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BACKGROUND: Recent studies have shown that TCM massage can alleviate or even reverse the progression of muscle fibrosis, so it is speculated that massage can also improve the pathological changes of gluteal muscle contracture. OBJECTIVE: To evaluate the role of massage on gluteal muscle contracture and the relevant mechanism. METHODS: Twenty young rabbits were divided into an experimental group and a control group, with penicillin and benzyl alcohol injection for 8 weeks respectively. Besides, the experimental group received massage therapies for 4 weeks, whereas the control group had no specific intervention. Cell morphology and structure were observed using hematoxylin and eosin staining, Masson staining and Sirius red staining. Expression of transforming growth factor-pi in the rabbit model of gluteal muscle contraction was measured using immunohistochemistry, reverse transcription PCR and western blot assays. The study protocol was approved by the Ethics Committee of Peking University Shenzhen Hospital in China. RESULTS AND CONCLUSION: The experimental group had significantly less hyperplasia of fiber tissue compared with the control group (F < 0.05). The expression levels of collagen type I and transforming growth factor-31 were significantly increased in the control group compared with the experimental group, as determined by reverse transcription PCR, western blot assay and immunohistochemical staining (P < 0.05). Therefore, massage therapy can alleviate the progression of gluteal fibrosis, which is expected to provide a new idea for the research and treatment of gluteal muscle contracture.
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Objective To explore the expression and effect of transforming growth factors-β1 (TGF-β1) and heat shock protein (HSP47) on gluteal muscle contracture (GMC). Methods We collected contraction band and adjacent muscle from GMC patients and explored the expression of TGF-β1 and HSP47 using immunohistohemistry, reverse transcription and polymerase chain reaction (RT-PCR), and Western blot analysis. Results TGF-β1 and HSP47 were intensely expressed in fibroblast cells and vascular endothelial cells. The expression of them increased 8.1-fold and 3.6-fold at the mRNA level, respectively (P<0.05). The same changes were found at the protein level, which increased 11.2-fold and 7.6-fold, respectively (P<0.05). Conclusion Up-regulation of TGF-β1 and HSP47 may initiate fibrotic cascade in the gluteal muscles of GMC patients.
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To investigate the efficacy of a combination therapy on gluteal muscle contracture, 286 definitely diagnosed patients were subjected to surgical treatment, and then functional exercises and physical therapy. The patients with severe symptoms were asked to have a set of specially-designed functional exercises. All the patients were followed up for 3 to 24 months by hospital visit, correspondenee or telephone interview. The effective rate was 100%, and the curative rate was up to 94.6%. Few patients developed complications and relapse was rare. It is concluded that the combination therapy, including surgical removal of diseased tissues, functional exercises and physical therapy, is an effective approach for the treatment of severe juvenile gluteal muscle contracture.
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[Objective]To compare the immediate therapeutic effects of the treatment of gluteal muscle constracture(GMC)with arthroscopic release of contractured tissue and conventional surgery.To investigate the indications of arthroscopic surgery.[Method]Ninty-six limbs of 48 patients with traditional surgery and 84 limbs of 42 patients with arthroscopic surgery were analyzed in terms of operation time,length of the incision,postoperative pain,complications,the time of exercise,postoperative hospital stay and one-year recurrence rate.[Result]Arthroscopic surgery group had smaller incisions,earlier exercise,less postoperative pain and shorter hospital stay than conventional surgery group,but the two groups showed no significant difference in operative time,complications,effects of operation and one-year recurrence rate.[Conclusion]Arthroscopic release of contracture tissue is a safe,effective,economical and cosmetic way to treat the gluteal muscle contracture.This method is worthy of wide promotion.
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[Objective]To evaluate the feasibility of early off-bed exercises after arthroscopically assisted radiofrequency release of gluteal muscle contracture.[Method]Patients of gluteal muscle contracture underwent arthroscopically assisted radiofrequency release of gluteal muscle contracture.Post-operative off-bed time,side effects,duration of urinary catheter drainage,wound healing,early recovery of function,and in-hospital time were studied.[Result]Off-bed time averaged 7 hours(6~8 hours).Two cases complained of being faint and nausea.After allopathic treatment,no serious complications appeared.Averaged duration of urinary catheter drainage was 7.5 hours.Primary healing of wounds were found in 67 patients,while 1 case got delayed wound healing.None of them had any infections.Functional scores averaged 9 at the time of discharging and 10 after 1 month.Post-operative in-hospital time averaged 2.58 days(2~6 days).[Conclusion]Arthroscopically assisted radiofrequency release of gluteal muscle contracture results in early post-operative off-bed time and reduction of suffering,which is propitious to functional recovery,rate of healing,and shorter in-hospital time.
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Objective To study the immunological pathogenesis of gluteal muscle contracture. Methods In 43 children with gluteal muscle contracture and 22 normal control cases, peripheral blood T-lymphocytes, B-lymphocyte and its subset were analyzed with flow cytometry. Results The percent of CD4+, B-lymphocyte and CD4+/CD8+ in children with gluteal muscle contracture were all significantly higher than those in the control(P0.05). Conclusion There is disorder of immunological regulation in children with gluteal muscle contracture. Immunologic factors may play an important role in the pathogenesis of gluteal muscle contracture.