# Mechanotherapy
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{{Short description|Type of physiotherapy}}
'''Mechanotherapy''' is a type of medical therapeutics in which treatment is given by manual or mechanical means. Mechanotherapy is a general term for physical therapy modalities that exploit mechanobiology principles for tissue rehabilitation and regeneration using the application of specific mechanical forces. The terms was defined in 1890 as “the employment of mechanical means for the cure of disease”. Mechanotherapy employs [mechanotransduction](/source/mechanotransduction) to stimulate tissue repair and remodelling.[{{Cite journal|last1=Khan|first1=K. M.|last2=Scott|first2=A.|date=2009-04-01|title=Mechanotherapy: how physical therapists' prescription of exercise promotes tissue repair|url= |journal=British Journal of Sports Medicine|language=en|volume=43|issue=4|pages=247–252|doi=10.1136/bjsm.2008.054239|issn= 1473-0480|pmc=2662433|pmid=19244270}}]
==History==
The ''American College of Mechano-Therapy'' operated in [Chicago](/source/Chicago) between roughly 1905 and 1920. It was founded by William C. Schulze, an 1897 graduate of [Rush Medical College](/source/Rush_Medical_College) and practicing MD licensed in Illinois, Minnesota, and Wisconsin.[[https://chiro.org/Plus/History/Colleges/NationalCC/Schulze-bio.pdf "William C. Schulze, M.D., D.C. (1870-1936): From Mail-Order Mechano-Therapists to Scholarship and Professionalism Among Drugless Physicians, by Joseph C. Keating, Jr., Ph.D., Professor Los Angeles College of Chiropractic, and William S. Rehm, D.C., Past President Association for the History of Chiropractic, 1995]] Schulze was born in [Germany](/source/Germany) in 1870. He incorporated the American College of Mechano-Therapy in 1907 and served as its president. Purporting to be the “largest eclectic school of drugless healing in the world,” the college offered a training course via correspondence. Though heavily criticized by the medical establishment, mechanical methods of healing nonetheless were increasingly popular in North America in the early part of the 20th century.[{{Cite web|url=https://archivalcollections.library.mcgill.ca/index.php/american-college-of-mechano-therapy-collection|title=American College of Mechano-Therapy Collection|last=|first=|date=|website=McGill Library Archival Catalogue|language=en|access-date=2018-02-15}}]
The American College of Mechano-Therapy published several books, such as "Text-book of Osteopathy" (1910) or "Clinical Lectures on Mechano-therapy" (1915).[{{Cite book|last=Mechano-Therapy|first=American College of|url=https://books.google.com/books?id=P-crAQAAMAAJ&q=machano|title=Text-book of Osteopathy|date=1910|publisher=American College of Mechano-Therapy|language=en}}][{{Cite book|url=https://books.google.com/books?id=HSQ6AQAAMAAJ|title=Clinical Lectures on Mechano-therapy|date=1915|publisher=American College of Mechano-Therapy|language=en}}]
==Exercise==
Mechanotherapy is used as term for [exercise prescription](/source/exercise_prescription) to promote healing and rehabilitation.[{{Cite journal|last1=Öhberg|first1=L.|last2=Lorentzon|first2=R.|last3=Alfredson|first3=H.|date=2004-02-01|title=Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up|url= |journal=British Journal of Sports Medicine|language=en|volume=38|issue=1|pages=8–11|doi=10.1136/bjsm.2001.000284|issn=1473-0480|pmc=1724744|pmid=14751936}}][{{Cite journal|last1=Boyer|first1=Martin I.|last2=Goldfarb|first2=Charles A.|last3=Gelberman|first3=Richard H.|date=2005-06-01|title=Recent progress in flexor tendon healing. The modulation of tendon healing with rehabilitation variables|journal=Journal of Hand Therapy|volume=18|issue=2|pages=80–85; quiz 86|doi=10.1197/j.jht.2005.02.009|issn=0894-1130|pmid=15891963}}] Loading of a tendon results in up regulation of [insulin-like growth factor](/source/insulin-like_growth_factor),[{{Cite journal|last1=Banes|first1=A. J.|last2=Tsuzaki|first2=M.|last3=Hu|first3=P.|last4=Brigman|first4=B.|last5=Brown|first5=T.|last6=Almekinders|first6=L.|last7=Lawrence|first7=W. T.|last8=Fischer|first8=T.|date=1995-12-01|title=PDGF-BB, IGF-I and mechanical load stimulate DNA synthesis in avian tendon fibroblasts in vitro|journal=Journal of Biomechanics|volume=28|issue=12|pages=1505–1513|issn=0021-9290|pmid=8666590|doi=10.1016/0021-9290(95)00098-4}}][{{Cite journal|last1=Scott|first1=Alexander|last2=Cook|first2=Jill L.|last3=Hart|first3=David A.|last4=Walker|first4=David C.|last5=Duronio|first5=Vincent|last6=Khan|first6=Karim M.|date=2007-03-01|title=Tenocyte responses to mechanical loading in vivo: a role for local insulin-like growth factor 1 signaling in early tendinosis in rats|journal=Arthritis and Rheumatism|volume=56|issue=3|pages=871–881|doi=10.1002/art.22426|issn=0004-3591|pmid=17328060}}] in addition to other cytokines and growth factors.[{{Cite journal|last1=Olesen|first1=Jens L.|last2=Heinemeier|first2=Katja M.|last3=Gemmer|first3=Carsten|last4=Kjaer|first4=Michael|last5=Flyvbjerg|first5=Allan|last6=Langberg|first6=Henning|date=2007-01-01|title=Exercise-dependent IGF-I, IGFBPs, and type I collagen changes in human peritendinous connective tissue determined by microdialysis|journal=Journal of Applied Physiology|volume=102|issue=1|pages=214–220|doi=10.1152/japplphysiol.01205.2005|issn=8750-7587|pmid=16973813}}] This up regulation results in proliferation at the cellular level and remodelling of the tendon matrix.
=== Muscle ===
The clinical justification for the use of mechanotherapy in muscle injury is formed from initial animal studies.[{{Cite journal|last1=Järvinen|first1=Tero A. H.|last2=Järvinen|first2=Teppo L. N.|last3=Kääriäinen|first3=Minna|last4=Aärimaa|first4=Ville|last5=Vaittinen|first5=Samuli|last6=Kalimo|first6=Hannu|last7=Järvinen|first7=Markku|date=2007-04-01|title=Muscle injuries: optimising recovery|journal=Best Practice & Research. Clinical Rheumatology|volume=21|issue=2|pages=317–331|doi=10.1016/j.berh.2006.12.004|issn=1521-6942|pmid=17512485}}] Generally, a rest period is undertaken to allow stabilisation of scar tissue, which is followed by controlled loading.
Loading of muscle leads to up regulation of a number of load-induced pathways, including mechanogrowth factor (MGF). MGF expression results in activation of satellite cells and hypertrophy.[{{Cite journal|last=Goldspink|first=Geoffrey|date=2003-01-01|title=Gene expression in muscle in response to exercise|journal=Journal of Muscle Research and Cell Motility|volume=24|issue=2–3|pages=121–126|issn=0142-4319|pmid=14609023|doi=10.1023/a:1026041228041|s2cid=24520913}}] Loading in this setting can increase rate and completeness of regeneration, improve myotubule alignment, and minimise myotubule atrophy.[{{Cite journal|last1=Challis|first1=Murray J.|last2=Jull|first2=Gwendolen J.|last3=Stanton|first3=Warwick R.|last4=Welsh|first4=Mark K.|date=2007-01-01|title=Cyclic pneumatic soft-tissue compression enhances recovery following fracture of the distal radius: a randomised controlled trial|journal=The Australian Journal of Physiotherapy|volume=53|issue=4|pages=247–252|issn=0004-9514|pmid=18047459|doi=10.1016/s0004-9514(07)70005-3|doi-access=free}}] Loading bone during rehabilitation can result in significantly increased strength and range of motion, compared with immobilized patients.