TISSUE HEALING

1. AUTHOR	Buckwalter-J-A.
INSTITUTION	Department of Orthopaedics, University of Iowa, Iowa City, USA.
TITLE	Effects of early motion on healing of musculoskeletal tissues.
SOURCE	Hand-Clin 1996 Feb, VOL: 12 (1), P: 13-24, ISSN: 0749-0712 81 Refs.
ABSTRACT	One of the most important advances in the promotion of musculoskeletal healing has come from understanding that treatment of injuries with prolonged rest may delay recovery and adversely affect normal tissues and that controlled early resumption of activity can promote restoration of function. Experimental studies of the past several decades confirm and help explain the deleterious effects of prolonged rest and the beneficial effects of activity on the musculoskeletal tissues. They have shown that maintenance of structure and composition of normal bone, tendon and ligament, articular cartilage and muscle, requires repetitive use and that changes in the patterns of tissue loading can strengthen or weaken normal tissues. Although all the musculoskeletal tissues can respond to repetitive loading, they vary in the magnitude and type of response to specific patterns of activity. Furthermore, their responsiveness may decline with increasing age. Skeletal muscle and bone demonstrate the most apparent response to changes in activity in individuals of any age. Cartilage and dense fibrous tissues also can respond to loading, but the responses are more difficult to measure. The effects of loading on healing tissues have been studied less extensively but the available evidence indicates that repair and remodeling tissues respond to loading and that, like immature normal tissues, repair tissues may be more sensitive to cyclic loading and motion than mature normal tissues. Early motion and loading of injured tissues is not without risks, however. Excessive or premature loading and motion of repair tissue can inhibit or stop healing. Unfortunately, the optimal methods for facilitating healing by early application of loading and motion have not been defined. Nonetheless, experimental studies and newer clinical investigations document the benefits of early controlled loading and motion in the treatment of musculoskeletal injuries, and show that optimal restoration of musculoskeletal function following injury or surgery requires early controlled activity. Author.

2. AUTHOR Salter-R-B.

INSTITUTION Division of Orthopaedic Surgery, University of Toronto, Canada.

TITLE History of rest and motion and the scientific basis for early continuous passive motion.

SOURCE Hand-Clin 1996 Feb, VOL: 12 (1), P: 1-11, ISSN: 0749-0712 66 Refs.

ABSTRACT The history of rest, early motion, and CPM is described. The success of CPM stems from two main factors: basic research has validated the concept, and the clinical applications of CPM for various joints of the extremities have produced very satisfactory results. Author.

2. AUTHOR	Salter-R-B.
INSTITUTION	Division of Orthopaedic Surgery, University of Toronto, Canada.
TITLE	History of rest and motion and the scientific basis for early continuous passive motion.
SOURCE	Hand-Clin 1996 Feb, VOL: 12 (1), P: 1-11, ISSN: 0749-0712 66 Refs.
ABSTRACT	The history of rest, early motion, and CPM is described. The success of CPM stems from two main factors: basic research has validated the concept, and the clinical applications of CPM for various joints of the extremities have produced very satisfactory results. Author.

3. AUTHOR Moe-K, Thom-E.

INSTITUTION Moland Fysioterapi og Trening, Saltrod.

TITLE (Musculoskeletal problems and physical activity. Results from a long- term study (see comments)). TT Muskel- og skjelettproblemer og fysisk aktivitet. Resultater fra en langtidsstudie.

SOURCE Tidsskr-Nor-Laegeforen 1997 Nov 30, VOL: 117 (29), P: 4258-61, ISSN: 0029-2001. CM Comment in: Tidsskr-Nor-Laegeforen 1998 Jan 20; 118(2):277.

ABSTRACT In two Norwegian industrial companies 42 employees (24 female/18 male) with shoulder, neck and back problems took part in a training programme for a period of 12 months. The programme comprised of daily relaxation exercises at work combined with training at home three times a week for about 30 minutes on each occasion. The physical therapy and training apparatus, TerapiMaster, which was constructed in Norway was used both at work and at home. The training programme was developed and monitored by an experienced physiotherapist. The observations of the training programme focused on changes in absenteeism during the training period compared with pre-study absenteeism. For employees with musculo-skeletal ailments the combination of relaxation exercises and physical training with professional instruction and follow-up significantly reduced absenteeism from 11.2 days per year (pre-study) to 0.2 days per year (at the end of the 12-month training period) (p <0.001). A follow-up 30 months after completion of the formal study showed that absenteeism remained at the reduced rate, probably because positive experiences and "good habits" developed during the study encouraged the participants to continue with the training programme. Author.

3. AUTHOR	Moe-K, Thom-E.
INSTITUTION	Moland Fysioterapi og Trening, Saltrod.
TITLE	(Musculoskeletal problems and physical activity. Results from a long- term study (see comments)). TT Muskel- og skjelettproblemer og fysisk aktivitet. Resultater fra en langtidsstudie.
SOURCE	Tidsskr-Nor-Laegeforen 1997 Nov 30, VOL: 117 (29), P: 4258-61, ISSN: 0029-2001. CM Comment in: Tidsskr-Nor-Laegeforen 1998 Jan 20; 118(2):277.
ABSTRACT	In two Norwegian industrial companies 42 employees (24 female/18 male) with shoulder, neck and back problems took part in a training programme for a period of 12 months. The programme comprised of daily relaxation exercises at work combined with training at home three times a week for about 30 minutes on each occasion. The physical therapy and training apparatus, TerapiMaster, which was constructed in Norway was used both at work and at home. The training programme was developed and monitored by an experienced physiotherapist. The observations of the training programme focused on changes in absenteeism during the training period compared with pre-study absenteeism. For employees with musculo-skeletal ailments the combination of relaxation exercises and physical training with professional instruction and follow-up significantly reduced absenteeism from 11.2 days per year (pre-study) to 0.2 days per year (at the end of the 12-month training period) (p <0.001). A follow-up 30 months after completion of the formal study showed that absenteeism remained at the reduced rate, probably because positive experiences and "good habits" developed during the study encouraged the participants to continue with the training programme. Author.