Bring our science to physical therapy convention

Dr. Anni talk at physical therapy convention 

Her talk abstract:

Mechanical macroscopic aspect of soft tissue management

Anni Wang, PT, DPT, AP, DOM, MS

Aurora Acupuncture and Physical Therapy

Manual Therapy as a branch of PT has achieved great clinical outcomes. The technique includes myofascial release, muscle energy technique, manual stretching, TB12 method, muscle mobilization etc. The results of manual therapy include likely increase of blood flow, decrease tightness, and decrease subjective pain level, however, there is no quantitative data showing the objective changes pre and post treatment. We have researched molecular level and cellular level inflammation process and cellular apoptosis, however, we don't have adequate data on a macroscopic level what is happening with our soft tissue that induces pain. This theory is proposing the mechanical aspect of peripheral pain management, the author has a background of material chemistry and mechanical engineering. 

Mechanical properties of material mainly include strength, elasticity, stiffness, toughness, rigidity, plasticity, viscosity etc. Biological soft tissue with ion/fluid/cellular activities bring complexity to quantifying its mechanical properties on a microscopic level. However, the mechanical properties of materials could be applied to biologic soft tissue (bone, skin, fascia, adipose tissue, muscle, nerve, vessels) at a macroscopic level, which actually has clinical significance. The biological activity can affect the various soft tissue mechanical property, and the change of mechanical property would in return restrict/affect the biological activity. The skin has a greater toughness than bone or adipose tissue, which provides a phenomenon of shock absorption and protection. Muscles have greater elasticity and provide strength. Fascia and adipose tissue have greater viscosity, and it connects/fills space to provide shape/support. Through qualitative or quantitative soft tissue mechanical property data, we can manipulate soft tissue biological activities towards pain free homeostasis. What's more, the mechanical property of individual's soft tissue varies (for example, due to different cellular level components, different proportions of adipose tissue and muscles), which correlates with individual genetic differences and environmental differences, thus, this proposal hypothesizes the soft tissue mechanical property is the qualitative/quantitative measurable individualized population health data, that might have clinical significance in pain management.

This theory applies mechanical engineering tools to soft tissue management, explaining the differences between elasticity, hardness, rigidity, plasticity, viscosity of each soft tissue category, and its clinical significance. The macroscopic mechanical property data of soft tissue not just objectively measures the change of soft tissue quality, but it also connects clinical patient presentation to support soft tissue dysfunctions and improvement.

Reference:

1. Bernardo Innocenti, Chapter 2 - Mechanical properties of biological tissues. Human Orthopaedic Biomechanics. March 2022, Pages 9-24
2. Alekya B., Sanjay Rao, Hardik J. Pandya. Engineering approaches for characterizing soft tissue mechanical properties: A review, Clinical Biomechanics, Volume 69, 2019,Pages 127-140,
3. Beekmans, S.V., Emanuel, K.S., Smit, T.H. et al. Minimally Invasive Micro-Indentation: mapping tissue mechanics at the tip of an 18G needle. Sci Rep 7, 11364 (2017).
4. Anni Wang, Alex Volinsky, Nathan Gallant. Cross-linking Effect on Polydimethylsiloxane (PDMS) Elastic Modulus Measured in Compression. J Appl Polym Sci. 2014;131(22) 
5. Silvia Budday, Richard Nay, Rijk de Rooij, Paul Steinmann, Thomas Wyrobek, Timothy C. Ovaert, Ellen Kuhl. Mechanical properties of gray and white matter brain tissue by indentation. Journal of the Mechanical Behavior of Biomedical Materials, Volume 46, 2015, Pages 318-330
6. Yo Kobayashi, Naomi Okamura, Mariko Tsukune, Masakatsu G. Fujie, Masao Tanaka. Non-minimum phase viscoelastic properties of soft biological tissues. Journal of the Mechanical Behavior of Biomedical Materials. Volume 110, 2020, 103795