Daily and short-term application of joint movement for the prevention of infrapatellar fat pad atrophy due to immobilization.
Keisuke Takeda, Eisuke Takeshima, Satoshi Kojima and 3 others
PMID 31871369WHAT IT FOUND
In rats, daily 10-minute joint movement during cast immobilization reduced knee extension restriction and fat pad cell shrinkage compared with immobilization alone.
The rats still did not reach normal values. This is animal evidence, not a tested human treatment.
Key findings
01Daily 10-minute joint movement reduced the knee extension restriction angle to 60.7 ± 8.4° in prevention rats, compared with 75.4 ± 7.8° in contracture rats.
02Prevention group adipose cell cross-sectional area was 1,165.0 ± 316.6 μm², larger than contracture group 954.6 ± 287.7 μm² but smaller than normal group 1,356.3 ± 275.1 μm².
03Fibrosis was present in 4 rats in the contracture group and 3 rats in the prevention group, compared with 0 rats in the normal group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done in rats, not people, so it does not show what happens in a patient. Each group had only 5 rats. The prevention group still had worse joint extension and adipose cell changes than the normal group. The intervention was performed under anesthesia and involved removing the cast daily, which is not the same as human care. Only the anterior aspect of the femoral condyle was examined, so other parts of the infrapatellar fat pad may not be represented. The study did not test the best time, intensity, or frequency of joint movement. The authors state that the relationship between range of motion changes and adipose cell changes is unknown because other joint structural factors are also involved.
Declared interests
The authors declare no conflicts of interest. The text does not state a funding source.
The easy way to misread this
Do not read this as evidence that daily knee movement prevents contracture in patients. The study was done in 15 rats, not humans, and the prevention group still had worse joint extension and fat pad cell size than normal rats.