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Amount of Torque and Duration of Stretching Affects Correction of Knee Contracture in a Rat Model of Spinal Cord Injury

  • Basic Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Joint contractures are a common complication of many neurologic conditions, and stretching often is advocated to prevent and treat these contractures. However, the magnitude and duration of the stretching done in practice usually are guided by subjective clinical impressions.

Questions/purposes

Using an established T8 spinal cord injury rat model of knee contracture, we sought to determine what combination of static or intermittent stretching, varied by magnitude (high or low) and duration (long or short), leads to the best (1) improvement in the limitation in ROM; (2) restoration of the muscular and articular factors leading to contractures; and (3) prevention and treatment of contracture-associated histologic alterations of joint capsule and articular cartilage.

Methods

Using a rat animal model, the spinal cord was transected completely at the level of T8. The rats were randomly assigned to seven treatment groups (n = 4 per group), which were composed of static or intermittent stretching in combination with different amounts of applied torque magnitude and duration. We assessed the effect of stretching by measuring the ROM and evaluating the histologic alteration of the capsule and cartilage.

Results

Contractures improved in all treated groups except for the low-torque and short-duration static stretching conditions. High-torque stretching was effective against shortening of the synovial membrane and adhesions in the posterosuperior regions. Collagen Type II and VEGF in the cartilage were increased by stretching.

Conclusions

High-torque and long-duration static stretching led to greater restoration of ROM than the other torque and duration treatment groups. Stretching was more effective in improving articular components of contractures compared with the muscular components. Stretching in this rat model prevented shortening and adhesion of the joint capsule, and affected biochemical composition, but did not change morphologic features of the cartilage.

Clinical Relevance

This animal study tends to support the ideas that static stretching can influence joint ROM and histologic qualities of joint tissues, and that the way stretching is performed influences its efficacy. However, further studies are warranted to determine if our findings are clinically applicable.

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Acknowledgments

We thank Chika Otsuka BSc, Tatsuya Marumo BSc, and Ryohei Watanabe BSc for their skilled technical assistance.

Author information

Authors and Affiliations

  1. Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Tomogaoka 7-10-2, Suma-ku, Kobe, Hyogo, 654-0142, Japan

    Hideki Moriyama PhD

  2. Hospital of National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Saitama, Japan

    Yoshiko Tobimatsu PhD

  3. Department of Integrated Rehabilitation, Faculty of Health Sciences, Hiroshima International University, Higashihiroshima, Hiroshima, Japan

    Junya Ozawa PhD, Nobuhiro Kito PhD & Ryo Tanaka PhD

Authors
  1. Hideki Moriyama PhD
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  2. Yoshiko Tobimatsu PhD
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  3. Junya Ozawa PhD
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  4. Nobuhiro Kito PhD
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  5. Ryo Tanaka PhD
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Corresponding author

Correspondence to Hideki Moriyama PhD.

Additional information

One of the authors (HM) has received funding from a research grant for the Grant-in-Aid for Young Scientists (21700545) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at Hiroshima University, Hiroshima, Japan.

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Moriyama, H., Tobimatsu, Y., Ozawa, J. et al. Amount of Torque and Duration of Stretching Affects Correction of Knee Contracture in a Rat Model of Spinal Cord Injury. Clin Orthop Relat Res 471, 3626–3636 (2013). https://doi.org/10.1007/s11999-013-3196-z

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  • DOI: https://doi.org/10.1007/s11999-013-3196-z

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