Cyclic tensile strain upregulates collagen synthesis in isolated tendon fascicles

Screen, Hazel R. C.; Shelton, Julia C.; Bader, Dan L.; Lee, David A.

doi:10.1016/j.bbrc.2005.08.102

Cited by 93 publications

(72 citation statements)

References 24 publications

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“…In the literature, it is well accepted that mechanical load induced as cyclic strain on connective soft tissues such as tendons is an important regulator of the fibroblast's metabolic activity as well as a regulator of the maintenance of the tendon matrix (Arnoczky et al, 2002;Barkhausen et al, 2003;Screen et al, 2005;Webb et al, 2006). Furthermore, the modulation of the mechanical stimuli affects several physiological parameters of human fibroblasts and coordinates the amount of proliferation, apoptosis and expression of proteins (Zeichen et al, 2000;Skutek et al, 2001;Skutek et al, 2003;Barkhausen et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Adaptational responses of the human Achilles tendon by modulation of the applied cyclic strain magnitude

Arampatzis

Karamanidis

Albracht

2007

Journal of Experimental Biology

285

434

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SUMMARY Tendons are able to remodel their mechanical and morphological properties in response to mechanical loading. However, there is little information about the effects of controlled modulation in cyclic strain magnitude applied to the tendon on the adaptation of tendon's properties in vivo. The present study investigated whether the magnitude of the mechanical load induced as cyclic strain applied to the Achilles tendon may have a threshold in order to trigger adaptation effects on tendon mechanical and morphological properties. Twenty-one adults (experimental group, N=11; control group, N=10) participated in the study. The participants of the experimental group exercised one leg at low-magnitude tendon strain (2.85±0.99%) and the other leg at high-magnitude tendon strain (4.55±1.38%) of similar frequency and volume. After 14 weeks of exercise intervention we found a decrease in strain at a given tendon force, an increase in tendon-aponeurosis stiffness and tendon elastic modulus and a region-specific hypertrophy of the Achilles tendon only in the leg exercised at high strain magnitude. These findings provide evidence of the existence of a threshold or set-point at the applied strain magnitude at which the transduction of the mechanical stimulus may influence the tensional homeostasis of the tendons. The results further show that the mechanical load exerted on the Achilles tendon during the low-strain-magnitude exercise is not a sufficient stimulus for triggering further adaptation effects on the Achilles tendon than the stimulus provided by the mechanical load applied during daily activities.

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Section: Discussionmentioning

confidence: 99%

Adaptational responses of the human Achilles tendon by modulation of the applied cyclic strain magnitude

Arampatzis

Karamanidis

Albracht

2007

Journal of Experimental Biology

285

434

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“…The strain at the cellular level is much lower compared with the external tendon strain (Arnoczky et al, 2002;Screen et al, 2005). Two modes were suggested for the transmission of the external strain to the cellular level: cell deformation and fluid flow-induced shear stress (Lavagnino et al, 2003;Lavagnino et al, 2008).…”

Section: Research Articlementioning

confidence: 99%

Human achilles tendon plasticity in response to cyclic strain: effect of rate and duration

Böhm

Mersmann

Tettke

et al. 2014

Journal of Experimental Biology

104

180

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High strain magnitude and low strain frequency are important stimuli for tendon adaptation. Increasing the rate and duration of the applied strain may enhance the adaptive responses. Therefore, our purpose was to investigate the effect of strain rate and duration on Achilles tendon adaptation. The study included two experimental groups (N=14 and N=12) and a control group (N=13). The participants of the experimental groups exercised according to a reference protocol (14 weeks, four times a week), featuring a high strain magnitude (~6.5%) and a low strain frequency (0.17 Hz, 3 s loading/3 s relaxation) on one leg and with either a higher strain rate (one-legged jumps) or a longer strain duration (12 s loading) on the other leg. The strain magnitude and loading volume were similar in all protocols. Before and after the interventions, the tendon stiffness, Young's modulus and cross-sectional area were examined using magnetic resonance imaging, ultrasound and dynamometry. The reference and long strain duration protocols induced significantly increased (P<0.05) tendon stiffness (57% and 25%), cross-sectional area (4.2% and 5.3%) and Young's modulus (51% and 17%). The increases in tendon stiffness and Young's modulus were higher in the reference protocol. Although region-specific tendon hypertrophy was also detected after the high strain rate training, there was only a tendency of increased stiffness (P=0.08) and cross-sectional area (P=0.09). The control group did not show any changes (P=0.86). The results provide evidence that a high strain magnitude, an appropriate strain duration and repetitive loading are essential components for an efficient adaptive stimulus for tendons.

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“…A decrease of protein synthesis [94] and an increase of collagenase activity in damaged and not damaged fascicles [95] degenerate the immobilized tendon. Curiously, these deleterious processes have been stopped through cyclic stretching in in vitro studies [96,97] . As such, stretching techniques must be applied in the correct dose because its capacity of turnover the collagen synthesis [10] .…”

Section: Conservative Treatment Of Shoulder Tendinopathymentioning

confidence: 99%

Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives

Camargo

Alburquerque‐Sendín

Salvini

2014

WJO

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Excessive mechanical loading is considered the major cause of rotator cuff tendinopathy. Although tendon problems are very common, they are not always easy to treat. Eccentric training has been proposed as an effective conservative treatment for the Achilles and patellar tendinopathies, but less evidence exists about its effectiveness for the rotator cuff tendinopathy. The mechanotransduction process associated with an adequate dose of mechanical load might explain the beneficial results of applying the eccentric training to the tendons. An adequate load increases healing and an inadequate (over or underuse) load can deteriorate the tendon structure. Different eccentric training protocols have been used in the few studies conducted for people with rotator cuff tendinopathy. Further, the effects of the eccentric training for rotator cuff tendinopathy were only evaluated on pain, function and strength. Future studies should assess the effects of the eccentric training also on shoulder kinematics and muscle activity. Individualization of the exercise prescription, comprehension and motivation of the patients, and the establishment of specific goals, practice and efforts should all be considered when prescribing the eccentric training.In conclusion, eccentric training should be used aiming improvement of the tendon degeneration, but more evidence is necessary to establish the adequate doseresponse and to determine long-term follow-up effects. Key words: Cellular; Mechanotransduction; Rehabilitation; Shoulder Impingement; Supraspinatus; Tendon injuries Core tip: Eccentric training can be considered a new and ambitious treatment approach for several tendinopathies. The paper establishes the basic principles for explaining the effects on the tendon of an intense mechanical load, as the eccentric training. Further, the authors bring other possible explanations of the success of this training for tendinopathies, as the individualization of the exercise programs and the motivation of the patients who reach specific goals. Negative and side effects are also identified. Finally, the main evidence afforded by original articles is commented and future research purposes are defined.Camargo PR, Alburquerque-Sendín F, Salvini TF. Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives. World J Orthop 2014; 5(5): 634-644 Available from:

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Cyclic tensile strain upregulates collagen synthesis in isolated tendon fascicles

Cited by 93 publications

References 24 publications

Adaptational responses of the human Achilles tendon by modulation of the applied cyclic strain magnitude

Adaptational responses of the human Achilles tendon by modulation of the applied cyclic strain magnitude

Human achilles tendon plasticity in response to cyclic strain: effect of rate and duration

Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives

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