title: Biomechanical and histological effects of augmented soft tissue mobilization therapy on achilles tendinopathy in a rabbit model.
abstract: OBJECTIVE
  Augmented soft tissue mobilization (ASTM) has been used to treat Achilles tendinopathy and is thought to promote collagen fiber realignment and hasten tendon regeneration. The objective of this study was to evaluate the biomechanical and histological effects of ASTM therapy on rabbit Achilles tendons after enzymatically induced injury.
  
  
  METHODS
  This study was a non-human bench controlled research study using a rabbit model. Both Achilles tendons of 12 rabbits were injected with collagenase to produce tendon injury simulating Achilles tendinopathy. One side was then randomly allocated to receive ASTM, while the other received no treatment (control). ASTM was performed on the Achilles tendon on postoperative days 21, 24, 28, 31, 35, and 38. Tendons were harvested 10 days after treatment and examined with dynamic viscoelasticity and light microscopy.
  
  
  RESULTS
  Cross-sectional area in the treated tendons was significantly greater than in controls. Storage modulus tended to be lower in the treated tendons but elasticity was not significantly increased. Loss modulus was significantly lower in the treated tendons. There was no significant difference found in tangent delta (loss modulus/storage modulus). Microscopy of control tendons showed that the tendon fibers were wavy and type III collagen was well stained. The tendon fibers of the augmented soft tissue mobilization treated tendons were not wavy and type III collagen was not prevalent.
  
  
  CONCLUSIONS
  Biomechanical and histological findings showed that the Achilles tendons treated with ASTM had better recovery of biomechanical function than did control tendons.
authors.affiliation: Research Fellow, Mayo Clinic, Biomechanics Laboratory, Rochester, MN.
authors.forename: Kan
authors.initials: K
authors.lastname: Imai
authors.affiliation: Research Fellow, Mayo Clinic, Biomechanics Laboratory, Rochester, MN.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ikoma
authors.affiliation: Engineer, Mayo Clinic, Biomechanics Laboratory, Rochester, MN.
authors.forename: Qingshan
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Professor, Mayo Clinic, Biomechanics Laboratory, Rochester, MN.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Professor and Director, Mayo Clinic, Biomechanics Laboratory, Rochester, MN.
authors.forename: Kai-Nan
authors.initials: KN
authors.lastname: An
authors.affiliation: Associate Professor and Consultant, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN. Electronic address: rgay@mayo.edu.
authors.forename: Ralph E
authors.initials: RE
authors.lastname: Gay
mesh_terms: D000125:Achilles Tendon; D000818:Animals; D001696:Biomechanical Phenomena; D001707:Biopsy, Needle; D004195:Disease Models, Animal; D004548:Elasticity / Q000502:physiology; D007150:Immunohistochemistry; D008297:Male; D008405:Massage / Q000379:methods*; D026741:Physical Therapy Modalities; D011817:Rabbits; D011897:Random Allocation; D012016:Reference Values; D052256:Tendinopathy / Q000473:pathology* / Q000534:rehabilitation*; D013708:Tendon Injuries / Q000473:pathology / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Achilles Tendon; Massage; Tendinopathy; Tendon Injuries