Visualization of joint cavitation in realtime

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test. Statistically significant differences between groups were expressed as p values less than 0.05. Results: The pain intensity in CH, neck and CHN with TENS was significantly decreased than control. Somatosensory cortex and prefrontal cortex blood flow were not significantly different between control, CH, neck, and CHN. Conclusion(s): These results suggested that TENS to the same dermatome might be effective when TENS could not be delivered directly to the affected area because of amputation and wound. Pain relief by TENS could be induced by limbic system, because the blood flow to the cerebral cortex was not significantly different between four interventions. Implications: Using TENS to the same dermatome might be effective when TENS can not be delivered directly to the affected area because of amputation and wound. Keywords: Transcutaneous electrical nerve stimulation; Dermatome; Functional near infrared spectroscopy Funding acknowledgements: Unfunded. Ethics approval: The Konan Women’s University Ethics Committee.

separation and sound production. The resulting cavity was continually visualized past the point of sound production. Conclusion(s): Our results offer direct experimental evidence that joint cracking is associated with cavity inception not bubble collapse. Implications: These observations are consistent with tribonucleation, a known process where opposing surfaces resist separation until a critical point where they then separate rapidly creating sustained gas cavities. Observed in vitro, this is the first in-vivo macroscopic demonstration of tribonucleation and as such, provides a new theoretical framework to investigate health outcomes associated with joint cracking. Keywords: Joint; Cavitation; Cracking Funding acknowledgements: Imaging costs were funded by the Canadian Chiropractic Research Foundation. Greg Kawchuk is supported by the Canada Research Chairs program. Ethics approval: Human Research Ethics Board (HREB), University of Alberta. Protocol MS1 Pro00041796. http://dx.doi.org/10.1016/j.physio.2015.03.3595

http://dx.doi.org/10.1016/j.physio.2015.03.3594 Research Report Platform Presentation Number: RR-PL-1788 Saturday 2 May 2015 17:17 Room 303–304

Research Report Platform Presentation Number: RR-PL-790 Saturday 2 May 2015 08:41 Room 334–335 VISUALIZATION OF JOINT CAVITATION IN REALTIME

GENE EXPRESSION RESPONSE IN THE PORCINE INTERVERTEBRAL DISC FOLLOWING SPINAL MANIPULATION

G. Kawchuk 1 , J. Fryer 1 , J. Jaremko 1 , H. Zeng 1 , L. Rowe 2 , R. Thompson 1

G. Kawchuk 1 , J. Matyas 2 , N. Duncan 2 , C. Klein 2

1 University

of Alberta, Edmonton, Canada; Newcastle, Newcastle, Australia

2 University

of

Background: Cracking sounds emitted from human synovial joints have been attributed historically to the sudden collapse of a cavitation bubble formed as articular surfaces are separated. Unfortunately, bubble collapse as the source of joint cracking is inconsistent with many physical phenomena that define the joint cracking phenomenon. Purpose: To ascertain the sequence of events that occur within the metacarpophalangeal joint during cracking through use of real-time cine magnetic resonance imaging. Methods: Ten metacarpophalangeal joints were studied by inserting the finger of interest into a flexible tube tightened around a length of cable used to provide long-axis traction. Before and after traction, static 3D T1-weighted magnetic resonance images were acquired. During traction, rapid cine magnetic resonance images were obtained from the joint midline at a rate of 3.2 frames per second until the cracking event occurred. Results: As traction forces increased in the joint to the joint, real-time cine magnetic resonance imaging demonstrated rapid cavity inception with simultaneous joint

1 University

of Alberta, Edmonton, Canada; Calgary, Calgary, Canada

2 University

of

Background: Spinal manipulative therapy (SMT) is a common therapeutic intervention provided with the intention of improving joint kinematics and/or spinal pain. Consequently, numerous investigators have studied its biomechanical and neurological outcomes. Less studied are biological responses to manipulation. It is well-known that when given static and cyclic mechanical loading, spinal tissues respond with upstream activity such as altered gene expression and downstream effects including alterations in proteoglycan and collagen content. Presently, it is not known if spinal tissues respond in similar ways to the short duration, impulse type forces characteristic of SMT. Purpose: To determine if a non-invasive, short duration application of force from SMT results in transduction of spinal loading into an altered gene expression pattern within the intervertebral disc. Methods: Six swine (Duroc x (Large White x Landrace, mean 48 ± 4 kg)) were maintained under anesthesia for 3 hrs. Two animals served as unloaded controls while the other four received SMT directed to the spinous process of the lumbar