Tuina Manipulation to Reduce Inflammation and Cartilage Loss in Knee Osteoarthritis Rats

We studied the mechanism of Tuina manipulation in treating knee osteoarthritis. We found that Tuina is effective for pain relieving and improving motor functions. However, there are still standard protocols for Tuina of KOA, and the conclusions are not reliable enough, so we are trying to build a standard protocol.

Recently, many teams have begun to develop Tuina or massage robots, which can output special mechanical wave forms for manipulation to achieve standardization of techniques. In addition, there are some cell mechanic loading devices, which can output the manual force for the cell for cellular research. We believe that the difficulty of Tuina in animals is how to maintain the standardization of manipulation and how to accurately locate acupuncture points.

We preliminarily verify the effect of Tuina on inhibiting synovial inflammation and the cartilage of proptosis through preliminary experiments, which will point out the direction for future research on the mechanism of Tuina for KOA. In the future, we'll focus on the mechanism of Tuina for KOA, mainly related to the mechanical signal transduction pathway, and how to inhibit synovial inflammation and cartilage apoptosis. After anesthetizing the rat, use a shaving machine to remove the hair of the right hind limb.

Then, place a medical cotton pad between the right ankle and hip joint. Fix the right knee joint at 180 degree extension using five to six layers of wet plaster bandage evenly. Spiral wrap the plaster bandage starting from the ankle and covering one third of the previous one.

Use a hairdryer to dry and harden the plaster. After the plaster bandage dries and hardens, mix the denture based materials to make it sticky and externally wrap the plaster with denture based materials to fix and prevent it from gnawing. Once the mixture hardens, turn off the anesthesia machine and supervise the blood circulation in the terminal limb.

Then, wait for the rat to wake up naturally. After three weeks of continuous immobilization, using surgical scissors, cut off the denture base material outside and plaster bandage. Rinse the lower limb of the rat with saline and dry it with gauze.

Select five acupoints on the right hind limb of the rat according to the principles of acupoint positioning. Before the Tuina manipulation, gently pull the rat tail to make it burrow into the bag and expose its hind limbs outside the bag. For Tuina manipulation, using one hand, place the rat in the prone position, holding its tail and hind leg.

Then place the performer's thumb on the selected acupuncture point to perform rhythmic press and kneading, driving the skin and subcutaneous tissue together in a circular motion, ensuring consistent intensity and frequency of manipulation. For the next mechanical withdrawal threshold, or MWT, stimulate the rat with electronic von Bray fiber at the center of the foot and withdraw the fiber when the rat shows obvious movements like leg raising and avoidance. The machine automatically records the maximum pressure value in Newton's.

After measurement, delete the values with large differences and take the average of the remaining three values as the MWT. Next for Paw Withdrawal Latency, or PWL, focus the spotlight on the center of the rat's foot and press the start button. Monitor the rat for behaviors such as foot retraction or paw licking, and record the time before pressing the stop button.

After measurement, delete the values with large differences and take the average of the remaining three values as the PWL. For statistical analysis, open the analysis software. If the data conforms to a normal distribution, perform a T-test.

Alternatively, analyze repeated measurement data by generalized estimating equations. The MWT results showed that the MWT of the right hind limb after modeling was significantly lower than before. Compared with the control group, the MWT of rats was significantly elevated after Tuina.

The PWL results showed that the PWL of the right hind limb after modeling was significantly shorter than before. Compared with the control group, the MWT of rats was significantly prolonged after Tuina.