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Free Online Class: Walk Better For People With Parkinson's Disease, Healing Through Words
Do you know someone with Parkinson's disease? Walk Better for People With Parkinson's Disease, Healing Through Words by Kimberly Burnham, PhD (Integrative Medicine). Free Class, Energetic Download and Notes at http://skl.sh/2BHbeAr and https://www.skillshare.com/r/profile/Kimberly-Burnham/1982084
Are you one of the ten million people worldwide living with Parkinson's disease? Is someone you love losing their independence or their ability to walk due to Parkinson's disease?
Possibly you have found success in medications and surgery. Perhaps you are looking for other ways to decrease the tremors in your hands, so you can enjoy a dinner out with friends. Maybe you want to improve your walking or are a lifelong runner who has had to give up exercise because of the stiffness in your legs and the pain in your back. Maybe you want to read this book to learn some easy ways to balance your brain chemistry and feel more expressive, more focused, and more successful.
ACUPUNCTURE, REIKI, CRANIOSACRAL THERAPY
Have you tried acupuncture for the symptoms of Parkinson's disease? Have you been thinking about how Craniosacral therapy, Integrative Manual Therapy or Reiki could improve your life?
MATRIX ENERGETICS or EMOTIONAL FREEDOM TECHNIQUE (EFT)
Maybe someone has talked to you about the benefits of Matrix Energetics, Emotional Freedom Technique's light tapping or Nature's Sensational Medicine. Perhaps you have never even heard of any of these things but your are searching for something that will help you feel better and are open to something new.
There is a saying, "You can't teach an old dog new tricks," but do you know the second part of the saying?
"The fastest way to become an old dog? .... Stop learning new tricks."
Yes, some of these exercises can seem crazy but before you decide, spend two minutes doing one of the many exercises, visualizations, movements. Spend some time looking at the colors around you or reading the research from ancient Traditional Chinese Medicine or the latest article from Amy Cuddy, a Harvard professor who has found that two minutes of "Power Posing" or standing in a Wonder Woman or Superman posture can improve testosterone levels, literally making you a more powerful leader. Striking a two minute pose, standing or moving in a particular way also decreases cortisol levels, which makes you more adaptable and less stressed.
Read the research linking dopamine to the energy of your gallbladder, even if it has been removed. In Acupuncture the gallbladder meridian is associated with the color green. It is, along with the liver a Wood Element. What if visualizing the color green flowing through your body, through your brain, through your liver and gallbladder could improve your control of movement, walking, or your facial expressions? Would it be worth spending two minutes a day?
What if visualizing yourself moving in a smooth controlled conscious way could help you in the real world to drive more safely, walk without falling and enjoy your family more. Read the research on motor imagery, on using the mind to heal the brain, on the response of dopamine to physical exercises as well as imaginative rehabilitation.
Imagination is being able to see something before it is visible before it is real in your life.
Would your life improve if you were more confident and compassionate or less angry and disappointed? What would change in the here and now if you could imagine a future with a full and independent life?
What if spending a few minutes a day thinking about disgusting food could improve your basal ganglia function. The basal ganglia is the part of the brain where surgically the deep brain stimulator is placed to suppress unwanted movements like ticks and tremors. What if your emotions could flow along the pathways that also light up the basal ganglia, making it possible for you to stand up, walk and turn as you navigate your world with more ease?
WHAT WOULD YOU DO TO FEEL BETTER?
What do you have to let go of to harness the healing in your own hands and in your own mind? Are you consciously using touch to improve your independence, your movement or your comfort?
Read this book for the easy ways to balance your brain chemistry and feel more expressive, more focused, and more successful
Look in these pages for other ways to decrease the tremors in your hands, so you can enjoy a dinner out with friends.
Improve your walking or get back to exercising by improving the stiffness in your legs and the pain in your back.
Easy tips and exercises to use in daily life from the fields of:
Integrative Manual Therapy
Osteopathic Manual Medicine
Emotional Freedom Technique
Acupressure / Acupuncture Therapy
5 Elements Theory of Traditional Chinese Medicine
Nature's Sensational Medicine
Darier's Disease: Skin, the Brain and Energy Medicine Approaches, Exercises for Enhanced Brain and Skin Health with Creative Problem Solving (Forthcoming Book)
Keep Out of The Heat
It would be easy to say, just keep out of the heat, don't sweat or get injured but that is difficult to do with a full life. This book is designed to help increase the quality of life of people with Darier's disease using nutrition and several forms of manual therapy and energy medicine.
A 2015 study found that Darier's disease or keratosis follicularis is worsened by heat, sun exposure, perspiration and mechanical trauma. Researchers noted, "Darier's disease is a rare autosomal dominant genodermatosis. It has an estimated prevalence of 1 in 55,000 to 100,000 individuals, regardless of gender. It is characterized by multiple keratotic papules on the seborrheic areas of the trunk, scalp, forehead and flexures, and the clinical picture is worsened by heat, sun exposure, perspiration and mechanical trauma. Histopathology observed loss of epithelial adhesion and abnormal keratinization. About 10% of cases present in the localized form of the disease. We report a case of segmental Darier's Disease Type I and discuss the main characteristics of this condition." - Medeiros, P. M., N. R. Alves, et al. (2015). "Segmental Darier's disease: a presentation of difficult diagnosis." An Bras Dermatol 90(3 Suppl 1): 62-65.
Another study listed common complaints as "itching, with exacerbations attributed to heat, sweating, sunlight, lithium, steroid therapy, stress, and menstruation "-Santos-Alarcon, S., C. Sanchis-Sanchez, et al. (2016). "Diclofenac sodium 3% gel for darier's disease treatment." Dermatol Online J 22(4).
Table of Contents for Darier's Disease: Skin, the Brain and Energy Medicine Approaches, Exercises for Enhanced Brain and Skin Health with Creative Problem Solving
About the Author 3
How To Use This Book 13
Keep Out of The Heat 16
What Can Change 18
What Do You Want? Health Coaching Wheel or Goal Setting 20
Health Coaching Wheel 22
Health Coaching Wheel Part 2 24
Nutrition and the Skin 26
Vitamin B Complex and Zinc 28
B3 or Flush Niacin 29
Radiation Induced Darier's 30
Skin and Niacin 31
Foods with Vitamin B and Vitamin A 33
Vitamin A 35
Traditional Chinese Medicine Color Therapies 36
Color Therapy 37
Metal Element Visualization 38
Breathing Exercises 39
Endoplasmic Reticulum Stress and Darier's Disease 40
Good Proteins 42
Magnesium Chloride Supplements 43
Calcium and the Brain 44
Endoplasmic Reticulum Stress 47
Acupuncture and Governing Vessel 20 49
GV 20 Stimulating the Governing Vessel and Conception Vessel 52
Acupressure, Diabetic Neuropathy and Endoplasmic Reticulum Stress 53
Ways to Stimulate Acupressure Points 55
Stomach 36 57
Endoplasmic Reticulum Stress and the Brain 58
Darier's and the Brain 59
The Relationship Between Skin and Mood 60
Effecting Change With Hands-On 63
Neurofascial Process Why You Should Touch 64
Tuning The Brain With Touch 65
Thriving on Touch 68
N as in Neural 71
Touch, Energy & Nervous System 72
Fascial System Connected To The.........Everything 73
“P” as in Process 74
Touch and Pain Reduction 75
Emotions and Organs 76
Recognizing Emotions 77
Angry Liver, Anxious Heart, Melancholy Spleen 79
Balancing Pain and Emotions 80
Intestines Boiling 81
Which Comes First: Smiling or That Happy Feeling 82
Touch and the Medical System 83
Traditional Chinese Medicine and Touch Diagnosis 84
Touch First Aid 85
Poetry and Symptoms 87
Therapeutic Writing 88
Found Poetry 89
Visual Poetry 90
Writing Poetry 91
Mind, Body, Spirit 92
One Hand Here, One Hand There Healing the Body and Brain 93
Rest Quietly Hands in Place 94
The Feeling of Hands 95
What Has Changed? 96
One Hand Here, One Hand There Healing with Brain Emotions and Colors 97
Time Travel and Integrating the Past and the Future 99
Bring Back To Now 101
List of Contact Points, Visualizations and Associated Structures to Use for Brain and Nervous System Health 103
Substantia Nigra 104
Limbic System 105
Almond Shaped Amygdala 106
Electricity and Light 110
Memory in the Hippocampus 112
The Heart and the Cirgulate Gyrus 113
Visualization and the Cingulate 114
Happy Anterior Cingulate Gyrus 115
Signal Carrier 116
Back Pain and Movement Disorders 119
Thalamus Comfort 121
Blinking Your Way to a Brighter Future 122
Vision, Balance, and Pain 125
Eliminating Hallucinations with the Mammillary Bodies 126
Harnessing the Limbic System 128
Basal Ganglia 130
Emotional Memory 132
Basal Ganglia Memories 133
Main Components of the Basal Ganglia 134
Exercise: Sleep Solutions 139
Hands-On Emotions 140
Organs and Structures 140
Touch Related References 147
More Books by Kimberly Burnham 152
Kimberly Burnham, PhD (Integrative Medicine), The Nerve Whisperer
Published in over 100 books, Kimberly Burnham is a writer, poet, and complementary medicine practitioner. She authored Awakenings: Peace Dictionary, Language and the Mind, a Daily Brain Health Program for people interested in improving their brain clarity, creativity and muscle movements. Her current project focuses on color words, the brain and vision health designed to assist people in seeing better. Kimberly's Ph.D. (Integrative Medicine) considered manual therapy techniques (Integrative Manual Therapy, Matrix Energetics, Acupressure, Reiki, CranioSacral Therapy, Myofascial release, Unwinding) and brain health coaching for people with Parkinson's disease. She is an avid gardener and environmentalist, who bicycled 3000 miles across the U.S. with Hazon (US Jewish Environmental group) in 2013. Contact Kimberly at https://www.nervewhisperer.solutions/ or email her at NerveWhisperer@gmail.com for a brain health coaching session.
She helps people with brain, spinal cord and vision issues including Darier's Disease, Parkinson's disease, Huntington's ataxia, diabetic neuropathy, multiple sclerosis, chronic back pain, autism, down syndrome, seizure disorders, macular degeneration, keratoconus, and night vision issues.
Kimberly Burnham co-owns a small self-publishing house - Creating Calm Network Publishing Group and helps authors, writers, and poets with publishing memoirs, novels, fiction, non-fiction essays, family cookbooks and more.
An award winning poet, Kim writes monthly for The Year of the Poet book and Inner Child Press. Kim recently read her peace poem for Spokane City Council as part of the Spokane Arts Poetry at the podium. She is a poet in residence for 2nd look books, a Spokane bookstore on the South Hill.
If you have Darier's disease and would like to have a consultation with Kimberly Burnham, please contact her at 860-221-8510 or via email NerveWhisperer@gmail.com or through her website http://NerveWhisperer.Solutions.
Mountain Climbers Over 55
People over 55 yr are 2.6 times less likely to suffer from acute mountain sickness than mountain climbers under 25 year old, said a study in High Altitude Medical Biology. The journal article noted the reason for these statistics, "self-medication, including acetazolamide and analgesics, had increased importantly from 17% to 56%, and contraception intake in women had increased from 19% to 32%." Researchers concluded, "in 1998 as compared to 1986, trekkers were older, climbed more slowly, had better awareness of altitude illness, used more medication, and suffered less from AMS." (Gaillard, S., P. Dellasanta, et al. (2004). "Awareness, prevalence, medication use, and risk factors of acute mountain sickness in tourists trekking around the Annapurnas in Nepal: a 12-year follow-up." High Alt Med Biol 5(4): 410-419.)
Prevention Starts with Awareness
No matter what age you are healthy adjustment to high altitudes starts with awareness. Consider what medications you are taking. Talk to your doctor about whether they will help you or hinder you as you set off for the mountains around Denver, Colorado or the mountains of Peru.
Another study recommended self assessment on climbs. "Acute mountain sickness is a common problem among adolescents. There are increasing numbers of adolescents traveling to high altitudes, and there appears to be a lack of information about the prevalence of acute mountain sickness in this age group. Motivated adolescents seemed capable of self-monitoring." -Imray, C. H., C. H. Kennedy, et al. (2004). "Self-assessment of acute mountain sickness in adolescents: a pilot study." Wilderness Environ Med 15(3): 202-206.
Know the symptoms of altitude sickness: difficulty sleeping, dizziness, headache, nausea or vomiting, loss of appetite, rapid heart rate and shortness of breath.
Tibetan Medicine for Heart Health
In a study to explore the protective effects of Tibetan medicine Zuo-Mu-A Decoction (ZMAD) on high altitude sickness, researchers found, "The cardiac muscle fibers were well-protected, mitochondrial matrix swelled mildly and ultrastructure changes were less prominent in the ZMAD group compared with the model group. ZMAD has the beneficial effect in protecting against myocardial injury." - Lu, M. Q., N. Tsring, et al. (2017). "Protective effects of traditional Tibetan medicine Zuo-Mu-A Decoction () on the blood parameters and myocardium of high altitude polycythemia model rats." Chin J Integr Med 23(12): 908-915.
Coca for Altitude Adjustment, Learning from History and Other Cultures
Tea made from coca leaves is available in many hotels and restaurants in Peru as travelers visit Cusco at 11,152 feet or 3,399m on their way to Machu Picchu. A 2015 study in Wilderness Environmental Medicine found, "the use of coca leaf for medicinal purposes is a centuries-old tradition of the native peoples of South America. Coca products are thought by many laypersons to provide risk-free benefits to users participating in strenuous activities at high altitude. Physiologic studies of coca have increased understanding of its possible mechanism of action as well as its potential impact on high altitude activities." - Biondich, A. S. and J. D. Joslin (2015). "Coca: High Altitude Remedy of the Ancient Incas." Wilderness Environ Med 26(4): 567-571.
Self-Massage and the Pericardium 6 Point. This is an acupressure point.
Acupressure for Lung 1 point and Breathing Exercises. This is an acupressure point.
Water for Brain Health. Always make sure you are drinking enough water.
Never Sleep While It Is Light
What time you arrive at your destination makes a difference in how well you adapt to time changes. One folk remedy for jet lag is "never, never sleep while it is light." This is easier to follow if you arrive at your destination in the evening as it is getting dark.
A study looking at athletes traveling for competition noted, "results from the current study suggest that sleep disruption, as a result of an early travel departure time (8 PM) and evening match (7:30 PM), and fatigue induced by competition had a greater effect on wellness ratings than long-haul air travel with a minimal time-zone change. " - Fowler, P., R. Duffield, et al. (2015). "Effects of northbound long-haul international air travel on sleep quantity and subjective jet lag and wellness in professional Australian soccer players." Int J Sports Physiol Perform 10(5): 648-654.
Acupuncture or Acupressure
Muscle stiffness from long haul travel and unusual hiking or walking in travel destinations can contribute to insomnia. Acupuncture or self administered acupressure can help. A research report in pain management noted, "Acupuncture is observed clinically to improve sleeping in chronic pain patients." -Hayhoe, S. (2017). "Insomnia: can acupuncture help?" Pain Manag 7(1): 49-57.
"Acupuncture has increasingly been used as an alternative therapy for treatment of Parkinson's disease (PD). However, the efficacy of acupunture for PD still remains unclear. The present study was designed to objectively and safely monitor anti-parkinsonian effects of electroacupuncture (EA) and brain activity in nonhuman primates modeling human PD. Six middle-aged rhesus monkeys were extensively studied by a computerized behavioral testing battery and by pharmacological MRI (phMRI) scans with specific dopaminergic drug stimulations. All animals were evaluated for behavior and phMRI responses under normal, parkinsonian, parkinsonian with EA treatment and parkinsonian after EA treatment conditions. Stable parkinsonian features were observed in all animals prior to entering the EA study and positive responses to levodopa (L-dopa) challenge were also seen in all animals. The results demonstrated that chronic EA treatments could significantly improve the movement speed and the fine motor performance time during the period of EA treatments, and the effectiveness of EA could be detected even 3 months after the EA treatment. The phMRI data revealed that chronic EA treatments could alter neuronal activity in the striatum, primary motor cortex (M1), cingulate gyrus and global pallidus externa (GPe) in the ipsilateral hemisphere to MPTP lesions. As seen in the changes of parkinsonian features, the residual effects of phMRI responses to apomorphine (APO) challenge could also be found in the aforementioned areas.
The results strongly suggest that anti-parkinsonian effects of electroacupuncture (EA) can be objectively assessed, and the method used in the present study could be translated into the human clinic with some minor modifications."
- Zhang, R., A. H. Andersen, et al. (2018). "Objectively measuring effects of electro-acupuncture in parkinsonian rhesus monkeys." Brain Res 1678: 12-19. https://www.ncbi.nlm.nih.gov/pubmed/29017909
Chronic pain is a significant issue for people with fibromyalgia and there are not many medications or conventional treatments that are effective. More and more people are looking to complementary and alternative medicine for solutions to health issues. In the first six months of 2017, there are already four journal articles on the benefits of acupuncture for pain relief in people with fibromyalgia. [Read more] How Acupuncture Alleviates Fibromyalgia Pain on the Sivana Spirit Blog with Kimberly Burnham.
Imagine a factory where they make kaleidoscopes. What do they need in order to be successful? What needs to be in place so that once they have the customers, the relationships set up and the first order comes in, they are ready to go? What needs to be in place for the kaleidoscopes to be produced and then more importantly enjoyed.
Kaleidoscopes are appreciated for their beauty, for the way they change the way we see things, and for the way we can have a completely different perspective when filtering the view through an artistically developed and functional nervous system, I mean kaleidoscope.
First they need a space in which to create products and services. Just like an efficient productive factory, our nervous system needs room to function and move. It needs the space to exchange signals and information. The nervous system can thrive in the absence of compression. It needs room to expand and communicate. There are pressure sensors in our body that keep track of just that - too much pressure.
Some call it the Goldilocks principle. You don't want too much pressure. You don't want the boundaries too loose. You want them just right. Practitioners of complementary medicine use many approaches to relax muscles, mobilize joints and create enough space for nerve that have been compressed or pinched. Practitioners use techniques with names like: Muscle Energy Technique, Integrative Manual Therapy, CranioSacral Therapy, Yoga, Pilates, Wisdom Healing Qigong, and other Movement and Manual Therapies - Hands-on Therapies
Once the factory owner has bought the land and built the space in which to develop his business, he needs to ensure that no one breaks into his factory and messes things up. Our nervous system is like the flashing red warning lights, the impossibly loud alarm, the Doberman's and the wall all rolled into one. Our nervous system needs, and maintains many of the protective mechanisms in the body. It needs to have a good boundary and safety system in place. The need for exchange from the outside and security issues for the internal environment have to be balanced. The security system needs to have a way to gain information from outside the perimeter, keep track of what is going on inside the perimeter, recognize the patterns of activity and identify friends and enemies. Our nervous system needs information in order to keep us alive and thriving. The observer feeding us that information is our sensory system with visual, auditory, taste and scent information as well as touch related data.
Once the space and security system is in place, the nervous system and all the tissues in the body need nutrients, the raw materials with which to build the walls and fibers of the individual nerve cells, the essential fatty layer around the cell that speeds up the communication system, the neurotransmitters and hormonal signaling system, and the electrolytes like sodium, potassium and calcium are needed to maintain the proper electrical balance across the system. Many alternative medicine practitioners can feel the hum or vibration of a well tuned nervous system.
Nutrients like proteins and fats are needed to build the system. They need to make their way into the digestive system at lunch time otherwise there is no chance they will make it to the nerve endings in the toes. Oxygen needs to move into the lungs, and from there into the blood stream in order for it to reach the sciatic nerves of the hips. The blood has to be flowing as well and that comes back to the compression issue. Blood vessels and nerves do best when they have space enough to adjust to our movement. What you don't want is a tether ball-like situation where part of the nerve or blood vessels is stuck while it gets moved around.
The nervous system also need fuels to generate energy. The brain needs carbohydrates and sugars to be broken down into glucose, while at the same time, too much sugar is toxic to the nervous system as in Diabetic Neuropathy and too little will put you in a coma. Goldilocks again. It needs to be balanced just right.
There is also a way in which time is a nutrient or a toxin depending on how it is used. For example you take someone with seizure activity add in the nutrients needed plus time can resolve the problem.
So how does the body sense whether there are enough nutrients or too many waste products and toxins? Chemical sensors tell your body the makeup of the blood flowing to the nerves, to the brain. There are a number of complementary medicine approaches which address the nutrients flowing into the body, into the nervous system and influence the communication between the nervous system and the digestive system and other networks in the body. These approaches include, Enriched Environments, Visceral Manipulation, Nutritional Therapies, Energy Medicine and Acupuncture.
Information is also like a nutrient that feeds our need for an interesting stimulating environment, ensuring a proper response which means we will be safe and thrive. Input data also gives us a reference around which we can model our selves or our nervous system. For example a person's nervous system will do better if they are seeing a practitioner whose nervous system is well regulated and calm. It is as if the client can model their nervous system after the practitioners. This is also important in leaders. A employees or followers can model their nervous system set point on a calm skilled leader or a rabble rouser inciting a mob. What kind of nervous system health are you modeling or expressing into the work environment?
All the time, even when we are sleeping, we are picking up information from our environment. Every moment our system is evaluating. Are we safe? Is there danger? Is there an opportunity for food or pleasure or a reward? Making that process more conscious, gives us more choices, making us safer and likely to get rewarded.
- Originally Published on The Catalyzed Leader Blog.
Kimberly Burnham, PhD
Published in over 100 books, Kimberly Burnham is a writer, poet, and complementary medicine practitioner. She authored Awakenings: Peace Dictionary, Language and the Mind, a Daily Brain Health Program for people interested in improving their brain clarity, creativity and muscle movements. Her current project focuses on color words, the brain and vision health designed to assist people in seeing better. Kimberly's Ph.D. (Integrative Medicine) considered manual therapy techniques (Integrative Manual Therapy, Matrix Energetics, Acupressure, Reiki) and health coaching for people with Parkinson's disease. She is an avid gardener and environmentalist, who bicycled 3000 miles across the U.S. in 2013. Kimberly Burnham is the managing editor of Inner Child Magazine and on the board of The United World Movement for Children. For a brain health coaching phone consultation or an appointment in Spokane, Washington contact Kimberly at https://www.nervewhisperer.solutions/ or email her at NerveWhisperer@gmail.com.
Connective Tissue Disorders and Manual Therapy
Manual therapy and Massage therapy practitioners, Acupuncturist, Integrative Manual Therapists, Osteopaths and Chiropractors use a variety of techniques to increase circulation and fluid flow, decrease scar tissue and pain, improve joint mobility and strength, reduce depression and eliminate the signs and symptoms of connective tissue and extracellular matrix disorders in the field of fasciology.
They treat clients with a variety of connective tissue dysfunctions including: Benign Joint Hypermobility, Marfan’s syndrome, Ehlers-Danlos syndrome / Cutis Hyperelastica, osteogenesis imperfecta, Scleroderma, Rheumatoid arthritis, Raynaud's phenomenon, mixed connective tissue disease (MCTD), Cardiovascular disorders, Down’s syndrome, metabolic disorders (homocystinuria and hyperlysinemia), Fibromyalgia, Recurrent joint dislocations, Chronic low back pain, Carpal tunnel syndrome and Motor vehicle accident (MVA) injuries.
This issue of The Burnham Review also focuses on the work on Helene Langevin, MD at the University of Vermont Medical School. She describes both the cellular properties of connective tissue and the effects of mechanical stretching and acupuncture in relationship to connective tissue. Many of the articles published by Dr. Langevin are available in full text.
In a recent article, Langevin notes, “a patient presenting with a flareup of ulcerative colitis preceded by a two week exacerbation of knee osteoarthritis would probably be thought to have two distinct problems, one in the gut and one in the knee. Establishing the presence of a connective tissue ‘‘bridge’’ between these two medical problems would potentially have important repercussions on both diagnosis and treatment of these conditions.” 1. Langevin, H. M. (2006). "Connective tissue: a body-wide signaling network?" Med Hypotheses 66(6): 1074-7 [Full Text] www.anatomytrains.com/uploads/rich_media/c04c7252238ff6f72d81f52c89a20f85.pdf and Anatomy Trains http://www.anatomytrains.com/at/library/articles and Fascia Research Congress http://www.fascia2007.com/presenters.php.
[Other Material on Connective Tissue Healing] https://www.nervewhisperer.solutions/peace/category/connective-tissue-healing
Self-Supervision System of Fasciology
The fascial network constituted by the connective tissues may be the anatomical basis for acupuncture therapy. Researchers found “acupoints were mainly located where thick connective tissues were present. In this fascial network, sensitive nerve endings, active cells and lymphatic vessels abounded in the sites with thick connective tissue, and needling at these sites induced definite biological effects. In light of biological phylogeny and embryo development, we believe that the connective tissue network may constitute a new functional system in the human body, the Self-supervision and control system.” 2. Wang, J., W. R. Dong, et al. (2007). "[From meridians and acupoints to self-supervision and control system: a hypothesis of the 10th functional system based on anatomical studies of digitized virtual human]." Nan Fang Yi Ke Da Xue Xue Bao 27(5): 573-9. http://www.camresearch.net/showabstract.php?pmid=17545059 and Wang, J., C. L. Wang, et al. (2007). "[Explanation of essence and substance basis of channels and collaterals with fasciology]." Zhongguo Zhen Jiu 27(8): 583-5. [PubMed Abstract] and [Abstract] http://www.camresearch.net/showabstract.php?pmid=17853756
Benign Joint Hypermobility
"Benign joint hypermobility syndrome (BJHS) is a connective tissue disorder with hypermobility in which musculoskeletal symptoms occur in the absence of systemic rheumatologic disease. When patients with this syndrome are first seen by a physician, their chief complaint is joint pain, so BJHS can be easily overlooked. Treatment modalities include patient education, activity modification, stretching and strengthening exercises for the affected joint, and osteopathic manipulative treatment.
Recurrent dislocation of the shoulder and patella as well as other orthopedic abnormalities are associated with joint laxity.
Strength training should consist of a combination of both open kinetic (distal extremity moves freely) and closed kinetic chain (distal extremity meets resistance) exercises. Closed kinetic chain exercises often simulate functional demands, while open kinetic chain activities are better for more targeted strength training.
Focused exercises to improve muscle strength, balance, and coordination may help improve joint stability and proprioception. Improvement of proprioception may reduce strain to the ligaments surrounding the joint and avoid further injury.
Thrust treatment techniques [Osteopathic Manipulative Treatment] applying high velocity/low amplitude forces are the most widely used, but because of the increased tissue fragility seen in BJHS and weak supporting structures of the joint, gentler techniques like facilitated positional release and Counterstrain are good alternatives.
OMT helps induce articular release resulting in increased joint motion, and reduced pain as well as improved blood flow, lymphatic drainage, and proprioception.” 3. Simpson, M. R. (2006). "Benign joint hypermobility syndrome: evaluation, diagnosis, and management." J Am Osteopath Assoc 106(9): 531-6. [Full Text] http://www.jaoa.org/cgi/content/full/106/9/531
Neural Effect of Connective Tissue Massage on Fibromyalgia
“Connective tissue massage (CTM) is a manipulative technique that facilitates the diagnosis and treatment of a wide range of pathologies. Observation and subsequent manipulation of the skin and subcutaneous tissues can have a beneficial effect upon tissues remote from the area of treatment. These effects appear to be mediated by neural reflexes that cause an increase in blood flow to the affected region together with suppression of pain.” 4. Goats, G. C. and K. A. Keir (1991). "Connective tissue massage." Br J Sports Med 25(3): 131-3. [PubMed Abstract] and [Abstract] http://www.camresearch.net/showabstract.php?pmid=1777777 5. Michalsen, A. and M. Buhring (1993). "[Connective tissue massage]." Wien Klin Wochenschr 105(8): 220-7 [PubMed Abstract] [Abstract] http://www.camresearch.net/showabstract.php?pmid=8506683.
Another randomized study of 48 individuals diagnosed with fibromyalgia showed “a series of 15 treatments with connective tissue massage conveys a pain relieving effect of 37%, reduces depression and the use of analgesics, and positively effects quality of life. The treatment effects appeared gradually during the 10-week treatment period.“ 6. Brattberg, G. and European Federation of Chapters of the International Association for the Study of Pain (1999). "Connective tissue massage in the treatment of fibromyalgia." Eur J Pain 3(3): 235-244 [PubMed Abstract] [Abstract] http://www.camresearch.net/showcitationlist.php?keyword=connective%20tissue%20fibroblasts.
Osteopath, Andrew Taylor Still's View of Connective Tissue
Dr Still “not only reset his patient’s hips, he also successfully treated goiters and acute appendicitis using manual techniques. He worked with muscles, bones, and joints, but, beyond that, “he worked with the fascia, which he described as the dwelling place of the soul.”7 (Still,1902). From a fascial perspective, muscles, bones, and joints are all included within the connective tissue.
7. Still, A. T. (1902). The Philosophy and Mechanical Principles of Osteopathy. Kansas City, Mo, Hudson-Kimberly Publication Co. [Full Text] 322 page e-book http://www.interlinea.org/atstill/eBookPMPO_V2.0.pdf.
The extracellular matrix, the microscopic aspect of connective tissue, is inherently a gel. It is only because of the movement of calcium ions (ie, calcium waves) that nutrients and waste products flow to and from the cells. Calcium ions depolymerize and make watery this otherwise unyielding gel. Similarly, when osteopathic manipulative treatment is used to treat patients with somatic dysfunction, it decongests the connective tissues to restore their acidic, gel-like character to a healthy, fluid quality. Then blood, lymph, and nerve function can operate efficiently.
Dr Still knew that congestion is antithetical to life when he said, fascia, “the framework of life,” is where we live and die. (Still,1902).
According to Still because “anyone can find disease,” the goal of osteopathic medicine is to “find health” in the tissues. This goal means practitioners must look for ways to support healthy metabolic activity of the connective tissues in which cells reside.8 (Lee,2006).
8. Lee, R. P. (2006). "Still's concept of connective tissue: lost in "translation"?" J Am Osteopath Assoc 106(4): 176-7; author reply 213-4. [Full Text] http://www.jaoa.org/cgi/content/full/106/4/176 and Sutherland, W. G., DO and D. Ada Strand and Anne Wales, editors, (1998). Contributions of Thought: the Collected Writings of W.G. Sutherland. Fort Worth, Tex, Sutherland Cranial Teaching Foundation; 1998 [Reference] http://www.osteopathic.org/pdf/pub_osteolit.pdf and Rogers, F. J., G. E. D'Alonzo, Jr., et al. (2002). "Proposed tenets of osteopathic medicine and principles for patient care." J Am Osteopath Assoc 102(2): 63-5 [Full Text] http://www.jaoa.org/cgi/reprint/102/2/63.
Extracellular Matrix Unifying Structure and Function
Describing connective tissue as “Osteopathic Tissue” or the place where manual therapy techniques take place, Lee notes, “the extracellular matrix and the cytoskeleton operate as an unified electromechanical and chemomechanical system to turn cell functions on and off. All the necessary elements for the health and maintenance of the organism exist in, and pass through, the extracellular matrix. Thus, we can say that the connective tissues are holistic, demonstrating a structure function interrelationship and containing all the necessary resources for self-healing." 9. Lee, R. P. (2006). "Still's concept of connective tissue: lost in "translation"?" J Am Osteopath Assoc 106(4): 176-7; author reply 213-4. [Full Text] http://www.jaoa.org/cgi/content/full/106/4/176
Ehlers-Danlos, Osteogenesis Imperfecta and Manual Therapy
Ehlers-Danlos Syndrome is a genetically based disorder, where the connective tissue is looser or more lax than it should due to problems with collagen synthesis. EDS is part of a group of connective tissue disorders characterized by abnormalities of the skin, ligaments and internal organs. The skin and blood vessels are extremely fragile and elastic. The skin is soft with rubber consistency and easily bruising. There are hypermobile joints with increased extensibility. There are also sometimes respiratory related problems. 10. Lopes, C., A. Manique, et al. (2006). "[Ehlers-Danlos syndrome - a rare cause of spontaneous pneumothorax]." Rev Port Pneumol 12(4): 471-80. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16969576
“Orthopaedic complications such joint pain, joint swelling, joint dislocation, back pain, with walking and hand function disability are the main problems in Ehlers-Danos syndrome. Physical therapy has an important place in management." 11. Le Tallec, H., A. Lassalle, et al. (2006). "[Two cases of rehabilitation in Ehler-Danlos syndrome]." Ann Readapt Med Phys 49(2): 81-4. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16430988
“Collagen mutations are directly responsible for the bone fragility of Osteogenesis Imperfecta and indirectly responsible for Ehlers-Danlos syndrome symptoms, by interference with N-propeptide removal.” 12. Cabral, W. A., E. Makareeva, et al. (2005). "Mutations near amino end of alpha1(I) collagen cause combined osteogenesis imperfecta/Ehlers-Danlos syndrome by interference with N-propeptide processing." J Biol Chem 280(19): 19259-69. [Full Text] http://www.jbc.org/cgi/content/full/280/19/19259
Integrative Manual Therapy and other hands-on techniques are used to help restore function and quality of life for people with Ehlers-Danlos syndrome, Osteogenesis Imperfecta and other connective tissue disorders which can lead to joint problems especially in the weight bearing joints of the legs.
CAM Treatment for Scleroderma
“Scleroderma is an autoimmune disease of the connective tissue characterized by fibrosis and thickening of various tissues. It can be limited to the skin or affect multiple organs, and its course ranges from slowly to rapidly progressive. There are “several promising natural treatments for scleroderma, including para-aminobenzoic acid, vitamin E, vitamin D, evening primrose oil, estriol, N-acetylcysteine, bromelain, and an avocado/soybean extract.” 13. Gaby, A. R. (2006). "Natural remedies for scleroderma." Altern Med Rev 11(3): 188-195. [Full Text] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17217320
Acupuncture and Tissue Planes
Helene Langevin, MD notes, “Acupuncture meridians traditionally are believed to constitute channels connecting the surface of the body to internal organs.”
University of Vermont medical researchers, “found an 80% correspondence between the sites of acupuncture points and the location of intermuscular or intramuscular connective tissue planes in postmortem tissue sections.” Dr. Langevin continues, “because the structure and composition of interstitial connective tissue is responsive to mechanical stimuli, we propose that it plays a key role in the integration of several physiological functions with ambient levels of mechanical stress.” 14. Langevin, H. M. and J. A. Yandow (2002). "Relationship of acupuncture points and meridians to connective tissue planes." Anat Rec 269(6): 257-65. [Full Text] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12467083 and [Full Text] http://www.med.uvm.edu/neurology/downloads/Relationshipofacupuncturepointsandmeridianstoconnectivetissueplanes.pdf
IMT and Soft Tissue Injuries
Integrative Manual Therapy (IMT) is being used to recovery function and decrease pain. A 2005 article describes some of the benefits. A car accident left Dina Drits with soft-tissue damage in her lower back and her pelvis out of alignment. “It hurt to brush my teeth and I couldn't walk for more than 15 minutes at a time. I couldn't do any of my regular sports and I was a ballroom dancer."
After IMT treatment Drits reported, “I absolutely do things I couldn't do. Yoga and tai chi are both therapeutic. I can go on long hikes now." 15. Collins, L. (2005). "Healing hands Integrated manual therapy is alternative method of relieving pain." 2005(Sept 17): [Full Text] http://deseretnews.com/dn/view/0,1249,600108104,00.html.
In an article aimed at helping athletes improve function, Holt writes, “manual therapies are time-consuming in the light of the simple task of hooking an athlete to a therapeutic machine. However, they are recognized as important techniques in controlling pain, restoring normal range of motion, and treating specialized conditions such as myofascial pain syndrome.” 16. Holt, J. (2004). "Manual Therapy and Athletic Injury Rehabilitation: Benefits of a Class of Therapy." The Sport Supplement, A Supplement of the Sports Journal Volume 12, Number 3: Summer(from www.thesportjournal.org/sport-supplement/vol12no3/03manual_therapy.asp and /www.friidrott.se/veteran/dokument/dunton/2004/trainin32.html).
Holt lists the benefits of manual therapies in connective tissue, muscle and joint related problems:
Massage Therapy for –> relief of spasm, increased lymphatic drainage, increased cutaneous circulation, increased cell metabolism, increased venous flow, increased extensibility of connective tissues, increased pliability of scar tissue, decreased neuromuscular excitability.
Myofascial Release for –> relief of spasm, decrease in gamma gain/relaxation of hypersensitivity to stretch, relaxation of tight fascia, joint mobilization, restoration of correct joint function, stimulation of joint receptors, increased large-diameter afferent fiber input.
Muscle Energy Technique for –> increased stretching of tight muscles/fascia, strengthening of weakened muscles, mobilization of restricted joints
Strain-Counterstrain for –> reducing/arresting inappropriate proprioceptive activity 17. Holt, J. (2004). "Manual Therapy and Athletic Injury Rehabilitation: Benefits of a Class of Therapy." The Sport Supplement, A Supplement of the Sports Journal Volume 12, Number 3: Summer(from www.thesportjournal.org/sport-supplement/vol12no3/03manual_therapy.asp and /www.friidrott.se/veteran/dokument/dunton/2004/trainin32.html).
The article also looks at the effects of Integrative Manual Therapy on knee pain. Lunn (2001) reported the case of an 18-year old male who had reconstructive surgery of the right anterior cruciate ligament following a skiing accident and subsequent re-injury. The patient used crutches, toe touch weight bearing only, no brace and medication for pain.
The specific techniques used were Jones’ Strain-Counterstrain, lymph node and blood vessel Advanced Strain-counterstrain, Myofascial Release, Bone Bruise Therapy, Disruption of Membrane, and Neural Tissue Tension. Home exercises were also performed as directed by the physical therapist. After two days, there was significant improvement in quadriceps strength, ambulation, and range of motion in hip, knee, and ankle joints, as well as sensory improvement in the affected thigh.” 18. Holt, J. (2004). "Manual Therapy and Athletic Injury Rehabilitation: Benefits of a Class of Therapy." The Sport Supplement, A Supplement of the Sports Journal Volume 12, Number 3: Summer(from www.thesportjournal.org/sport-supplement/vol12no3/03manual_therapy.asp and /www.friidrott.se/veteran/dokument/dunton/2004/trainin32.html).
Another article notes “two disabled patients diagnosed with Ehlers-Danlos syndrome had spinal pain, including neck and back pain, headache, and extremity pain. Commonalities among these 2 cases included abnormal spinal curvatures (kyphosis and scoliosis), joint hypermobility, and tissue fragility. One patient had postsurgical thoracolumbar spinal fusion (T11-sacrum) for scoliosis and osteoporosis. The other patient had moderate anterior head translation.”
The clients both benefitted from joint mobilization techniques. Researchers noted, “both patients were able to reduce pain and anti-inflammatory medication usage in association with chiropractic care.
Significant improvement in self-reported pain and disability as measured by visual analog score, Oswestry Low-Back Disability Index, and Neck Pain Disability Index were reported, and objective improvements in physical examination and spinal alignment were also observed following chiropractic care. Low-force chiropractic adjusting techniques may be a preferred technique of choice in patients with tissue fragility.” 19. Colloca, C. J. and B. S. Polkinghorn (2003). "Chiropractic management of Ehlers-Danlos syndrome: a report of two cases." J Manipulative Physiol Ther 26(7): 448-59.[PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12975632
Manipulation and Sleep
"The aim of the study was to evaluate the short-term and 1-year follow-up results of connective tissue manipulation of the back and combined ultrasound therapy (US and high-voltage pulsed galvanic stimulation) in terms of pain, complaint of nonrestorative sleep, and impact on the functional activities in patients with fibromyalgia (FM).
Statistical analyses revealed that pain intensity, impact of FM on functional activities, and complaints of nonrestorative sleep improved after the 20 treatment program." 20. Citak-Karakaya, I., T. Akbayrak, et al. (2006). "Short and long-term results of connective tissue manipulation and combined ultrasound therapy in patients with fibromyalgia." J Manipulative Physiol Ther 29(7): 524-8. [PubMed Abstract] and [Abstract] http://www.camresearch.net/showabstract.php?pmid=16949941
Two books explain in detail ways to use Integrative Manual Therapy to work with the connective tissue and extremity joints
Dr. Sharon W. Giammatteo’s most recent book focuses exclusively on connective tissue and the use of Integrative Manual Therapy for connective tissue disorders. 21. Weiselfish-Giammatteo, S., J. B. Kain, et al. (2005). Integrative manual therapy for the connective tissue system : myofascial release. Berkeley, Calif., North Atlantic Books.
In a 2000 article W. Giammatteo describes some of the things a therapist working with connective tissue and structural disorders affecting the knees should consider, “muscle spasm of muscles which move the pelvis, hip, knee and ankle joints can contribute to decreased joint mobility and ranges of motion. The iliacus, piriformis, adductors, hamstrings, quadriceps, and gastrocnemius muscles typically compromise knee function when they are in spasm. Often there is scarring and hypertrophy of the connective tissue in the region of the knee, especially the joint capsule, the medial and lateral collateral ligaments, the tendons of medial hamstrings and gastrocnemius, and the cartilage of the meniscus.
Compromised knee joint space causes friction which results in breakdown of the hyaline cartilage. Osteoarthritis will possibly occur.
Occasionally circulation is affected which may cause a deep, burning discomfort in and around the knee joint. The common vascular problems which affect knee circulation are impingements and stenosis of the femoral artery and femoral vein at the hip joint region.
The tibial lymph node which is inferior to the knee joint may be swollen secondary to infection, which causes pain, swelling and congestion of the knee and distal leg. Often knee joint problems may be secondary to limited dorsiflexion of the ankle joints: the tibiotalar and subtalar joints.
When dorsiflexion is less than 10 degrees, the tibia cannot glide forward on talus during walking and running. This limitation of motion results in excessive extensor forces transcribed up the leg. In this scenario, the quadriceps goes into spasm, compresses the patella against the femur, causing a breakdown of hyaline cartilage behind the patella, causing chondromalasia.” 22. Giammatteo, S. (2000). What is Integrative Manual Therapy and How Does it Relate to Knee Injuries: from http://www.centerimtboulder.com/sportsinjuries_article1.htm.
She goes on to say, “many approaches are utilized to affect healing on a cellular and also on a systems level. Improved structural integrity will change the status quo for improved potential. Functional Rehabilitation is then more effective.” 23. Giammatteo, S. (2000). What is Integrative Manual Therapy and How Does it Relate to Knee Injuries: from http://www.centerimtboulder.com/sportsinjuries_article1.htm.
“According to homotoxicology illness is defined as an overload of the connective tissue matrix with toxic substances, the homotoxins. In order to support elimination of these homotoxins, complex homeopathic medicines were developed.
Fibroblasts are the local cells of matrix and produce and modulate the composition of the extracellular matrix (ECM) in every organ.
As the modulation of the ECM is dependent on the activity of the fibroblasts, plant extracts may modulate the composition of the ECM via the inhibitory effect on fibroblasts cell growth.” 24. Valentiner, U., M. Weiser, et al. (2003). "The effect of homeopathic plant extract solutions on the cell proliferation of human cutaneous fibroblasts in vitro." Forsch Komplementarmed Klass Naturheilkd 10(3): 122-7. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12853718
Connective Tissue Dysplasia and Terri G Varicosities
An analysis was made of two groups of patients presenting with varicosities. The first group comprised 82 patients aged 15 to 30 years without risk factors. The second group accrued 85 patients with traditional risk factors: pregnancy and birth, overweight, considerable dynamic and physical loading, age from 30 to 50 years, and intake of hormonal contraceptives.
It has been established that the key role in the development of varicosis is played by connective tissue dysplasia (CTD), the intensity of which predetermines the origination of phlebopathy and varicosis as well as the rate of their progression. The most frequently occurring is the mechanism of the development of phlebopathy as structural and functional defectiveness of all venous vessels of the extremity, leading to the rise of the deposited blood volume in the leg because of the high elasticity of venous walls.
Secondly, CTD that initially impairs valve morphology, results in local varicosis under the effect of reflux hydrodynamic strokes at the weakened venous wall.” 25. Tsukanov Iu, T. and A. Tsukanov (2004). "[Varicosis of the lower extremities as a consequence of connective tissue dysplasia]." Angiol Sosud Khir 10(2): 84-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15163975
"A 47-year-old woman presented with facial spasm, swollen fingers and Raynaud's phenomenon due to cerebrovascular disorder and mixed connective tissue disease (MCTD).
In this case, systemic atherosclerosis might have been linked to these autoimmune reactions." 26. Kanazawa, M., Y. Wada, et al. (2004). "Mixed connective tissue disease associated with antineutrophil cytoplasmic antibodies against proteinase-3 and systemic atherosclerosis: a case report." Clin Rheumatol 23(5): 456-9. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15459817
Blood Vessel Walls in Ehlers-Danlos and Nutrition
Problems of the blood vessel wall integrity and easy bruising is a common feature in Ehlers-Danlos syndrome. 27. Yen, J. L., S. P. Lin, et al. (2006). "Clinical features of Ehlers-Danlos syndrome." J Formos Med Assoc 105(6): 475-80.
There are manual therapy techniques to address membrane wall fragility (Disruption of Membrane technique). 28. Weiselfish-Giammatteo, S. (2000) Disruptions of Membrane. from www.centerimt.com/Products/videos.asp. Bloomfield, CT, Dialogues in Contemporary Rehabilitation.
People should also consider the benefits of essential fatty acids (fish oils) and antioxidants in the healing of membrane wall weakness.
Smooth Muscle in Fibroblasts
“Alpha smooth muscle actin was recently shown to be present in mouse subcutaneous tissue fibroblasts in the absence of tissue injury. 29. Storch, K. N., D. J. Taatjes, et al. (2007). "Alpha smooth muscle actin distribution in cytoplasm and nuclear invaginations of connective tissue fibroblasts." Histochem Cell Biol 127(5): 523-30. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17310383
Green Tea, Essential Fatty Acids
“Some green tea catechins are chondroprotective. Consumption of green tea may be prophylactic for arthritis and may benefit the arthritis patient by reducing inflammation.” 30. Adcocks, C., P. Collin, et al. (2002). "Catechins from green tea (Camellia sinensis) inhibit bovine and human cartilage proteoglycan and type II collagen degradation in vitro." J Nutr 132(3): 341-6. [Full Text] http://jn.nutrition.org/cgi/content/full/132/3/341
Essential fatty acids, especially polyunsaturated fatty acids (PUFA) can benefit cartilage and connective tissue disorders. One study found, “the pathologic indicators manifested in human OA cartilage can be significantly altered by exposure of the cartilage to n-3 PUFA, but not to other classes of fatty acids.” 31. Curtis, C. L., S. G. Rees, et al. (2002). "Pathologic indicators of degradation and inflammation in human osteoarthritic cartilage are abrogated by exposure to n-3 fatty acids." Arthritis Rheum 46(6): 1544-53. [Full Text] retracted http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12115185
Another study found, “n-3 PUFA (represented by EPA in this study) positively affect the healing characteristics of medial collateral ligament (MCL) cells and therefore may represent a possible noninvasive treatment to improve ligament healing.” 32. Hankenson, K. D., B. A. Watkins, et al. (2000). "Omega-3 fatty acids enhance ligament fibroblast collagen formation in association with changes in interleukin-6 production." Proc Soc Exp Biol Med 223(1): 88-95. [Full Text] http://www.ebmonline.org/cgi/content/full/223/1/88
Low Level Laser / Cold Laser
Low level laser therapy (LLLT) is a therapeutic intervention used by manual therapist for back pain. “Low level laser therapy is a non-invasive light source treatment that generates a single wavelength of light. It emits no heat, sound, or vibration. It is also referred to as photobiology or biostimulation. LLLT is believed to affect the function of connective tissue cells (fibroblasts), accelerate connective tissue repair and act as an anti-inflammatory agent. Lasers with different wavelengths, varying from 632 to 904 nm, are used in the treatment of musculoskeletal disorders. 33. Yousefi-Nooraie, R., E. Schonstein, et al. (2007). "Low level laser therapy for nonspecific low-back pain." Cochrane Database Syst Rev(2): CD005107. [Abstract] http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005107/frame.html
34. Luminex Medical Laser System 4 different heads with laser diodes of an average power of 500mW at a wavelength of 867nm[Full Text] www.medicallasersystems.com
Infertility and Manual Therapy
“In a study to assess the effectiveness of site-specific manual soft tissue therapy in facilitating natural fertility and improving in vitro fertilization (IVF) pregnancy rates in women with histories indicating abdominopelvic adhesion formation, researchers found, "this innovative site-specific protocol of manual soft-tissue therapy facilitates fertility in women with a wide array of adhesion-related infertility and biomechanical reproductive organ dysfunction. The therapy, designed to improve function by restoring visceral, osseous, and soft-tissue mobility, is a nonsurgical, noninvasive manual technique with no risks and few, if any, adverse side effects or complications.
Mobilization of the soft tissues using site-specific manual therapy appears to break the attachments of the collagenous cross-links within the adhesions, thus restoring normal mobility and function to the previously adhered organs.
According to Mojzisovà, "there is a direct relationship between the condition of the lower back muscles and the way the reproductive organs function." 35. Mojzis L, Nemec R, Hlavaty V. Children of Your Own: the Mojzis Method. Boulder, Colo: Richmond Bay; 1990. and (Volejnikova,2001). Volejnikova H. Female infertility: a study of physical treatment by the method of L. Mojzisovà for functional disturbances of the pelvic region. J Orthopaedic Med. 2001;23:47-49.
The purpose of the second Prague study, based on 2006 randomly selected infertile women, was to determine which types of infertility were best suited for treatment by the Mojzisovà method. Results showed that conception rates ranged from a low of 11% for women aged 40 to 44 to a high of 46% for the age group 20 to 24. 36. Wurn, B. F., L. J. Wurn, et al. (2004). "Treating Female Infertility and Improving IVF Pregnancy Rates With a Manual Physical Therapy Technique." Medscape General Medicine 6(2):51: [Full Text] http://www.medscape.com/viewarticle/480429_print and www.clearpassage.com.
Back Pain Mechanism and Fear
"We hypothesize that pain-related fear leads to a cycle of decreased movement, connective tissue remodeling, inflammation, nervous system sensitization and further decreased mobility.
The integration of connective tissue and nervous system plasticity into the model will potentially illuminate the mechanisms of a variety of treatments that may reverse these abnormalities by applying mechanical forces to soft tissues (e.g. physical therapy, massage, chiropractic manipulation, acupuncture), by changing specific movement patterns (e.g. movement therapies, yoga) or more generally by increasing activity levels (e.g. recreational exercise).
An integrative mechanistic model incorporating behavioral and structural aspects of cLBP will strengthen the rationale for a multidisciplinary treatment approach including direct mechanical tissue stimulation, movement reeducation, psychosocial intervention and pharmacological treatment to address this common and debilitating condition." 37. Langevin, H. M. and K. J. Sherman (2007). "Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms." Med Hypotheses 68(1): 74-80. [Full Text] www.chiro.org/LINKS/ABSTRACTS/Pathophysiological_Model_for_Chronic_Low_Back_Pain.shtml[PubMed Abstract] www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16919887
Chiropractor, Dan Murphy, highlighted a number of key points:
1) In chronic low back pain, there is an integration between connective tissue fibrosis and the nervous system perception of pain.
2) Adverse connective tissue fibrosis can be remodeled by applying mechanical forces to soft tissues, (chiropractic spinal adjusting).
3) The association between symptoms and imaging results (X-ray, CT, MRI) has been consistently weak, and up to 85 percent of patients with low back pain cannot be given a precise pathoanatomical diagnosis.
4) Ongoing pain is associated with widespread neuroplastic changes at multiple levels within the nervous system, including primary afferent neurons, spinal cord, brainstem, thalamus, limbic system and cortex."
5) There are distinct "brain networks" involved in acute vs. chronic pain. Chronic pain is specifically related to regions for cognition and emotions.
6) Chronic back pain results in neuronal or glial loss in the pre-frontal and thalamic gray matter. 38. Dr. Dan Murphy,DC from [Full Text]www.chiro.org/LINKS/ABSTRACTS/Pathophysiological_Model_for_Chronic_Low_Back_Pain.shtml
According to Langevin & Sherman, evidence supports the fact that among chronic low back patients, pain affects how they move, resulting in abnormal trunk muscle activity during postural perturbation, impaired control of trunk and hip during arm movements and abnormal postural compensation for respiration. As a result of emotional, behavioral and motor dysfunction, abnormal connective tissue remodeling, inflammation, nervous system sensitization and further decreased mobility occurs, creating a vicious cycle." 39. Warren, H (2006) Fibrosis May Be Related to Chronic Pain www.warrenhammer.comand www.chiroweb.com/columnist/hammer
Fibrosis May Be Related to Chronic Pain
Langevin and Sherman stressed the association of abnormal connective tissue with the nervous system: "Both increased stress due to overuse, repetitive movement and / or hypermobility, and decreased stress due to immobilization or hypomobility can cause changes in connective tissue." Both hyper- and hypomobility can result in either atrophy or fibrosis. Inflammation, tissue hypo-oxygenation and cytokines such as TGF-1 will promote fibrosis.
Whether it is the presence of trigger points within the fascia causing painful muscle contraction, microinjury, inflammation, growth factors or abnormal biomechanics, there will be an increase in fibrosis, leading to increased tissue stiffness and further loss of motion.
“They also state that research into this area will help explain why treatments such physical therapy, massage, chiropractic manipulation, acupuncture, movement therapies and yoga may be valuable.” 40. Warren, H (2006) Fibrosis May Be Related to Chronic Pain www.warrenhammer.comand www.chiroweb.com/columnist/hammer
Neck and Dura Connection
"The connective tissue attachments to the cervical spinal dura mater originate from the ligamentum nuchae (LN) and rectus capitis posterior minor (RCPM) muscle Our results indicate that: 1) the attachments between the LN and RCPM and the dura occur between vertebrae C1-C2 and the occipital bone and C1, respectively, and that they are substantial normal anatomic attachments, 2) attachments between the LN and RCPM are usually present, and 3) the attachments between the LN and dura mater can be identified on MRI. These latter attachments may play a role in neck pain, making their MRI appearance clinically important."
41. Humphreys, B. K., S. Kenin, et al. (2003). "Investigation of connective tissue attachments to the cervical spinal dura mater." Clin Anat 16(2): 152-9. [PubMed Abstract] and [Abstract] http://www.camresearch.net/showabstract.php?pmid=12589671
“Acupuncture points and meridians are commonly believed to possess unique electrical properties. Recent studies indicate a correspondence between acupuncture meridians and connective tissue planes. We hypothesized that segments of acupuncture meridians that are associated with loose connective tissue planes (between muscles or between muscle and bone) visible by ultrasound have greater electrical conductance (less electrical impedance) than non-meridian, parallel control segments.
Meridian segments were determined by palpation and proportional measurements. Connective tissue planes underlying those segments were imaged with an ultrasound scanner. Along each meridian segment, four gold-plated needles were inserted along a straight line and used as electrodes. A parallel series of four control needles were placed 0.8 cm medial to the meridian needles.
Tissue impedance was on average lower along the Pericardium meridian, but not along the Spleen meridian, compared with their respective controls. Ultrasound imaging of meridian and control segments suggested that contact of the needle with connective tissue may explain the decrease in electrical impedance noted at the Pericardium meridian. 42. Ahn, A. C., J. Wu, et al. (2005). "Electrical impedance along connective tissue planes associated with acupuncture meridians." BMC Complement Altern Med 5: 10. [Full Text] http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15882468
Energy and TCM
"There are three inter-related levels of a macromolecular energy-information relay system in the human body, each generated by a specific type of semi-conductant tissue and each with a specific function.
The surface layer of the energy body, generated by fluid connective tissue and known as the ordinary channel system or meridian system in traditional Chinese medicine (TCM), functions in the service of immunosurveillance through detection of distress signals and transmitting energy-information regarding immunoresponse.
The middle layer of the energy body, generated by semi-conductant hard and spongy bone tissue, known as the extraordinary channel system in TCM, functions in the service of longevity and regeneration, as described in Bodhidharma's classic, Bone Marrow Washing. The bone marrow energy-information system has direct relevance to modern stem cell research on the role of stem cells in regeneration of injured tissue.
The deepest layer of the nery body, generated by semi-conductant nervous system tissue, notably the vagus nerve and spinal column, functions in the services of awakening consciousness and in immortality. This system is described in the Tibetan Inner Fire meditations as well as in the Taoist shen breathing practices. There is very little scientific understanding of the central channel system." 43. Brown, D. P. (2007). "The Energy Body and Its Functions: Immunosurveillance, Longevity, and Regeneration." Ann N Y Acad Sci. [Abstract] http://www.camresearch.net/showabstract.php?pmid=17905935
“Acupuncture needle rotation has been previously shown to cause specific mechanical stimulation of subcutaneous connective tissue. Needle rotation induced extensive fibroblast spreading and lamellipodia formation within 30 min, measurable as an increased in cell body cross sectional area. Significant effects of rotation were present throughout the tissue, indicating the presence of a response extending laterally over several centimeters.” 44. Langevin, H. M., N. A. Bouffard, et al. (2006). "Subcutaneous tissue fibroblast cytoskeletal remodeling induced by acupuncture: evidence for a mechanotransduction-based mechanism." J Cell Physiol 207(3): 767-74. [Full Text] http://drwdowin.com/Research.html
In many cell types such as fibroblasts, endothelial cells, and sensory neurons, focal adhesions form a mechanical link between extracellular collagen matrix and intracellular cytoskeleton. 45. Chicurel, M. E., Chen, C. S., Ingber, D. E. (1998) Cellular control lies in the balance of forces. Curr. Opin. Cell Biol. 10,232-239 46. Giancotti, F. G., Ruoslahti, E. (1999) Integrin signaling. Science 285,1028-1032 [Full Text] http://www.sciencemag.org/cgi/content/abstract/285/5430/1028?ijkey=61ec39623ca419e89a29e55d4dce4dad1d93edb6&keytype2=tf_ipsecsha
The mechanism of mechanical load detection is thought to be a mechanosensory complex composed of extracellular matrix-integrin-cytoskeletal components linked to a kinase cascade. 47. Burridge, K., Fath, K., Kelly, T., Nuckolls, G., Turner, C. (1988) Focal adhesions: transmembrane junctions between the extracellular matrix and the cytoskeleton. Annu. Rev. Cell Biol. 4,487-525
In this model, load deformation displaces matrix molecules tethered to clustered integrins at focal adhesions. 48. Muller, J. M., Chilian, W. M., Davis, M. J. (1997) Integrin signaling transduces shear stress-dependent vasodilatation of coronary arterioles. Circ. Res. 80,320-326 [Full Text]http://circres.ahajournals.org/cgi/content/full/80/3/320?ijkey=5b507f251758363034d127ceb355c7babf84809a
The cell membrane displacement is transduced by an integrin to an integrin binding protein such as talin and then to associated proteins such as vinculin, tensin, paxillin, Src, and focal adhesion kinase 49. Clark, E. A., Brugge, J. S. (1995) Integrins and signal transduction pathways: the road taken. Science 268,233-239 [Full Text] http://www.sciencemag.org/cgi/content/abstract/268/5208/233?ijkey=3ac4cbb92d7d33ab01005d747add96aa7b2c9c5f&keytype2=tf_ipsecsha
In addition, one or more of these proteins can undergo a conformation change in response to displacement and initiate a series of phosphorylation and binding reactions in the protein complex. Therefore, the result of mechanical load deformation of an integrin molecule via extracellular matrix attachment is activation of a signaling cascade leading to a wide range of cellular responses, including changes in the actin cytoskeleton with formation of stress fibers.
50. Banes, A. J., Tsuzaki, M., Yamamoto, J., Fischer, T., Brigman, B., Brown, T., Miller, M. (1995) Mechanoreception at the cellular level: the detection, interpretation and diversity of responses to mechanical signals
51. Banes, A. J., Tsuzaki, M., Yamamoto, J., Fischer, T., Brigman, B., Brown, T., Miller, M. (1995) Mechanoreception at the cellular level: the detection, interpretation and diversity of responses to mechanical signals. Biochem. Cell Biol. 73,349-365.
52. Dartsch, P. C., Hammerle, H. (1986) Orientation response of arterial smooth muscle cells to mechanical stimulation. Eur. J. Cell Biol. 41,339-346
53. Sumpio, B. E., Banes, A. J., Buckley, M., Johnson, G. (1988) Alterations in aortic endothelial cell morphology and cytoskeletal protein synthesis during cyclic tensional deformation. J. Vasc. Surg. 7,130-138.
The pulling of collagen fibers induced by acupuncture needle manipulation appears to have a similar effect on connective tissue fibroblasts via their attachment to collagen fibers at focal adhesion complexes.
These observations suggest that the mechanical signal created by acupuncture needle manipulation can induce intracellular cytoskeletal rearrangements in fibroblasts and possibly in other cells present within connective tissue, such as capillary endothelial cells. Cytoskeletal reorganization in response to mechanical load signals has been shown to induce cell contraction, migration, and protein synthesis. Potentially powerful effects may derive from this mechanical signal transduction, including autocrine and paracrine cellular effects, with modification of the surrounding extracellular matrix.
54. Sumpio, B. E., Banes, A. J., Buckley, M., Johnson, G. (1988) Alterations in aortic endothelial cell morphology and cytoskeletal protein synthesis during cyclic tensional deformation. J. Vasc. Surg. 7,130-138
55. Harris, A. K., Wild, P., Stopak, D. (1980) Silicone rubber substrata: a new wrinkle in the study of cell locomotion. Science 208,177-179. [Full Text] http://www.sciencemag.org/cgi/content/abstract/208/4440/177?ijkey=3fc4fd3eee0db9f991198c90f73f8755d3dc832d&keytype2=tf_ipsecsha
In summary, the insertion and manipulation of acupuncture needles may have both local and remote therapeutic effects based on the same underlying mechanism: mechanical coupling of needle to connective tissue, winding of tissue around the needle, generation of a mechanical signal by pulling of collagen fibers during needle manipulation, and mechanotransduction of the signal into cells. Downstream effects of this mechanical signal may include cell secretion, modification of extracellular matrix, amplification and propagation of the signal along connective tissue planes, and modulation of afferent sensory input via changes in the connective tissue milieu. 56. Langevin, H. M., D. L. Churchill, et al. (2001). "Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture." Faseb J 15(12): 2275-82. [Full Text] http://www.fasebj.org/cgi/content/abstract/15/12/2275
Researchers reported, brief (10 min) static tissue stretch attenuated the increase in both soluble Transforming growth factor beta 1 (TGF-beta1) (ex vivo) and Type-1 procollagen (in vivo) following tissue injury. These results have potential relevance to the mechanisms of treatments applying brief mechanical stretch to tissues (e.g., physical therapy, respiratory therapy, mechanical ventilation, massage, yoga, acupuncture).”
57. Bouffard, N. A., K. R. Cutroneo, et al. (2007). "Tissue stretch decreases soluble TGF-beta1 and type-1 procollagen in mouse subcutaneous connective tissue: Evidence from ex vivo and in vivo models." J Cell Physiol. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17654495
Ultrasound Shows Tissue Changes
“The goal of this study was to show that ultrasound can be used to quantify dynamic changes in local connective tissue structure in vivo.
3-D renditions of ultrasound images showed longitudinal echogenic sheets that matched with collagenous sheets seen in histological preparations.
The combination of ultrasound and semi-variogram analyses allows quantitative assessment of dynamic changes in the structure of human connective tissue in vivo.” 58. Langevin, H. M., D. M. Rizzo, et al. (2007). "Dynamic morphometric characterization of local connective tissue network structure in humans using ultrasound." BMC Syst Biol 1: 25. [Full Text] http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17550618
Connecting and Communicating
“Unspecialized "loose" connective tissue forms an anatomical network throughout the body.” Langevin “hypothesis that, in addition, connective tissue functions as a body-wide mechanosensitive signaling network. Three categories of signals are discussed: electrical, cellular and tissue remodeling, each potentially responsive to mechanical forces over different time scales. It is proposed that these types of signals generate dynamic, evolving patterns that interact with one another. Such connective tissue signaling would be affected by changes in movement and posture, and may be altered in pathological conditions (e.g. local decreased mobility due to injury or pain). Connective tissue thus may function as a previously unrecognized whole body communication system.
Understanding the temporal and spatial dynamics of connective tissue bioelectrical, cellular and tissue plasticity responses, as well as their interactions with other tissues, may be key to understanding how pathological changes in one part of the body may cause a cascade of ‘‘remote’’ effects in seemingly unrelated areas and organ systems.59. Langevin, H. M. (2006). "Connective tissue: a body-wide signaling network?" Med Hypotheses 66(6): 1074-7. [Full Text] www.anatomytrains.com/uploads/rich_media/c04c7252238ff6f72d81f52c89a20f85.pdf and Anatomy Trains http://www.anatomytrains.com/at/library/articles and Fascia Research Congress http://www.fascia2007.com/presenters.php
Mechanical stretching of connective tissue occurs with normal movement and postural changes, as well as treatments including physical therapy, massage and acupuncture. Connective tissue fibroblasts were recently shown to respond actively to short-term mechanical stretch (minutes to hours) with reversible cytoskeletal remodeling, characterized by extensive cell spreading and lamellipodia formation.
In unstretched tissue, the pattern of alpha-actin was diffuse and granular. With tissue stretch (30 min), alpha-actin formed a star-shaped pattern centered on the nucleus, while beta-actin extended throughout the cytoplasm including lamellipodia and cell cortex. This dual response pattern of alpha- and beta-actin may be an important component of cellular mechanotransduction mechanisms relevant to physiologic and therapeutic mechanical forces applied to connective tissue.” 60. Langevin, H. M., K. N. Storch, et al. (2006). "Fibroblast spreading induced by connective tissue stretch involves intracellular redistribution of alpha- and beta-actin." Histochem Cell Biol 125(5): 487-95. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16416024
Cellular Stretching & Tissue Shape
“Cytoskeleton-dependent changes in cell shape are well-established factors regulating a wide range of cellular functions including signal transduction, gene expression, and matrix adhesion. Although the importance of mechanical forces on cell shape and function is well established in cultured cells, very little is known about these effects in whole tissues or in vivo.
Tissue stretch ex vivo (average 25% tissue elongation from 10 min to 2 h) caused a significant time-dependent increase in fibroblast cell body perimeter and cross-sectional area. At 2 h, mean fibroblast cell body cross-sectional area was 201% greater in stretched than in unstretched tissue. Fibroblasts in stretched tissue had larger, "sheetlike" cell bodies with shorter processes. In contrast, fibroblasts in unstretched tissue had a "dendritic" morphology with smaller, more globular cell bodies and longer processes.
The dynamic, cytoskeleton-dependent responses of fibroblasts to changes in tissue length demonstrated in this study have important implications for our understanding of normal movement and posture, as well as therapies using mechanical stimulation of connective tissue including physical therapy, massage, and acupuncture. 61. Langevin, H. M., N. A. Bouffard, et al. (2007). "Connective tissue fibroblast response to acupuncture: dose-dependent effect of bidirectional needle rotation." J Altern Complement Med 13(3): 355-60. [Abstract] http://www.acupuncture.com/newsletters/m_jun07/res.htm#1
Loose connective tissue forms a continuous network throughout the body, including subcutaneous and interstitial connective tissues surrounding and permeating muscles and organs. Therapeutic mechanical deformation of loose connective tissue is used routinely in physiotherapy (e.g., in stress-relaxation techniques), as well as in many “alternative” therapies such as massage, myofascial release, and osteopathic and chiropractic manipulations. In addition, acupuncture was recently shown to cause winding, pulling, and deformation of subcutaneous connective tissue.
Mechanotransduction through connective tissue with resultant effects on fibroblast cell shape and function was recently proposed as a mechanism for the therapeutic effect of acupuncture. Understanding the downstream cellular and molecular effects of mechanotransduction in loose connective tissue may therefore give key insights into the therapeutic mechanisms of a variety of treatments for musculoskeletal pain.” 62. Langevin, H. M., N. A. Bouffard, et al. (2005). "Dynamic fibroblast cytoskeletal response to subcutaneous tissue stretch ex vivo and in vivo." Am J Physiol Cell Physiol 288(3): C747-56. [Full Text] http://ajpcell.physiology.org/cgi/content/full/288/3/C747 and Langevin HM, Churchill DL, and Cipolla MJ. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture. FASEB J 15: 2275–2282, 2001. and Langevin HM, Churchill DL, Wu J, Badger GJ, Yandow J, Fox JR, and Krag MH. Evidence of connective tissue involvement in acupuncture.FASEB J 16: 872–874, 2002.
63. Langevin, H. M., N. A. Bouffard, et al. (2007). "Connective tissue fibroblast response to acupuncture: dose-dependent effect of bidirectional needle rotation." J Altern Complement Med 13(3): 355-60. [Abstract] http://www.acupuncture.com/newsletters/m_jun07/res.htm#1
Molecular Mimicry, Pathogens and Connective Tissue
Aggregatibacter (formerly Actinobacillus) actinomycetemcomitans64 (Ready,2007) is just one of the thousands of different types of bacterium found in the mouth and is one of the causes of gum disease. Not only does gum disease put teeth at risk, but it has also been linked with certain kinds of heart disease. The star-shaped pattern within the colony is typical of these bacteria when grown under suitable conditions. 64. Ready, Darren Wellcome (2007) [Image] http://www.wellcome.ac.uk/en/bia/gallery.html?image=6)
65. Tabeta, K., H. Yoshie, et al. (2001). "Characterization of serum antibody to Actinobacillus actinomycetemcomitans GroEL-like protein in periodontitis patients and healthy subjects." Oral Microbiol Immunol 16(5): 290-5. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11555306
If these bacteria escape their normal habitats, the surface components that mimic the sLe(x) oligosaccharide might bind to host antigens of the selectin family which could promote binding to endothelial cells and, consequently, initiation of the events leading to infective endocarditis. 66. Hirota, K., H. Kanitani, et al. (1995). "Cross-reactivity between human sialyl Lewis(x) oligosaccharide and common causative oral bacteria of infective endocarditis." FEMS Immunol Med Microbiol 12(2): 159-64. [PubMed Abstract] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8589666
In another study researchers looked at, “the adhesion of A. actinomycetemcomitans to extracellular matrix components of the connective tissue. Mutants were identified which exhibited the following phenotypes: a decrease in collagen binding; a decrease in fibronectin binding; a decrease in binding to both proteins; and an increase in binding to both collagen and fibronectin.
Collectively, the results support the hypothesis that A. actinomycetemcomitans host colonization involves afimbrial adhesins for extracellular matrix proteins, and that the expression of adhesion is modulated by global regulatory mechanisms. 67. Mintz, K. P. (2004). "Identification of an extracellular matrix protein adhesin, EmaA, which mediates the adhesion of Actinobacillus actinomycetemcomitans to collagen." Microbiology 150(Pt 8): 2677-88. [Full Text] http://mic.sgmjournals.org/cgi/content/full/150/8/2677?view=long&pmid=15289564 68. Ruiz, T., C. Lenox, et al. (2006). "Novel surface structures are associated with the adhesion of Actinobacillus actinomycetemcomitans to collagen." Infect Immun 74(11): 6163-70. [Full Text] http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17057091
The ECM is a biologically active tissue composed of a complex mixture of macromolecules, including multiple collagen types, fibronectin, laminin and glycosaminoglycans. The ECM not only serves a structural function but also affects a number of cellular activities, including migration, proliferation and differentiation. ECM proteins that have been described to act as a substrate for bacterial adhesion include collagens, laminin, fibronectin, fibrinogen, vitronectin and heparan sulfate. 69. Patti, J. M., Allen, B. L., McGavin, M. J. & Hook, M. (1994). MSCRAMM-mediated adherence of microorganisms to host tissues. Annu Rev Microbiol 48, 585–617. [PubMed Abstract]
In addition, ubiquitous signaling molecules have also been identified that regulate the adhesion of this pathogen to these substrates.” 70. Mintz, K. P. (2004). "Identification of an extracellular matrix protein adhesin, EmaA, which mediates the adhesion of Actinobacillus actinomycetemcomitans to collagen." Microbiology 150(Pt 8): 2677-88. [Full Text] http://mic.sgmjournals.org/cgi/content/full/150/8/2677?view=long&pmid=15289564
Selected Work Helene M Langevin, MD et al.
1. Langevin, H. M., D. M. Rizzo, et al. (2007). "Dynamic morphometric characterization of local connective tissue network structure in humans using ultrasound." BMC Syst Biol 1: 25 [Full Text] http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17550618.
2. Langevin, H. M., N. A. Bouffard, et al. (2006). "Subcutaneous tissue fibroblast cytoskeletal remodeling induced by acupuncture: evidence for a mechanotransduction-based mechanism." J Cell Physiol 207(3): 767-74 [Full Text] http://drwdowin.com/Research.html.
3. Langevin, H. M. (2006). "Connective tissue: a body-wide signaling network?" Med Hypotheses 66(6): 1074-7 [Full Text] www.anatomytrains.com/uploads/rich_media/c04c7252238ff6f72d81f52c89a20f85.pdf and Anatomy Trains http://www.anatomytrains.com/at/library/articles and Fascia Research Congress http://www.fascia2007.com/presenters.php.
4. Langevin, H. M., N. A. Bouffard, et al. (2005). "Dynamic fibroblast cytoskeletal response to subcutaneous tissue stretch ex vivo and in vivo." Am J Physiol Cell Physiol 288(3): C747-56 [Full Text] http://ajpcell.physiology.org/cgi/content/full/288/3/C747
5. Ahn, A. C., J. Wu, et al. (2005). "Electrical impedance along connective tissue planes associated with acupuncture meridians." BMC Complement Altern Med 5: 10 [Full Text] http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15882468.
6. Langevin, H. M., E. E. Konofagou, et al. (2004). "Tissue displacements during acupuncture using ultrasound elastography techniques." Ultrasound Med Biol 30(9): 1173-83 [Full Text] http://www.bme.columbia.edu/eekweb/journals/2004-eek_umb_displacement.pdf.
7. Langevin, H. M., C. J. Cornbrooks, et al. (2004). "Fibroblasts form a body-wide cellular network." Histochem Cell Biol 122(1): 7-15 [Full Text] http://www.uvm.edu/~annb/faculty/PDFs/7-15.pdf.
8. Iatridis, J. C., J. Wu, et al. (2003). "Subcutaneous tissue mechanical behavior is linear and viscoelastic under uniaxial tension." Connect Tissue Res 44(5): 208-17 [Full Text] http://www.med.uvm.edu/neurology/downloads/Subcutaneoustissuemechanicalbehavior.pdf.
9. Langevin, H. M. and J. A. Yandow (2002). "Relationship of acupuncture points and meridians to connective tissue planes." Anat Rec 269(6): 257-65 [Full Text] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12467083.
10. Langevin, H. M., D. L. Churchill, et al. (2002). "Evidence of connective tissue involvement in acupuncture." Faseb J 16(8): 872-4 [Full Text] http://www.med.uvm.edu/neurology/downloads/Evidenceofconnectivetissueinvolvementinacupuncture.pdf.
11. Langevin, H. M., D. L. Churchill, et al. (2001). "Biomechanical response to acupuncture needling in humans." J Appl Physiol 91(6): 2471-8 [Full Text] http://www.med.uvm.edu/neurology/Downloads/Biomechanicalresponsetoacupunctureneedlinginhumans.pdf.
12. Langevin, H. M., D. L. Churchill, et al. (2001). "Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture." Faseb J 15(12): 2275-82 [Full Text] http://www.fasebj.org/cgi/content/abstract/15/12/2275.
1. Chicurel, M. E., C. S. Chen, et al. (1998). "Cellular control lies in the balance of forces." Curr Opin Cell Biol 10(2): 232-9. [Full Text] http://www.seas.upenn.edu/~chenlab/pdf/07_Chicurel98.PDF
2. Still, A. T. (1902). The Philosophy and Mechanical Principles of Osteopathy. Kansas City, Mo, Hudson-Kimberly Publication Co. [Full Text] 322 page e-book http://www.interlinea.org/atstill/eBookPMPO_V2.0.pdf
3. Weiselfish-Giammatteo, S., J. B. Kain, et al. (2005). Integrative manual therapy for the connective tissue system: myofascial release. Berkeley, Calif., North Atlantic Books.
4. Weiselfish-Giammatteo, S. (2000) Disruptions of Membrane. from www.centerimt.com/Products/videos.asp. Bloomfield, CT, Dialogues in Contemporary Rehabilitation.
Public Medline http://www.ncbi.nlm.nih.gov
CAM Research http://www.camresearch.net
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