In vitro modeling of repetitive motion strain and manual medicine treatments: Potential roles for pro- and anti-inflammatory cytokines

Abstract

Despite positive clinical outcomes documented post-treatment with a variety of manual medicine treatments (MMT), the underlying cellular mechanisms responsible remain elusive. We have developed an in vitro human fibroblast cell system used to model various biomechanical strains that human fibroblasts might undergo in response to repetitive motion strain (RMS) and MMT. Our data utilizing this system suggest that RMS induces disruption of cell-cell and cell-matrix contacts, which appear are reversed when a modeled MMT is also added to the treatment protocol. Similarly, while RMS induces secretion of several inflammatory cytokines, modeled MMT attenuates this secretory response. In terms of strain direction, fibroblasts strained equiradially exhibit unique cytokine secretory profiles vs. those strained heterobiaxially. Taken together, these data suggest that this cell model may prove useful in identifying the cellular mechanisms by which various fascial strains used clinically to treat somatic dysfunctions yield positive clinical outcomes such as reduced pain, reduced analgesic use and improved range of motion.

Towards a Rosetta Stone of manual therapeutic methodology

“…Such laboratory experiments are not designed to truly and fully model such complex processes. After all, while the cultures presented in our papers (Cao et al, 2013a(Cao et al, , 2013bHicks et al, 2012;Meltzer et al, 2010;Standley and Meltzer, 2008;Meltzer and Standley, 2007;Eagan et al, 2007;Dodd et al, 2006) certainly include human cells, they are devoid of blood, neurons and many other vital components most certainly likely to play roles (perhaps even more important than biophysical stimuli themselves) in manual medicine efficacy. The goals of our very limited research scope is to provide proof of concept ideas by which biomechanical stimuli directed at human cells and tissues in manners that may model some limited aspects of clinically relevant strain models, change cell behavior in ways that may relate to improvement in the human condition post-manual medicine treatments.…”

Fascia Research II: Second International Fascia Research Congress

“…The paper by Standley and Meltzer (13) shows effects at a molecular level of pressure and shear, the major forces they see as involved in manual therapies. Many therapies address the tissues at the junctions between muscle and bone; defining the architecture at this location may help in understanding how such therapies work and in developing testable hypotheses for treatment effects and ways to improve treatments for specific conditions.…”

What can we learn from the Fascia Congress?

“…fibroblasts, the principle cell type within the fascia) involve particular ''strain directions''. For example, myofascial release (MFR) can produce ''clinician-directed strain enhancement of ATP-dependent cytokine secretion [that] may underlie the clinical antiinflammatory benefits seen post-MFR, such as improved range of motion (ROM), decreased oedema, and reduced analgesic requirements'' (Standley and Meltzer, 2008).…”