Effect Of Extracorporeal Shock Wave Combined With Ultrashort Wave Diathermy On Immobilized-induced Fibrosis And Contracture Of Skeletal Muscle And Its Possible Mechanism

Objective: The purpose of this study was to examine the intervention effect of radial extracorporeal shock wave combined with ultrashort wave diathermy on immobilization-induced fibrosis and contracture of skeletal muscle and explore its underlying mechanism.Methods: The groups included male rabbits for group(C).To cause joint contracture,rabbits underwent plaster fixation of a left knee joint at full extension.After immobilization for 4 weeks,all rabbits were randomly divided into 5 groups: model group(M),natural recovery group(NR),radial extracorporeal shock wave treatment group(R),ultrashort wave diathermy group(U),radial extracorporeal shock wave combined with ultrashort wave diathermy group(RU).The intervention effect of radial extracorporeal shock wave combined with ultrashort wave diathermy on fibrosis and contracture of muscle was assessed by evaluating the cross sectional area and the collagen deposition of skeletal muscle,measuring the knee-joint range of motion and measuring the protein levels for TGF-β1 and HIF-1α in the rectus femoris.Results: The combined treatment was more effective than radial extracorporeal shock wave or ultrashort wave diathermy alone.In comparison of the total and myogenic contracture,The total and myogenic contracture in the RU group was significantly smaller than those of the R group(P < 0.05)and U group(P < 0.01);H&E staining showed that the CAS increase was significant in the RU group in comparison with the R group(P > 0.05),but it is significant in comparison with the U group(P < 0.01);Sirius red staining revealed that the collagen fiber area in the RU group was lower than the U and R groups,and the decrease was significant difference only when compared with the R group(P < 0.001);In the comparison of HIF-1α and TGF-β1 protein levels,the protein level in RU group was lower than the R and U groups(P < 0.05);The protein level in RU group was significantly lower than the U group(P < 0.001),but there was no statistical difference compared with the R group(P > 0.05).Conclusion: Radial extracorporeal shock wave combined with ultrashort wave diathermy was effective in alleviating contracture and fibrosis of skeletal muscle,and reducing the molecular manifestations of muscle fibrosis in a rabbit model of immobilization-induced joint contracture,reversing the process of joint contractures to some extent at an early age.