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Month: December 2015

Mechanical stimulation repair muscle


Muscle regeneration through mechanical stimulation may one day replace or enhance drug- and cell-based regenerative treatments, according to a new study by a team of engineers and biomedical scientists at the Wyss Institute for Biologically Inspired Engineering at Harvard University and the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS).

The study suggests that mechanically driven therapies that promote skeletal muscle regeneration could augment or replace methods currently being used. The finding was published Monday in the journal Proceedings of the National Academy of Sciences.

“Chemistry tends to dominate the way we think about medicine, but it has become clear that physical and mechanical factors play very critical roles in regulating biology,” said Harvard bioengineer David Mooney, the study’s senior author. “The results of our new study demonstrate how direct physical and mechanical intervention can impact biological processes and can potentially be exploited to improve clinical outcomes.” Mooney is a Wyss Institute core faculty member and the Robert P. Pinkas Family Professor of Bioengineering at SEAS.

The multidisciplinary team spanning the Wyss Institute’s programmable nanomaterials and bioinspired robotics platforms was led by Mooney. It also included soft roboticist and Wyss core faculty member Conor Walsh, an associate professor of mechanical and biomedical engineering at SEAS and founder of the Harvard Biodesign Lab; and biomechanical engineer Georg Duda, a Wyss associate core faculty member, vice director of the Berlin-Brandenburg Center for Regenerative Therapies, and the director of the Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration at Charité-Universitätsmedizin Berlin.

In humans, up to half of body mass is made up of skeletal muscle, which plays a key role in locomotion, posture, and breathing. Although skeletal muscles can overcome minor tears and bruising without intervention, major injuries commonly caused by motor vehicle accidents, other traumas, or nerve damage can lead to extensive scarring, fibrous tissue, and loss of muscle function.

The team, which included researchers in mechanobiology, applied combined murine models of muscle injury and hindlimb ischemia to investigate two potential mechanotherapies: an implanted magnetic biocompatible gel and an external, soft robotic pressurized cuff.

To alleviate severe muscle injuries, the team implanted a magnetized gel called a biphasic ferrogel, which would be in direct contact with the damaged tissue. Mice in another experimental group did not receive the ferrogel implant, but instead were fitted with a soft robotic, non-invasive pressurized cuff over the injured leg.

The ferrogel was subjected to magnetic pulses to apply cyclic stimulation to the muscle, while pulses of air allowed the cuff to cyclically massage the hind leg. Both groups received two weeks of localized mechanical perturbation using the two distinct methods.

The researchers discovered that cyclic mechanical stimulation provided by either magnetized gel or robotic cuff resulted in a 2.5-fold improvement in muscle regeneration and reduced tissue scarring over the course of two weeks, ultimately leading to an improvement in regained muscle function. The results confirmed that mechanical stimulation of muscle alone can foster regeneration, and the ferrogel implant and pressurized cuff resulted in very similar levels of regeneration.

“Until now most approaches to muscle regeneration have been biologic, relying on the use of drugs or cells,” said Christine Cezar, lead author on the study. “Our finding that mechanical stimulation alone is enough to enhance muscle repair could open the door to new non-biologic therapies, or even combinatorial therapies that employ both mechanical and biological interventions to treat severely damaged skeletal muscles.”

The direct stimulation of muscle tissue increases the transport of oxygen, nutrients, fluids, and waste removal from the site of the injury, which are all vital components of muscle health and repair. Mooney said one of the most exciting aspects of this research is that its translation to the clinic in the form of a stimulatory device could be relatively rapid compared to drug or cell therapies.

Down the road, the principle of using mechanical stimulation to enhance regeneration or reduce formation of scarring or fibrosis could also be applied to a wide range of medical devices that interface mechanical components with body tissues. Currently, clinical devices are often plagued by thickened tissue capsules that form at the intersection of machine and man. The team plans to explore how the findings can make the jump from the laboratory to the clinic.

“This work clearly demonstrates that mechanical forces are as important biological regulators as chemicals and genes, and it shows the immense potential of developing mechanotherapies to treat injury and disease,” said Wyss Institute Director Donald Ingber, who is a pioneer in the field of mechanobiology. “The challenge now is to advance this new mechanotherapeutic approach from the bench to bedside, where the real impact on human lives can occur.”

In addition to Mooney, Walsh, Duda, and Cezar, the authors of the study included Ellen Roche, a former doctoral student who completed her studies at the Wyss Institute and Harvard SEAS and is now a postdoctoral research fellow at the National University of Ireland, Galway, and Herman Vandenburgh, associate professor in the Department of Pathology and Lab Medicine at Brown University.

The work was supported by funding from the National Institutes of Health, the National Science Foundation’s Materials Research Science and Engineering Center at Harvard University, a Fulbright International Science and Technology Award, and the Wyss Institute Director’s Cross-Platform Challenge Award.

Source:  Harvard Gazette


Cancer Patients and Massage

massage is greatThe stress-relieving benefits of massage have been well documented, but a recent study shows that massage may have more profound benefits that just relieving stress and relaxing tight muscles.

The study, published in the journal BMJ, looked at the benefits of massage for brain cancer patients. To be expected, these patients often suffer from neurological problems, which affect their physical functioning, their cognitive abilities and their psychological well-being.

They also have to deal with the progressive nature of their illness and difficult treatments like radiation, surgery and chemotherapy. Brain cancer patients typically report a high prevalence of depression and other mental disorders.

In this study, 25 brain tumor patients who were classified as “distressed” received a massage twice a week for four weeks. At the end of week four, the distress scores for all participants were below the threshold for experiencing distress. In other words, the factors leading to their diagnosis faded away.

“This is more significant than I would have expected,” said Dr. Keri Peterson, a spokesperson for the American Massage Therapy Association.

What’s more, the issues these patients reported as “concerns” for them prior to the massage were no longer worrisome by the end of the four weeks. At the baseline assessment before the massages began, at least 75 percent  of participants reported the following items of concern: sadness, worry, fatigue, nervousness, pain, sleep and getting around. At least 50 percent reported concerns with insurance, fears, depression, dry or itchy skin, work, transportation, eating, constipation, tingling in hands and feet, and nausea.

At the end of week four, only 50 percent of patients reported concerns with fatigue. All the other sources of concern were felt by 40 percent or fewer of the participants. For example, while 100 percent of participants reported sadness at the onset of the study, only 40 percent reported sadness after four weeks of massage. The reduction in worries led to improved emotional, social and physical well-being.

However, when the massages were discontinued, the improvements began to fade, although they still scored better than before the study started.

Cancer patients have nearly twice the risk of developing psychiatric distress compared to the general population, and the benefits of massage may extend to those with other types of cancer as well. A massage to relieve back pain is different than one that will reduce stress and improve one’s well-being.

Post-Exercise Massage

post massageLonger days offer the perfect backdrop to dust off the running shoes and embark on a new fitness goal. One unwanted side effect is increased muscle soreness. The good news is that integrating massage therapy into your health and wellness routine can help alleviate some discomfort. In fact, research indicates that massage therapy reduces inflammation of skeletal muscle acutely damaged through exercise. The study, conducted by the Buck Institute for Research on Aging and McMaster University in Ontario, provides evidence for the benefits of massage therapy for those with musculoskeletalinjuries and potentially for those with inflammatory disease, according to the lead author of the research.

  • The study found evidence at the cellular level that massage therapy may affect inflammation in a way similar to anti-inflammatory medications.
  • The researchers “found that massage activated the mechanotransductionsignaling pathways focal adhesion kinase (FAK)

Do not Call It Pampering Massage Wants to Be Medicine

While massage may have developed a reputation as a decadent treat for people who love pampering, new studies are showing it has a wide variety of tangible health benefits.

Research over the past couple of years has found that massage therapy boosts immune function in women with breast cancer, improves symptoms in children with asthma, and increases grip strength in patients with carpal tunnel syndrome. Giving massages to the littlest patients, premature babies, helped in the crucial task of gaining weight.

The benefits go beyond feelings of relaxation and wellness that people may recognize after a massage. The American College of Physicians and the American Pain Society now include massage as one of their recommendations for treating low back pain, according to guidelines published in 2007.massage relax

New research is also starting to reveal just what happens in the body after a massage. While there have long been theories about how massage works—from releasing toxins to improving circulation—those have been fairly nebulous, with little hard evidence. Now, one study, for example, found that a single, 45-minute massage led to a small reduction in the level of cortisol, a stress hormone, in the blood, a decrease in cytokine proteins related to inflammation and allergic reactions, and a boost in white blood cells that fight infection.

Massage is already widely used to treat osteoarthritis, for which other treatments have concerning side effects. A study published in the Archives of Internal Medicine in 2006 showed that full-body Swedish massage greatly improved symptoms of osteoarthritis of the knee. Patients who had massages twice weekly for four weeks and once a week for an additional four weeks had less pain and stiffness and better range of motion than those who didn’t get massages. They were also able to walk a 50-foot path more quickly.

“If massage works then it should become part of the conventionally recommended interventions for this condition and if it doesn’t work we should let [patients] know so they don’t waste their time and money,” says Adam Perlman, the lead author of the study and the executive director of Duke Integrative Medicine in Durham, N.C.Scientists are also studying massage in healthy people.

In a small study published in the journal Science Translational Medicine last month, a 60-minute massage promoted muscle recovery after exercise. In the study, 11 young men exercised to exhaustion and then received a massage in one leg. Muscle biopsies were taken in both quad muscles before exercise, after the massage and 2½ hours later.

The short massage boosted the production of mitochondria, the energy factory of the cell, among other effects. “We’ve shown this is something that has a biological effect,” says Mark Tarnopolsky, a co-author of the study and a professor of pediatrics and medicine at McMaster University Medical Center in Hamilton, Ontario.

A 2010 study with 53 participants comparing the effects of one 45-minute Swedish massage to light touch, found that people who got a massage had a large decrease in arginine-vasopressin, a hormone that normally increases with stress and aggressive behavior, and slightly lower levels of cortisol, a stress hormone, in their blood after the session. There was also a decrease in cytokine proteins related to inflammation and allergic reactions.

Mark Hyman Rapaport, the lead author of the study and the chairman of psychiatry and behavioral science at the Emory University School of Medicine in Atlanta, says he began studying massage because, “My wife liked massages and I wasn’t quite sure why. I thought of it as an extravagance, a luxury for only people who are very rich and who pamper themselves.” Now, Dr. Rapaport says he gets a massage at least once a month. His group is now studying massage as a treatment for generalized anxiety disorder.