functional MRI (fMRI) during passive finger extension (FE) for predicting the motor function recovery of hemiplegic stroke survivors.Methods Nineteen survivors of a 1st cerebral infarction in the non-M1 cortex with complete paralysis on one side were selected for study.Within 1 week after the stroke,fMRI was performed while one of the patient's paralyzed fingers was passively flexed and extended.fMRI signals were acquired from the sensorimotor cortex (SMC),the supplementary motor area (SMA) and the premotor area (PM).Fugl-Meyer (FM) scores of arm motor function were recorded one week,one month and three months after the stroke.Results The early fMRI results were used to classify cortex activation performances as type Ⅰ (activation mainly on the affected side,but SMC and SMA activated bilaterally),type Ⅱ (activation of the SMC and SMA only on the affected side) or type Ⅲ (only activation of the SMC on the affected side).At one week after stroke the average FM scores of the three groups were not significantly different.At one month the three average FM scores were 47.1 ± 5.5 points,36 ±6.7 points and 11.2 ± 3.1 points,for groups Ⅰ,Ⅱ and Ⅲ respectively,each significantly different from the others.At three months the average FM ratings of groups Ⅰ (61.1 ± 3.8 points) and Ⅱ (59 ± 5.2 points) were not significantly different,but both were significantly higher than the average score of group Ⅲ (10.8 ± 5.6 points).Conclusion The early stage fMRI characteristics of hemiplegic patients can be used for predicting motor outcomes.
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Objective To study the effects of active and passive movement of the affected hand after ischemic stroke on brain activity patterns using blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) and to explore the central mechanism of movement treatment for hand disability.Methods Five pa-tients with subcortical cerebral infarction in Brunnstrom stages 1 to 3 (both upper limb and hand affected) were investigated using BOLD-fMRI during active and passive clenching and relaxing of the affected hand.Statistical parametric mapping software (SPM5) was used to integrate the activity data and display them in one standard brain map.The activated areas were then compared.Results The BOLD-fMRI signals aroused by both active and passive move-ment were enhanced in the contralateral sensorimotor cortex,the contralateral premotor cortex,bilaterally in the sup-plementary motor area and in the bilateral cerebellum.Both movements also activated the ipsilateral sensorimotor cor-tex and premotor cortex,which are not normally activated during such movements in healthy people.The areas were more extensive and the activation was stronger during passive movement.Moreover,the activated brain areas induced by active movement were mainly on the contralateral side,while passive movement induced activation distributed over both hemispheres almost evenly.Conclusions Both active and passive movement significantly activate the brain areas responsible for movement of the affected hand.Both are useful for boosting brain reorganization after stroke.
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Objective To assess differences in brain activation between active and passive movement of the right hand using blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI). Methods Nine healthy adult right handed volunteers were studied. fMRI was performed with active and passive finger-to-finger movement. Results Right hand active and passive movement produced significant activation in the contralateral sensorimotor cortex ( SMC ), the contralateral premotor cortex ( PMC ), bilaterally in the supplementary motor area (SMA) and in the ipsilateral cerebellum. The activated brain areas were centered on the contralateral SMC and PMC and located more forward during active movement than during passive movement. The contralateral SMC was the most strongly and the most frequently activated brain area. The contralateral posterior parietal cortex (PPC) was less relevant to the hand movements. Unlike active movement, passivemovement activated more areas in the posterior central gyrus than in the anterior central gyrus. Conclusions Both active and passive movement significantly activate the brain areas which are responsible for hand movement, but there are some differences in the locations of the cortex areas activated and in the incidence activation except in the contralateral SMC.
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Objective To observe the effects of passive movement on the functional outcome after occlusion of the middle artery in the brain and reperfusion, and to explore the molecular mechanisms involved. Methods Cerebral infarction models were established in rats using left middle cerebral artery occlusion ( MCAO). The survivors were randomly divided into a passive movement group and a natural recovery group. There was also a sham-operated group and a normal group. Passive movement treatment (twice a day, twenty min per time) was started at different times after reperfusion. The expression of brain-derived neurotrophic factor (BDNF) and B cell lymphoma/leukemia-2 gene (Bcl-2) were determined using real-time PCRs. Results Expression of BDNF and Bcl-2 was detected a-round the infarction area in both groups. The expression of BDNF and Bcl-2 was highest in the sub-groups where passive movement was begun 24 or 48 h after the operation. Conclusions The expression of BDNF and Bcl-2 in the brain peaks when daily, moderate intensity passive movement is administered beginning 24 to 48 h after reperfusion. Passive movement might have a protective and rehabilitative effect after cerebral infarction.
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Objective:To discuss the preventive function of passive movement and electric stimulation on rats with disuse osteoporosis. Methods:Through cutting the sciatic nerve and femoral nerve of experimental rats,we made an animal model of disuse osteoporosis,and divided them into five groups:the pseudo operation group,the denervation group(DG),denervation with passive movement group(PMG), denervation with electric stimulation group(ESG),and denervation with passive movement and electric stimulation group(PMESG).Then the changes of biochemistry indicators of bone metabolism were observed in all groups.Results:Compared with sham group,the Bone gla protein(BGP)value in the other groups were markedly lower(P0.05).Compared with DNG,the BGP value in the other groups increased,especially that the BGP in the PMESG was significantly increased(P
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Any method that deforms the skin of the extremities may increase lymphatic flow rate, and may be applied to treat peripheral lymphedema. This study was undertaken to investigate whether or not elastic adhesive tape with passive exercise can increase lymph flow in the rabbit hind leg by effective and periodic skin deformation. Cannulation into a pre-popliteal afferent lymphatic vessel in the lower left leg of 22 male New Zealand White rabbits was performed under a stereomicroscope. After stabilization, lymph was collected at rest or during passive exercise with an electric motor at 60 r.p.m. for 15 minutes and was then measured. Lymph flow rate was calculated and expressed as g/hour. Increase of lymph flow rate due to taping was significant only for passive exercise (p=0.0317). The lymph flow rate increased linearly as the area of tape was increased (p=0.0011), and lymph flow rates were significantly different according to site (p=0.0017). Tape on the anterior aspect of the ankle caused salient deformation and tended to increase the lymph flow rate more so than tape on the dorsum of the foot (p=0.0831). Taping with elastic adhesive tape in passive exercise increased the lymph flow rate in the rabbit hind leg by deforming the skin, which suggests a novel therapeutic method in cases of peripheral lymphedema.
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Animals , Male , Rabbits , Bandages , Elasticity , Hindlimb/physiology , Lymph/physiology , MotionABSTRACT
Objective To study the effects of passive movement (PM) and electric stimulation(ES) on soleus of the tail suspended rats. Methods Seventy-two male Wistar rats(68～76g) were used in this experiment and divided into a normal control group, a model group (tail suspension), a ES group (tail suspension plus ES) and a PM group(tail suspension plus PM).The cross-sectional area of the muscle fibers and proportion of various types of muscle fibers in soleus were observed by histociemical staining of succinic dehydrogenase (SDH) and image pattern analyzer. Results The results showed that the cross-sectional area of all types of soleus muscle fibers in the PM and ES groups was significantly larger than that in the model group, with the area of the intermediate muscle fibers more significantly larger in particular. The proportion of the red fibers decreased and that of the intermediate fibers increased in the model group after one week of tail-suspension. Conclusion Passive movement and electrical stimulation could slow down the muscle atrophy of soleus of the tail-suspended rats.