Mechanotherapy

Mechanotherapy was defined in 1890 as “the employment of mechanical means for the cure of disease”. Mechanotherapy employs mechanotransdution in order to stimulate tissue repair and remodelling.[1]

History

The American College of Mechano-Therapy operated in Chicago, IL, between roughly 1905 and 1920. It was founded by William Charles Schulze, an 1897 graduate of Rush Medical College and practicing MD licensed in Illinois, Minnesota, and Wisconsin. Schulze was born in Germany in 1870. Schulze incorporated the American College of Mechano-Therapy in 1907 and served as its president. Purporting to be the “largest eclectic school of drugless healing in the world,” the College offered a training course via correspondence. Though heavily criticized by the medical establishment, mechanical methods of healing nonetheless were increasingly popular in North America in the early part of the 20th century.[2]

Exercise

Mechanotherapy is used as term for exercise prescription to promote healing and rehabilitation.[1] Mechanotherapy is a useful term for exercise which is prescribed for rehabilitation because tissue repair is driven by the physiological process of mechanotransduction.

Uses

Tendon

Tendon, as a tissue is mechanoresponsive. Various academic studies show that tendons can respond well to controlled loading, post-injury.[3][4] Loading of a tendon results in up regulation of insulin-like growth factor,[5][6] in addition to other cytokines and growth factors.[7] This up regulation results in proliferation at the cellular level and remodelling of the tendon matrix.

Muscle

The clinical justification for the use of mechanotherapy in muscle injury is formed from initial animal studies.[8] Generally, a rest period is undertaken to allow stabilisation of scar tissue, which is followed by controlled loading.

Loading of muscle leads to up regulation of a number of load-induced pathways, including mechanogrowth factor (MGF). MGF expression results in activation of satellite cells and hypertrophy.[9] Loading in this setting can increase rate and completeness of regeneration, improve myotubule alignment, and minimise myotubule atrophy.[8]

Bone

One of the integral components of bone are osteocytes, which act as the primary mechanosensors. Evidence suggests that mechanotherapy can be useful in the rehabilitation of bone fractures.[10] Loading bone during rehabilitation can result in significantly increased strength and range of motion, compared with immobilized patients.[10]

Massage

Another, related use of the term Mechanotherapy is the original term for therapeutic massage. It was developed as an independent branch of manual medicine in Sweden in the early 20th century. It quickly became popular in the U.S. and many chiropractic colleges in the U.S. in the first half of the 20th century also offered separate degree programs in mechanotherapy. Mechanotherapists received a Doctor of Mechanotherapy (DM) degree and were licensed to practice in many states and practiced in many more states without a license. A DM degree is a graduate professional degree that indicates proficiency in mechano- or massage therapy. Mechanotherapists do not claim to be physicians or to diagnose or treat diseases.

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References
  1. Khan, K. M.; Scott, A. (2009-04-01). "Mechanotherapy: how physical therapists' prescription of exercise promotes tissue repair". British Journal of Sports Medicine. 43 (4): 247–252. doi:10.1136/bjsm.2008.054239. ISSN 1473-0480. PMC 2662433. PMID 19244270.
  2. "American College of Mechano-Therapy Collection". McGill Library Archival Catalogue. Retrieved 2018-02-15.
  3. Öhberg, L.; Lorentzon, R.; Alfredson, H. (2004-02-01). "Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up". British Journal of Sports Medicine. 38 (1): 8–11. doi:10.1136/bjsm.2001.000284. ISSN 1473-0480. PMC 1724744. PMID 14751936.
  4. Boyer, Martin I.; Goldfarb, Charles A.; Gelberman, Richard H. (2005-06-01). "Recent progress in flexor tendon healing. The modulation of tendon healing with rehabilitation variables". Journal of Hand Therapy. 18 (2): 80–85, quiz 86. doi:10.1197/j.jht.2005.02.009. ISSN 0894-1130. PMID 15891963.
  5. Banes, A. J.; Tsuzaki, M.; Hu, P.; Brigman, B.; Brown, T.; Almekinders, L.; Lawrence, W. T.; Fischer, T. (1995-12-01). "PDGF-BB, IGF-I and mechanical load stimulate DNA synthesis in avian tendon fibroblasts in vitro". Journal of Biomechanics. 28 (12): 1505–1513. doi:10.1016/0021-9290(95)00098-4. ISSN 0021-9290. PMID 8666590.
  6. Scott, Alexander; Cook, Jill L.; Hart, David A.; Walker, David C.; Duronio, Vincent; Khan, Karim M. (2007-03-01). "Tenocyte responses to mechanical loading in vivo: a role for local insulin-like growth factor 1 signaling in early tendinosis in rats". Arthritis and Rheumatism. 56 (3): 871–881. doi:10.1002/art.22426. ISSN 0004-3591. PMID 17328060.
  7. Olesen, Jens L.; Heinemeier, Katja M.; Gemmer, Carsten; Kjaer, Michael; Flyvbjerg, Allan; Langberg, Henning (2007-01-01). "Exercise-dependent IGF-I, IGFBPs, and type I collagen changes in human peritendinous connective tissue determined by microdialysis". Journal of Applied Physiology. 102 (1): 214–220. doi:10.1152/japplphysiol.01205.2005. ISSN 8750-7587. PMID 16973813.
  8. Järvinen, Tero A. H.; Järvinen, Teppo L. N.; Kääriäinen, Minna; Aärimaa, Ville; Vaittinen, Samuli; Kalimo, Hannu; Järvinen, Markku (2007-04-01). "Muscle injuries: optimising recovery". Best Practice & Research. Clinical Rheumatology. 21 (2): 317–331. doi:10.1016/j.berh.2006.12.004. ISSN 1521-6942. PMID 17512485.
  9. Goldspink, Geoffrey (2003-01-01). "Gene expression in muscle in response to exercise". Journal of Muscle Research and Cell Motility. 24 (2–3): 121–126. doi:10.1023/a:1026041228041. ISSN 0142-4319. PMID 14609023.
  10. Challis, Murray J.; Jull, Gwendolen J.; Stanton, Warwick R.; Welsh, Mark K. (2007-01-01). "Cyclic pneumatic soft-tissue compression enhances recovery following fracture of the distal radius: a randomised controlled trial". The Australian Journal of Physiotherapy. 53 (4): 247–252. doi:10.1016/s0004-9514(07)70005-3. ISSN 0004-9514. PMID 18047459.
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