Mechanobiology, Injury and Health
Determination of mRNA TNFα levels in peripheral blood leukocytes from SMT-treated asymptomatic subjects
Previous work from our laboratory has suggested that normal subjects who received a single manipulative therapy demonstrate a significantly reduced production of the soluble inflammatory mediators, tumor necrosis factor β, (TNFα) and interleukin-1 β, (IL-1β) (Teodorczk-Injeyan et al, 2005). These results are in concordance with other reports on the anti-inflammatory potential of SMT (Song et al, 2005; Mohammadian et al 2002). In vivo studies have shown alleviation of symptoms and shortening of the duration of pain and hyperalgesia caused by experimental induction of intervertebral foramen (IVF) inflammation following application of a manipulative force in an animal model (Song et al, 2005). Furthermore, using the same model, a manipulative force applied by activator was able to reduce hyperexcitibility in inflamed dorsal ganglion neurons thus, possibly, leading to a decrease in pain (Song et al, 2005). In contrast, Xu et al. have recently shown that neuropathic pain is associated with the up-regulation of immunoactive TNFα production (Xu et al, 2006).
While the available evidence suggests that spinal manipulative therapy can produce anti-inflammatory systemic effects, potential mechanisms underpinning such effects have not been explored. The proposed study will begin such an investigation.
Comparison of abdominal musculature thickness in postpartum and nulliparous women
Weis, Carol Ann & Triano, Jay
Low back pain (LBP) is one of the most common problems in health care today. In the pregnant population it is often accepted as an unavoidable complaint of normal gestation. The etiology of pain in pregnancy is unknown and it has been suggested that causation is multifactoral. It has been postulated that a weakened abdominal musculature to accommodate the growing baby may be a key factor. For some women, the pain can be debilitating and interfere with sleep, work and normal activities of daily living. Fortunately, the majority of women experiencing pain during pregnancy recover spontaneously shortly after delivery.
It has been determined that abdominal muscles have an important role in stabilizing the lumbar spine, which in turn has implications for the management and prevalence of low back pain. In the non-pregnant population, activation of the TA muscle will alleviate LBP in many. That result has been generalized to pain during pregnancy but remains unsubstantiated.
Several methods of assessing muscle have been used to contrast healthy and back pain sufferers including relative strength, endurance and recruitment timing with varied results. More recently, ultrasound imaging of muscles has been promising in defining morphologic differences between healthy and low back subjects. The purpose of this preliminary study is to evaluate the morphology of the abdominal musculature via ultrasound, defined by healthy nulli-para women and those who are within 4 weeks post-partum. Knowledge of the relevant changes between muscle groups will give foundation to clinical approaches in effort to prevent and to treat back pain associated with pregnancy.
Sensori-motor changes in an animal model of lumbar facet joint inflammation
Back pain is the most commonly reported type of persistent pain and costs the US economy an estimated $90 billion annually (Luo et al., 2003; see also Borghouts et al., 1999; Mantyselka et al., 2002; Sheehan et al., 1996). Facet joint dysfunction is a common source of back pain, thought to be due to inflammation or trauma (Kikuchi et al. 1984; Ng et al., 2005), but while studies have been undertaken on animal models of facet joint inflammation, there have been none directed at a range of sensory and of motor dysfunction tests, especially studies on long-term changes.
Three series of experiments are planned, each spanning two months. This will allow following the specific approach of Tachihara et al., 2007 in the first series, and two possible modifications of the model to suit our specific needs. This approach will ensure that we have project-specific data in time for the planned submission date for the NIH application we have been discussing. As these are exploratory studies and it is not possible to predict the success or the variation in establishing relevant model animals, there will be two groups of ten rats each in each of the three series, one group given the CFA injection and one given the vehicle as a control. This plan will also allow the possibility in the last or the last two series, depending upon the success of model induction and upon the variability in the changes seen in the sensory and motor tests, to develop a technique of spinal manipulation appropriate for this model, and to test this technique against the values achieved of measures of the changes seen.
Once the model is induced animals will be allowed one week for stabilization, and the animals will be tested each week over the next seven weeks. Following the period of testing the animals will be sacrificed humanely and tissues may be retained for subsequent analysis.