title: Understanding Mechanobiology: Physical Therapists as a Force in Mechanotherapy and Musculoskeletal Regenerative Rehabilitation.
abstract: Achieving functional restoration of diseased or injured tissues is the ultimate goal of both regenerative medicine approaches and physical therapy interventions. Proper integration and healing of the surrogate cells, tissues, or organs introduced using regenerative medicine techniques are often dependent on the co-introduction of therapeutic physical stimuli. Thus, regenerative rehabilitation represents a collaborative approach whereby rehabilitation specialists, basic scientists, physicians, and surgeons work closely to enhance tissue restoration by creating tailored rehabilitation treatments. One of the primary treatment regimens that physical therapists use to promote tissue healing is the introduction of mechanical forces, or mechanotherapies. These mechanotherapies in regenerative rehabilitation activate specific biological responses in musculoskeletal tissues to enhance the integration, healing, and restorative capacity of implanted cells, tissues, or synthetic scaffolds. To become future leaders in the field of regenerative rehabilitation, physical therapists must understand the principles of mechanobiology and how mechanotherapies augment tissue responses. This perspective article provides an overview of mechanotherapy and discusses how mechanical signals are transmitted at the tissue, cellular, and molecular levels. The synergistic effects of physical interventions and pharmacological agents also are discussed. The goals are to highlight the critical importance of mechanical signals on biological tissue healing and to emphasize the need for collaboration within the field of regenerative rehabilitation. As this field continues to emerge, physical therapists are poised to provide a critical contribution by integrating mechanotherapies with regenerative medicine to restore musculoskeletal function.
authors.affiliation: W.R. Thompson, PT, DPT, PhD, Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, Indiana.
authors.forename: William R
authors.initials: WR
authors.lastname: Thompson
authors.affiliation: A. Scott, PT, PhD, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Alexander
authors.initials: A
authors.lastname: Scott
authors.affiliation: M.T. Loghmani, PT, PhD, Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University.
authors.forename: M Terry
authors.initials: MT
authors.lastname: Loghmani
authors.affiliation: S.R. Ward, PT, PhD, Departments of Radiology, Orthopaedic Surgery, and Bioengineering, University of California-San Diego, La Jolla, California.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Ward
authors.affiliation: S.J. Warden, PT, PhD, FACSM, Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W Michigan St, CF-326. Indianapolis, IN 46202 (USA). stwarden@iu.edu.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Warden
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology; D002450:Cell Communication / Q000502:physiology; D003299:Cooperative Behavior; D006801:Humans; D018482:Muscle, Skeletal / Q000166:cytology* / Q000293:injuries / Q000502:physiology*; D009140:Musculoskeletal Diseases / Q000628:therapy; D010348:Patient Care Team; D059825:Physical Therapists; D026741:Physical Therapy Modalities; D024382:Professional Role; D044968:Regenerative Medicine; D012046:Rehabilitation; D015398:Signal Transduction / Q000502:physiology