Effect of Heat in Increasing the Range of Knee Motion After the Development of a Joint Contracture: An Experiment With an Animal Model Mariko Usuba,

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Effect of Heat in Increasing the Range of Knee Motion After the Development of a Joint Contracture: An Experiment With an Animal Model Mariko Usuba, MS, PT, Yutaka Miyanaga, MD, PhD, Shumpei Miyakawa, MD, PhD, Toru Maeshima, PhD, Yoshio Shirasaki Archives of Physical Medicine and Rehabilitation Volume 87, Issue 2, Pages 247-253 (February 2006) DOI: 10.1016/j.apmr.2005.10.015 Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 Radiograph of an animal’s knee joint immobilized in flexion. The subcutaneous femorotibial ligature to immobilize the knee in flexion, placement of the goniometer, and definition of maximum knee extension angle used in this study are drawn over the film. Archives of Physical Medicine and Rehabilitation 2006 87, 247-253DOI: (10.1016/j.apmr.2005.10.015) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 Treatment of the S+US group. The ankle of the experimental side was tied to a vertically installed spring scale, and static stretching with a tensile force of approximately 250 to 300g was applied for 20 minutes while ultrasound heat was applied to both the medial and lateral areas of a knee joint. Archives of Physical Medicine and Rehabilitation 2006 87, 247-253DOI: (10.1016/j.apmr.2005.10.015) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 Measurement of the viscoelasticity of the knee joint in bone-joint-bone complex. Archives of Physical Medicine and Rehabilitation 2006 87, 247-253DOI: (10.1016/j.apmr.2005.10.015) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 4 Microphotographs of the knee joint of the rats on the sixth treatment day. (A) Control nonexperimental joint. (B) Contractured experimental joint after 6 stretching sessions (S group). (C) Contractured experimental joint after 6 S+IR treatments (S+IR group). (D) Contractured experimental joint after 6 S+US treatments (S+US group). NOTE. Bars represent 1mm. Archives of Physical Medicine and Rehabilitation 2006 87, 247-253DOI: (10.1016/j.apmr.2005.10.015) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 5 Microphotographs of the synovial lining cells at the posterior component. (A) One to 3 layers of synovial lining cells in the control group. (B) Increased and disarranged synovial lining cells in the S+US group. Hematoxylin and eosin stain. NOTE. Bars represent 50μm. Archives of Physical Medicine and Rehabilitation 2006 87, 247-253DOI: (10.1016/j.apmr.2005.10.015) Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions