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Vascular Fasciatherapy Danis Bois Method: a Study on Mechanism Concerning the Supporting Point Applied on Arteries

Studie som nevner svært mye interessant om blodsirkulasjon, tensegritet og om bindevev. Den er rettet mot en spesifikk metode for spontan bevegelse, men har mye interessante teamer som gjelder andre bodyworkmetoder også.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3242644/

«Vascular research especially made a jump forward with the Nobel Prize awarded to Furchgott, Ignarro and Murad for having discovered the endogenous production of nitric oxide (NO). »

«Mesenchyme differentiates and generates every type of connective tissue and many organs in adults(3) including bone, muscle, and the middle layer of the skin, excepting nervous tissue and the digestive track(7).»

«In this study, one can notice that they are totally or partially at the origin of vascular endothelium and mesothelium (peritoneum, pleura, pericardium)(6). And this vascular endothelium is the origin of blood, which is also considered as specialized connective tissue(6).»

Forskjellen mellom arterier og kapillærer:
«Capillaries have the function of distributing blood in the body, bringing about an exchange between blood and tissues. Structurally, arteries carry and separate blood and tissues.»

«Fascia is a very sensitive tissue that detects any kind of stress — physical, emotional or psycho-social. It reacts by contracting and imprisoning the organs it covers, thus impairing their physiological functions. Furthermore, the tightening of their connective parts induces a perceptible disturbance in mobility and rhythm of these organs.»

«ECs respond to increased blood flow by causing relaxation of the surrounding VSMCs. VSMC relaxation in response to flow occurs over seconds to minutes and if high flow persists, remodeling of the artery wall enlarges the lumen over time in a period of weeks to months(36). Decreased flow induces vessel narrowing(37), and extreme low flow may lead to complete vessel regression, which involves apoptosis of the ECs(38).»

«The human body seems to be made of the only and same tissue which is functionally differentiated: there are only tissue connections, simply a histological continuum without any clear separation between the skin and hypodermis, the vessels, the aponeurosis, and the muscles(46). So connective tissue, its cells, MEC, and fibers are an obvious link in this construction.»

«The theory of tensegrity emerged from the interests of architects (from Richard Buckminster Fuller to Rene Motro) and biologists (Donald Ingber(47)), and their meeting point of connection with our discussion can be found in these definitions: “a type of prestressed structural network, composed of opposing tension and compression elements that self-stabilizes its shape through establishment of a mechanical force balance”, and “tensegrity is used to stabilize the shape of living cells, tissue and organs, as well as our whole bodies”(4). Hence, the use of this architectural system for structural organization provides a mechanism to physically integrate part and whole(4).»

«Arteries have a special relation with fascias. Connective tissue is present in the three tunics of the artery. Adventitia is a typical sheathing fascia, which becomes tense in reaction to stress. Media is an association of muscle and connective tissue reacting to local mechanical variations (i.e. blood pressure) or general influence (i.e. stress) by tensing and/or by contracting. Intima, whose endothelium can be assimilated to a very big autocrine/paracrine formation(48)reacting mainly to the influence of blood qualities (i.e. type of flow, components), lies on a connective layer underlining endothelium.»

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The Architecture of the Connective Tissu e in the Musculoskel etal System-An Often Overlooked Function al Parameter as to P roprioception in the Locomotor Apparatus

Om bindevevets struktur, mye om mechanoreceptors i bindevevet (golgi, ruffini og pacini spesielt), pluss den nevner «dynamic ligaments» som en del av bindevevet inni og igjennom muskler.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091473/

«The discrimination between so-called joint receptors and muscle receptors is an artificial distinction when function is considered. Mechanoreceptors, also the so-called muscle receptors, are arranged in the context of force circumstances-that is, of the architecture of muscle and connective tissue rather than of the classical anatomic structures such as muscle, capsules, and ligaments. »

«The receptors for proprioception are concentrated in those areas where tensile stresses are conveyed over the elbow joint. Structures cannot be divided into either joint receptors or muscle receptors when muscular and collagenous connective tissue structures function in series to maintain joint integrity and stability. In vivo, those connective tissue structures are strained during movements of the skeletal parts, those movements in turn being induced and led by tension in muscular tissue. In principle, because of the architecture, receptors can also be stimulated by changes in muscle tension without skeletal movement, or by skeletal movement without change in muscle tension. »

«A mutual relationship exists between structure (and function) of the mechanoreceptors and the architecture of the muscular and regular dense connective tissue. Both are instrumental in the coding of proprioceptive information to the central nervous system.»

«Schleip mentions the fascia as «the dense irregular connective tissue that surrounds and connects every muscle, even the tiniest myofibril, and every single organ of the body forming continuity throughout the body.»(

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Destroy user interface control2,

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Destroy user interface control3) In this way, fascia is considered an important integrative element in human posture and movement organization (locomotor apparatus) and is often referred to as the «organ of form.»(

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Destroy user interface control4) »

«The primary connective tissue of the body is the embryonic mesoderm. The mesoderm represents the matrix and environment within which the organs and structures of the body have been differentiated and therefore are embedded.»

«The principal function of mesoderm as «inner tissue» is «mediating» in the sense of «connecting» (binding) and «disconnecting» (shaping space). »

«Regular dense connective tissue structures such as ligaments convey (transmit) those forces «passively.»»

«Connective tissue and fasciae are richly innervated. Fascial layers may thus play an important role in proprioception and nociception. Considerations such as «architecture versus anatomy (topography),»mutatis mutandis may also apply for the spatial organization of mechanoreceptors, the morphologic substrate for proprioception. »

«Mechanoreceptors are in fact free nerve endings (FNEs), whether or not equipped with specialized end organs. The main stimulus for such receptors is deformation. Variation exists as to the microarchitecture of the ending.»

«Mechanoreceptors associated with muscles, including the muscle auxiliary structures such as tendons, are usually classified(14

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Destroy user interface control17) as follows:

  • FNEs (unencapsulated)
  • Muscle spindles (sensory endings with encapsulated intrafusal muscle fibers)
  • GTOs (type III endings, relatively large-100 -600 μm diameter-spray-like endings, with high threshold and very slow-adapting)

The mechanoreceptors typically associated with joints are these:

  • FNEs (unencapsulated)
  • LCs (type II ending with a two- to five-layered capsule, less than 100 μm in length, with low threshold and rapidly adapting). Here, this term is preferred to paciniform corpuscle.
  • RCs (type I ending, relatively small-up to 100 μm-spray-like ending with low threshold and slow-adapting)»

«Those nerve fibers are involved in the afferent pathway of proprioceptive information from the transitional areas between the connective tissue layers and the muscle fascicles organized in series with them [shown schematically in Fig. 7(a)]. This also seems to represent a more ligamentous or articular «pattern of innervation» compared with the related nerve fascicles running on the «outside» of the innervated structure. This is actually a typical capsular or articular pattern [see Fig. 7(a)]. »

«An in series unit of muscular tissue/RDCT layer/skeletal element equipped with mechanosensitive substrate at the transitional areas between the various tissue components constitutes the basic unit of the spatial organization of the substrate of proprioception. Such a unit may occur as a muscle fraction in series with a muscle compartment wall that is shared with the muscular tissue of an adjacent muscle. It may also appear as a muscle compartment wall with muscle fascicles inserting unilaterally and with afferent nerve fibers reaching the related mechanoreceptors from the outer side. This was introduced earlier as the typical «dynamic ligament» (dynament-see Fig. 10, pattern 4).»

«The conclusion is that, in vivo, the activity of a mechanoreceptor is defined not only by its functional properties, but also by its architectural environment. If Abrahams, Richmond, and Bakker(

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Destroy user interface control34) state that the topography of mechanoreceptors provides a «subtle comparative function in the process of sensory coding of muscle events,» they raise the important issue of the spatial distribution of receptors in the process of proprioception. To this should be added the notion that the architecture of the muscular and connective tissue and consequent receptor distribution plays a significant role in the coding of the proprioceptive information that is provided.»

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The effects of neurodynamic mobilization on fluid dispersion within the tibial nerve at the ankle: an unembalmed cadaveric study

Om hva nevropati og skader på nerver gjør, og hvordan neurodynamiske øvelser øker blodsirkulasjon internt i nerven. Nevner også hvordan skader, lav blodsirkulasjon og betennelser skaper sammensmeltninger i bindevevet mellom nerver og omliggende vev (muskler, skjelett, bindevev) som gjør at nervene ikke glir og dermed kan gi oss begrenset bevegelighet.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172954/

«These disorders include compression syndromes or other neuromuscular conditions that may be accompanied by neuropathic pain. Damaged nerves exhibit predictable pathophysiological responses including impaired nerve mobility, increased mechanosensitivity, impaired nerve conduction, nerve tissue ischemia, axonal transport inhibition, and intraneural edema.

The following popper user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.  Impaired nerve mobility and increased mechanosensitivity provide the basis for existing studies of neurodynamic techniques. »

«Impaired nerve mobility and mechanosensitivity can be clinically assessed by measuring changes in joint range of motion, pain reproduction, or change of symptoms following neurodynamic mobilization.

«Intraneural edema is a common response to nerve injury, and is intimately involved in the proliferation of damage to nerve structure and function.

The following popper user interface control may not be accessible. Tab to the next button to revert the control to an accessible version. Edema is found in peripheral nerves that have been subject to trauma such as compression,excessive tension events, or vibration.  Even mild injury may result in epineurial edema,  but compression that is prolonged or of great magnitude leads to a breach of the diffusion barriers created by both the perineurium and microvasculature, resulting in endoneurial edema. The absence of lymphatic vessels in the endoneurium limits drainage of this edema, thereby creating a ‘mini-compartment syndrome’ within the nerve. »

«This ‘mini-compartment syndrome’, due to the increase in endoneurial pressure, subsequently leads to fibrosis and adhesions, impairing intrafascicular gliding. This loss of intrafascicular gliding creates an internal stretch lesion (Fig. 1). »

«The results showed significant mobilization effects in that there was increased fluid dispersion within the tibial nerve after the intervention. »

…de brukte bare kadavere i denne studien.
«The results showed significant mobilization effects in that there was increased fluid dispersion within the tibial nerve after the intervention. Because the tibial nerve was dissected free of all adjacent tissue and eliminated any external interfaces, the response to the mobilization appeared to be due to intraneural mechanics.»

Bevegelsene «pumper» internt i nerven og øker blodgjennomstreømning.
«During the mobilization technique, the tibial nerve alternately elongated and shortened which may have provided a temporary increase in intraneural pressure followed by a period of relaxation. Although speculative, it appears that this repetitive or ‘pumping’ action may have created a flushing of the dye and an alteration of the intraneural pressure as the intraneural fluid was dispersed.»

«In the early stages of stretch injury or compression, the ability to prevent or at least reduce edema may prevent or slow the inhibition of blood flow, thus preventing the sequelae leading to impaired axonal transport, demyelination, loss of elasticity due to fibrosis or adhesions, and ultimately to alteration in nerve structure and function. «

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Hypoxia-generated superoxide induces the development of the adhesion phenotype

Viktig studie om mekanismen bak hvordan hypoxi gir arrvev (adhesions) i kroppen. Relatert til hyperventilering vil lite CO2 gir hypoxi og sammen med trange blodkar vil de utsatte stedene i kroppen utvikle arrvev mellom muskler og nerver. Nevner hvordan antioksidanter er viktig for å unngå arrvev, spesielt etter operasjoner. Og motsatt, at oksidanter kan skape arrvev fra friskt vev. Nevner også hvordan nitratreaksjoner er med å skaper arrvev, så mulig at CO2 bidrar med å dempe nitratreaksjonene og dermed dempe dannelsen av arrvev. Den viser også at det kan være mulig å få arrvev celler om til å bli normale celler.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2574925/

«Adhesion fibroblasts exhibit higher TGF-β1 and type I collagen expression as compared to normal peritoneal broblasts. Furthermore, exposure of normal peritoneal fibroblasts to hypoxia results in an irreversible increase in TGF-β1 and type I collagen. We postulated that the mechanism by which hypoxia induced the adhesion phenotype is through the production of superoxide either directly or through the formation of peroxynitrite. »

«Hypoxia treatment resulted in a time-dependent increase in TGF-β1 and type I collagen mRNA levels in both normal peritoneal and adhesion fibroblasts.»

«In contrast, treatment with SOD, to scavenge endogenous superoxide, resulted in a decrease in TGF-β1 and type I collagen expression in adhesion fibroblasts to levels seen in normal peritoneal fibroblasts; no effect on the expression of these molecules was seen in normal peritoneal fibroblasts. »

«In conclusion, hypoxia, through the production of superoxide, causes normal peritoneal fibroblasts to acquire the adhesion phenotype. Scavenging superoxide, even in the presence of hypoxia, prevented the development of the adhesion phenotype. These findings further support the central role of free radicals in the development of adhesions.»

«Postoperative adhesions are a significant source of impaired organ functioning, decreased fertility, bowel obstruction, difficult reoperation, and possibly pain (1,2)

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«The processes that result in either normal peritoneal tissue repair or the development of adhesions include the migration, proliferation, and/or differentiation of several cell types, among them inflammatory, immune, mesothelial, and fibroblast cells (3)

«Hypoxia, resulting from tissue injury, has been suggested to play an important role in wound healing, and may therefore be a critical factor in the development of postoperative adhesions (4,7)

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Destroy user interface contrHypoxia is known to trigger the expression of TGF-β1, which consequently increases the expression of extracellular matrix proteins, including type I collagen (4) 

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Destroy user interface contr«Type I collagen synthesis has been shown to be crucially dependent on the availability of molecular oxygen in tissue culture, animal, and human wound healing experiments (8,9)

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Destroy user interface controlMoreover, exposure of normal peritoneal fibroblasts to hypoxia irreversibly induces TGF-β1 and type I collagen to levels seen in adhesion fibroblasts (4,10)

«Additionally, hypoxia is known to acutely promote superoxide (O2.−) generation from disparate intracellular sources that include xanthine dehydrogenase oxidase (11), mitochondrial electron transport chain (12), and NAD[P]H oxidase (13).

In biological systems, superoxide dismutase (SOD) protects against the deleterious actions of this radical by catalyzing its dismutation to hydrogen peroxide plus oxygen, (14) Whereas SOD breaks down O2.−, xanthine oxidase synthesizes O2.−. Xanthine oxidase appears to be one of the major superoxide-producing enzymes (14)«

«Scavenging superoxide restores both TGF-β1 and type I collagen mRNA levels in adhesion fibroblasts to levels observed in normal peritoneal fibroblasts»
«Normal peritoneal and adhesion fibroblasts treated with super-oxide dismutase, a O2.− scavenging enzyme, exhibited a dose–response decrease (0, 5, 10, 15, and 20 units/ml) in TGF-β1 and type I collagen mRNA levels in adhesion fibroblasts while not effecting normal peritoneal fibroblasts (Figs. 3A and B).»

«Scavenging superoxide during hypoxia exposure protects against the development of the adhesion phenotype»

«Peroxynitrite treatment increased the adhesion phenotype markers, TGF-β1 and type I collagen»

«Adhesion fibroblasts are myofibroblasts, defined as transiently activated fibroblasts exhibiting features intermediate between those of smooth muscle cells and fibroblasts, including the expression of α-SM actin (29,21) and a depleted antioxidant system (22). In normal wound healing, as the wound resolves, the cellularity decreases and the myofibroblasts disappear by apoptosis (23). However, in several pathological cases, including fibrosis, myofibroblastic differentiation persists and causes excessive scarring (24,25)

«This is further supported by the fact that when O2.− was scavenged, there was in a significant decrease in TGF-β1 and type I collagen in adhesion fibroblasts to levels seen in normal peritoneal fibroblasts. »

«Reactive oxygen species (ROS) are involved in TGF-β-stimulated collagen production in murine embryo fibroblasts (NIH3T3), and the effect of glutathione depletion on TGF-β-stimulated collagen production may be mediated by facilitating ROS signaling (37)

«Reactive oxygen and nitrogen intermediates control the synthesis of cytokines and growth factors in several in vitro models (40). For instance, they modulate the expression and/or release of monocyte chemoattractant protein-1 (41,42), tumor necrosis factor-α, interleukin (IL)-1 (43,44), IL-8 (45,46), platelet-derived growth factor (47,48), and TGF-β1 (49). «

«Adhesion fibroblasts exhibited a significantly lower level of nitric oxide (NO) and higher protein nitration as compared to normal peritoneal fibroblasts, although there was no difference in the iNOS expression level between the two cell lines (17,50,51). This strongly indicates that adhesion fibroblasts use NO to form ONOO−, and consequently their basal ONOO− levels are higher than normal peritoneal fibroblasts. «

«Thus, treatment with SOD might affect the homeostasis of myofibroblasts by inducing cell death or the phenotypic reversion of myofibroblasts into normal fibroblasts. »

«Our results clearly indicate that hypoxia generated O2.− is a key player in the formation of the adhesion phenotype. This became evident when normal peritoneal fibroblasts were treated with SOD under hypoxic conditions and no change in adhesion markers was seen.»


«In this model, hypoxia-generated O2.− exerts its effect directly by enhancing the expression of TGF-β1, which consequently leads to elevated levels of type I collagen, a hallmark of the adhesion phenotype.»

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Neuromuscular strain as a contributor to cognitive and other symptoms in chronic fatigue syndrome: hypothesis and conceptual model

Viktig studie om nervesystemet og bindevevets «adhesions» som bidragsyter til smerte.

http://www.frontiersin.org/Integrative_Physiology/10.3389/fphys.2013.00115/full

«Work by Brieg, Sunderland, and others has emphasized the ability of the nervous system to undergo accommodative changes in length in response to the range of limb and trunk movements carried out during daily activity. If that ability to elongate is impaired—due to movement restrictions in tissues adjacent to nerves, or due to swelling or adhesions within the nerve itself—the result is an increase in mechanical tension within the nerve. »

«This adverse neural tension, also termed neurodynamic dysfunction, is thought to contribute to pain and other symptoms through a variety of mechanisms. These include mechanical sensitization and altered nociceptive signaling, altered proprioception, adverse patterns of muscle recruitment and force of muscle contraction, reduced intra-neural blood flow, and release of inflammatory neuropeptides. »

«In our clinical work, we have found that neuromuscular restrictions are common in CFS, and that many symptoms of CFS can be reproduced by selectively adding neuromuscular strain during the examination.»

«As defined by Yunus, central sensitivity is “clinically and physiologically characterized by hyperalgesia (excessive sensitivity to a normally painful stimulus, e.g., pressure), allodynia (painful sensation to a normally non-painful stimulus, e.g., touch and massage), expansion of the receptive field (pain beyond the area of peripheral nerve supply), prolonged electrophysiological discharge, and an after-stimulus unpleasant quality of pain (e.g., burning, throbbing, numbness)” (Yunus, 2008).»

«These symptoms might be mediated by amplified central sensitivity, but peripheral factors, which have been described in FM and irritable bowel syndrome (IBS), may also play a role (e.g., Price et al., 2009; Staud et al., 2009). »

«Staud has shown that local anesthetic injection into trapezius muscle tender points results in lower levels of thermal hyperalgesia in the forearm, consistent with peripheral nociceptive input as a contributor to central sensitization (Staud et al., 2009).»

«The interaction of nerve mechanics and function has been termed neurodynamics. As an example of the principles of neurodynamics, the median nerve elongates approximately 20% as the upper extremity moves from a position of full wrist and elbow flexion to one of full wrist and elbow extension (Butler, 1991). »

» If that ability to elongate is impaired—due to movement restrictions in tissues adjacent to the median nerve and its branches, or due to swelling or adhesions within the median nerve itself—the result is an increase in mechanical tension within the nerve. This adverse neural tension, also termed neurodynamic dysfunction, is thought to contribute to pain and other symptoms through mechanical sensitization and altered nociceptive signaling, altered proprioception, adverse patterns of muscle recruitment and force of muscle contraction, reduced intra-neural blood flow, and release of inflammatory neuropeptides (Lindquist et al., 1973; Kornberg and McCarthy, 1992;Shacklock, 1995; Slater and Wright, 1995; Balster and Jull, 1997; Van der Heide et al., 2001; Kobayashi et al., 2003; Orlin et al., 2005).»

«It is now well-established that manual stretch of nerves is capable of evoking increased sweating and alterations of blood flow in peripheral tissues, providing evidence of electrophysiologic activity in sympathetic nerve fibers (Lindquist et al., 1973; Kornberg and McCarthy, 1992; Slater and Wright, 1995; Orlin et al., 2005). Conversely, treatment of areas of adverse neural tension (for example in carpal tunnel syndrome, cervico-brachial pain, and osteoarthritis) leads to improved functional outcomes (Rozmaryn et al., 1998; Deyle et al., 2000; Tal-Akabi and Rushton, 2000;Akalin et al., 2002; Allison et al., 2002).»

«The most notable examples of these provocation maneuvers are ankle dorsiflexion, the passive straight leg raise test, the upper limb tension (or neurodynamic) tests, and the seated slump test (Butler, 1991,2000). Test-retest reliability is good for straight leg raise, slump testing, and upper limb neurodynamic testing. (Coppieters et al., 2001;Herrington et al., 2008

«Because it is not possible to differentiate completely between adverse neural tension and strain in muscles, fascia, and other soft tissues, we will use the more general term “neuromuscular strain” in this paper. »

«As shown on the left in Figure 1, neuromuscular strains and movement restrictions can develop as a result injuries and activities of daily life (for example, due to soft tissue and peri-neural adhesions around scars, contusions and fractures that reduce range of motion, anatomic abnormalities like scoliosis and kyphosis, overuse injuries, and others).»

«If the neuromuscular strains were not treated, and if the individual adapted to the increased symptom burden with decreased activity, then neural, soft tissue and muscular restrictions would be expected to worsen, leading to greater impairment and greater central sensitization. »

«In our clinical work, we have found that neuromuscular restrictions are common in CFS.»
«We have also noted that many symptoms of CFS can be reproduced by selectively adding neuromuscular strain during the examination (Rowe et al., 2013a,b). »

«Despite the elevation of the leg, which might have been expected to improve venous return to the heart and thereby improve blood flow to the brain, lightheadedness increased, as did visual blurring. Both individuals remained more fatigued than usual for 12–24 h. Thus, supine neuromuscular strain provoked increased fatigue and cognitive disturbance, the two symptoms not adequately explained by the central sensitivity hypothesis thus far.»

«We have observed that open treatment of these movement restrictions using manual therapy is associated with clinical improvement (Rowe et al., 2013a,b).»

«The hypothesis can be tested by evaluating the whether the response to a given neuromuscular strain differs between CFS subjects and controls with regard to immediate and delayed (24-h) symptoms, and with regard to measures of central sensitivity, such as changes in heart rate variability, or changes in pain sensitivity as measured by pressure-pain thresholds. «