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No description available.

O controle postural em idosos tem sido estudado com o objetivo de melhor entender os fatores que levam esta população a sofrer mais quedas que os indivíduos jovens. A maior variabilidade de força dos músculos flexores plantares (MFP) aparenta estar diretamente associada ao menor controle postural principalmente em adultos jovens. Além disto, o treinamento específico de estabilidade de força dos MFP em baixas intensidades parece diminuir a variabilidade de força destes músculos e também diminuir a oscilação postural de adultos jovens. Entretanto, faltam esclarecimentos sobre a associação entre variabilidade de força dos MFP e oscilação postural na população idosa, bem como os efeitos de um treinamento específico de estabilidade de força destes músculos para esta mesma população. Sendo assim, o objetivo do presente estudo foi analisar a associação entre variabilidade de força dos MFP e a oscilação postural de idosas e examinar os efeitos do treinamento de estabilidade de força na variabilidade da força dos MFP, na coativação muscular dos músculos tibial anterior (TA) e gastrocnêmio medial (GM) e na oscilação corporal destas idosas. Para isto, 40 mulheres idosas foram divididas em quatro grupos: Grupo GT5 (n=10) que realizou treinamentos a 5% da contração isométrica voluntária máxima (CIVM) dos MFP; Grupo GT10 (n=10) que realizou treinamentos a 10% da CIVM dos MFP; Grupo GTLP (n=10) que realizou treinamentos a 10% de uma repetição máxima dos MFP no equipamento Leg Press; Grupo GC (n=10) que não realizou nenhum treinamento específico para os MFP e foi utilizado como controle. Foram avaliadas a oscilação corporal durante a manutenção da postura bipodal ereta, a variabilidade da força dos MFP e a coativação muscular dos músculos TA e GM antes e após o período de treinamento. Este treinamento foi realizado uma vez por semana durante quatro semanas. Em cada sessão de treino a participante realizou cinco séries em que mantinha por 30 segundos a força isométrica de flexão plantar, de acordo com as especificações de seu grupo. Os resultados revelaram que o treinamento de estabilidade de força dos MFP realizado pelos grupos GT5, GT10 e GTLP foi eficiente e diminuiu a variabilidade de força das participantes na condição de 5% da CIVM com feedback visual, além disso, mostrou que o grupo GT5 também diminuiu sua variabilidade de força para a condição 10% da CIVM com feedback visual. Em relação ao controle postural, foi observado que os grupos GT5 e GT10 aumentaram sua amplitude média de oscilação na direção ântero-posterior após o treinamento. Com relação à ativação dos músculos TA e GM, os grupos GT5 e GT10 diminuíram o índice de coativação muscular para as condições 5% e 10% com feedback visual após o treinamento e o grupo GT5 ainda apresentou diminuição da coativação para a condição 5% sem feedback visual. Finalmente, os resultados apontaram que para população idosa não há relação entre a variabilidade de força dos MFP e o controle da postura. Portanto, estes resultados indicam que, na população idosa não existe associação entre controle postural e variabilidade de força dos MFP, e mesmo que não esteja claro o efeito do treinamento no controle da postura, a redução da variabilidade da força e coativação muscular podem ser interpretadas como um ganho em termos de controle motor / Elderly postural control has been studied in order to better understand the factors that lead this population to suffer more falls than young individuals. Greater variability of plantar flexor muscles (PFM) strength appears to be directly associated to lower postural control mainly in young adults. In addition, specific training of PFM strength stability at low intensities seems to decrease force variability of these muscles and also to decrease postural oscillation of young adults. However, there is a lack of clarification about the association between PFM force variability and postural oscillation in elderly population, as well as the effects of specific stability strength training of these muscles for this same population. Thus, the objective of the present study was to analyze the association between PFM force variability and postural oscillation in elderly, and to examine the effects of strength stability training on PFM force variability in the muscle coactivation of anterior tibial muscles (AT) and medial gastrocnemius (MG) and in the body oscillation of these elderly women. For this, 40 elderly women were divided into four groups: Group TG5 (n = 10) who performed training at 5% of maximal voluntary isometric contraction (MVIC) of PFM; TG10 group (n = 10) who performed training at 10% of the MVIC of PFM; TGLP group (n = 10) who underwent training at 10% of a maximum repetition of the PFMs in the Leg Press equipment; Group CG (n = 10) who did not perform any specific training for PFMs and was used as control. Body oscillation was evaluated during maintenance of upright bipodal posture, PFM force variability, and muscle coactivation of AT and MG muscles before and after the training period. This training was performed once a week for four weeks. In each training session participant performed five series in which he maintained for 30 seconds the isometric force of plantar flexion, according to the specifications of his group. The results showed that the PFM force stability training performed by TG5, TG10 and TGLP groups was efficient and decreased the strength variability of the participants in the 5% condition of the MVIC with visual feedback, in addition, showed that the TG5 group also decreased its force variability to the 10% MVIC condition with visual feedback. Regarding the postural control, it was observed that the TG5 and TG10 groups increased their mean amplitude of oscillation in the anteroposterior direction after the training. Regarding the activation of the AT and MG muscles, the TG5 and TG10 groups decreased the muscle activation rate for the 5% and 10% conditions with visual feedback after the training and the TG5 group still showed a decrease of the coactivation for the condition 5% without visual feedback. Finally, the results pointed out that for the elderly population there is no relation between the PFM strength variability and the posture control. Therefore, these results indicate that, in the elderly population, there is no association between postural control and PFM strength variability, and even though the effect of training on posture control is not clear, the reduction in strength variability and muscle coactivation can be interpreted as a gain in terms of motor control

Resumo: Este projeto tem como proposta avaliar o comportamento biológico das células estromais mesenquimais multipotentes autólogas associadas ou não às matrizes de colágeno, na reconstrução tendínea. Optou-se em trabalhar com ovinos e, para isso, os ovinos foram submetidos à ferida no tendão flexor superficial do membro torácico esquerdo, que consistiu na realização de uma tenectomia parcial medindo 1,5cm de comprimento e 0,3cm de largura. Aos 30, 60 e 90 dias após o procedimento cirúrgico foram retirados os tendões flexores superficiais dos membros torácicos dos animais e os fragmentos colhidos foram destinados para procedimento histológico, e de microscopia eletrônica de varredura. Nas avaliações histopatológicas evidenciou-se aumento na quantidade de fibroblastos aos 30, 60 e 90 dias após a intervenção cirúrgica, além de uma desorganização severa da matriz colágena nos diferentes grupos. A microscopia eletrônica de varredura mostrou nos tendões do grupo controle (G1) aos 30, 60 e 90 dias após o procedimento cirúrgico, fibras colágenas finas, ramificadas com perda do arranjo, quando comparadas com as fibras colágenas do tendão normal. O grupo G2 apresentou melhor organização das fibras, porém similares às observadas no G1. Já no grupo G3 a melhor organização e arranjo das fibras colágenas foram evidentes. Dessa maneira, esses resultados permitem inferir que a engenharia de tecidos utilizando CTMs associadas a enxertos biológicos apresentam tratamento clínico promissor para a reparação de tendões / Abstract: This project has as purpose to pick, cultivate, characterize and study the biological behavior of the Mesenchymal Stem Cells and the collagen scalffold, in the reconstruction of the connective tissue Tendons. It was decided to work with sheep and, therefore, three treatments were accomplished using Autologous Mesenchymal Stem Cells and applied in the superficial flexor tendon of the left thoracic member of the sheep, injured for the experience. The sheep were submitted to the wound in the superficial flexor tendon of the left thoracic limb that consisted of an accomplishment of a partial tenectomic measuring 1,5cm of length and 0,3cm of width. After 30, 60 and 90 days after the surgical procedure, the superficial flexor tendons of the left thoracic limb of the animals were withdrawed and the picked fragments were sent to histology procedure, and Scan electron microscopy. In the histopatology evaluations, there was an increase of fibroblast amount after 30, 60 and 90 days after the surgical intervention of the control group (G1), the one treated with collagen scalfod, and the one treated with collagen scalffold associated to the Mesenchymal Stem Cells, besides of sever disorganization of the main collage which was more severe at the 30 days in the different groups when compared to the normal tissue. The Scan electron microscopy showed in the tendons of the control group (G1) after, 30, 60 and 90 days after the surgical procedure thin collagen fibers, ramified with lose of arrangement, when compared to the collagen fibers of the normal tendon. Group G2 showed better organization of the fibers, however, similar to the ones observed in G1. In G3, the best organization and arrangement of the collagen fibers were evident. Finally, it can be verified that the implantation of collagen scalfold associated to Mesenchymal Stem Cells is of great importance to the wound healing / Orientador: Silvana Martinez Baraldi Artoni / Coorientador: José Wanderley Cattelan / Banca: Aparecida Maria Fontes / Banca: Ana Maria de Guzzi Plepis / Banca: Aureo Evangelista Santana / Banca: Antonio Carlos Alessi / Doutor

Resumo: Nas últimas três décadas muitas pesquisas têm sido realizadas com o objetivo de compreender o processo cicatrização dos tendões flexores e ainda hoje, a reabilitação envolve processos complexos e não compreendidos totalmente. As incertezas em colocar a sutura central na face dorsal vascularizada ou na face palmar avascularizada, persistem ainda na prática clínica e nos experimentos das técnicas de reparo dos tendões flexores dos dedos da mão na região da bainha digital. O objetivo deste estudo foi analisar as propriedades mecânicas e histopatológicas da colocação de um ponto de sutura simples no tendão flexor profundo dos dedos do pé de coelhos, verificando os efeitos na interface sutura-tendão e comparar a colocação deste ponto na região do tendão fibroso, vascularizada e na região do tendão fibrocartilaginoso avascular. Foram estudados 88 coelhos machos divididos em dois grupos de acordo com o local de colocação do ponto de sutura e em mais três subgrupos de acordo com o tempo de seguimento pós- operatório de sete, 14 e 21 dias. O procedimento cirúrgico consistiu na colocação de um único ponto na região de tendão fibroso (Grupo TF) e na região de tecido fibrocartilaginoso (Grupo TFC) no tendão flexor profundo dos dedos do pé do coelho. Em ambos os grupos, os tendões estavam íntegros, sem lesão e os animais permaneceram livres de imobilização. As propriedades mecânicas estudadas foram carga máxima, tensão na carga máxima, módulo de elasticidade, energia na carga máxima e energia por área. Três tendões de cada grupo foram submetidos à análise histológica descritiva por meio de microscopia óptica com ênfase no progresso das etapas da cicatrização tendinosa. A análise das propriedades mecânicas demonstrou comportamento semelhante em ambos... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: In the last three decades many studies have been undertaken with the aim of understanding the process of flexor tendon healing and even now, the rehabilitation involves a complex and not fully understood process. The doubts concerning placing the core suture in the vascularized dorsal region than of the palmar avascularized region remain in clinical practice and in the experimental techniques in the repair of flexor tendons of the finger in the digital sheath. The aim of this study was to evaluate the mechanical and histopathologic properties of placing a single suture on the deep flexor tendon in rabbit toes, examining the effects on suture-tendon interface and compare the placement of this point at normal vascularized tendon as well as at the avascular fibrocartilagenous tendon. Eighty-eight male rabbits were studied and divided into two groups according to the local of the point of suture and in three subgroups according to the time of postoperative segment of seven, fourteen and twenty-one days. The surgical procedure was inserting a single point in the region of fibrous tendon (TF Group) and the region of fibrocartilagenous tissue (TFC Group) in deep flexor tendon in rabbit toes. In both groups, the tendons were intact without injury and the animals were allowed free movement. The mechanical properties were maximum load, stress at maximum load, elasticity modulus (Young modulus), energy at maximum load and energy per area. Three tendons from each group were subjected to descriptive histological analysis by an optical microscopy emphasizing the process of tendon healing stages. The analysis of mechanical properties showed similar trend in both groups, with increasing values in accordance with the periods of seven, fourteen and twenty-one days in most of the variables. The control group showed relative similarity than operated group except in TFC twenty one days group that operated... (Complete abstract click electronic access below) / Orientador: Sérgio Swain Muller / Coorientador: Trajano Sardenberg / Banca: Ivan Chakkour / Banca: Antonio Carlos da Costa / Banca: Gilberto Hiroshi Ohara / Banca: Paulo Roberto de Almeida Silvares / Doutor

Abstract Early motion is crucial for tendon healing and functional results after flexor tendon repair in the fingers. Motion, however, causes stress in the repair site, which can result in failure of the repair. A flexor tendon repair is made with fine calibre sutures, which sets exceptional requirements for the suture materials used in flexor tendon repair. Nitinol (nickel-titanium alloy) is a shape memory alloy, which can exist in two temperature-dependent forms, soft martensite and stiff austenite. It is possible to fabricate a nitinol wire that is soft and pliable, yet has high tensile strength. It also has excellent biocompatibility. Therefore, it is a potential candidate flexor tendon repair suture material. This study evaluates biomechanical aspects of martensite nitinol wire as a flexor tendon repair suture material. The study hypothesis was that nitinol wire improves the strength of the repairs compared with the repairs made with conventional suture materials. It was found that nitinol core repairs and circumferential repairs performed significantly better when compared with repairs made with commonly used braided polyester and polypropylene of equal calibre. To further optimise the performance of the nitinol wire in tendon surgery, two experimental models were developed to study the suture-tendon interface. The aim was to prevent pull-out of the suture loop so that surgeons could have full advantage of the tensile strength of the nitinol suture. First, it was tested whether it is possible to improve the suture’s ability to grip the tendon tissue by changing the suture type from monofilament to multifilament. Multifilament suture loops reached higher pull-out strength when compared with round monofilament loops when a locking loop was used. Subsequently, the grip of four different previously reported core repair loops was tested. Based on their failure mechanism, two novel loops were developed. The novel loops demonstrated superior ability to grip the tendon. The novel loops can be useful with high tensile strength suture materials and in repairs, which are prone to suture pull-out. / Tiivistelmä Varhainen korjauksen jälkeinen aktiivinen kuntoutus on osoittautunut hyödylliseksi jänteen paranemiselle. Varhainen liike altistaa korjauksen kuormitukselle, joka voi johtaa korjauksen pettämiseen. Korjaukset tehdään ohuilla langoilla. Tämä asettaa erityisiä vaatimuksia jännekorjauksessa käytettävälle ommelainemateriaalille. Nikkeli-titaani (nitinoli) on nk. muistimetalli. Sillä on kaksi lämpötilariippuvaista muotoa: pehmeä martensiitti ja jäykkä austeniitti. Nitinolista voidaan valmistaa ohutta pehmeää ja taipuisaa lankaa, jonka vetolujuus on suuri. Nitinolin siedettävyys jännekudoksessa on todettu hyväksi, minkä vuoksi se on lupaava materiaali käytettäväksi jännekorjauksissa. Tässä tutkimuksessa kokeiltiin martensiittisen nitinolilangan käyttöä jänteen ydinompeleena ja pintaompeleena. Olettamuksena oli, että nitinolilangalla saadaan kestävämpiä korjauksia kuin nykyään käytössä olevilla langoilla. Tulosten mukaan nitinolilangalla tehdyt korjaukset olivat kestävämpiä, kun niitä verrattiin saman paksuiseen punottuun polyesteriin ja polypropyleeniin. Lisäksi kehitimme kaksi mallia, joiden tarkoituksena oli parantaa nitinolilankasilmukan pitoa jännekudoksesta. Tarkoituksena oli löytää keinoja, joilla langan otetta jännekudoksesta voidaan parantaa ja langan hyvät vetolujuusominaisuudet pääsevät oikeuksiinsa. Ensin muutimme langan muotoa perinteisestä yksisäikeisestä pyöreästä monisäikeiseen muotoon. Monisäikeisen langan läpileikkausvoima oli huomattavasti suurempi kuin yksisäikeisen pyöreän langan. Ero oli havaittavissa vain, kun käytettiin lukitsevaa silmukkaa. Tämän jälkeen testasimme neljän perinteisesti käytetyn korjaustekniikan silmukan pitokykyä ja tulosten perusteella kehitimme kaksi uutta silmukkaa. Työssä kehitetyt silmukat pitivät kiinni jänteestä huomattavasti paremmin kuin perinteiset silmukat. Työssä kehitetyillä silmukoilla voidaan optimoida vahvojen ommelainemateriaalien suorituskyky jännekirurgiassa.

O controle postural em idosos tem sido estudado com o objetivo de melhor entender os fatores que levam esta população a sofrer mais quedas que os indivíduos jovens. A maior variabilidade de força dos músculos flexores plantares (MFP) aparenta estar diretamente associada ao menor controle postural principalmente em adultos jovens. Além disto, o treinamento específico de estabilidade de força dos MFP em baixas intensidades parece diminuir a variabilidade de força destes músculos e também diminuir a oscilação postural de adultos jovens. Entretanto, faltam esclarecimentos sobre a associação entre variabilidade de força dos MFP e oscilação postural na população idosa, bem como os efeitos de um treinamento específico de estabilidade de força destes músculos para esta mesma população. Sendo assim, o objetivo do presente estudo foi analisar a associação entre variabilidade de força dos MFP e a oscilação postural de idosas e examinar os efeitos do treinamento de estabilidade de força na variabilidade da força dos MFP, na coativação muscular dos músculos tibial anterior (TA) e gastrocnêmio medial (GM) e na oscilação corporal destas idosas. Para isto, 40 mulheres idosas foram divididas em quatro grupos: Grupo GT5 (n=10) que realizou treinamentos a 5% da contração isométrica voluntária máxima (CIVM) dos MFP; Grupo GT10 (n=10) que realizou treinamentos a 10% da CIVM dos MFP; Grupo GTLP (n=10) que realizou treinamentos a 10% de uma repetição máxima dos MFP no equipamento Leg Press; Grupo GC (n=10) que não realizou nenhum treinamento específico para os MFP e foi utilizado como controle. Foram avaliadas a oscilação corporal durante a manutenção da postura bipodal ereta, a variabilidade da força dos MFP e a coativação muscular dos músculos TA e GM antes e após o período de treinamento. Este treinamento foi realizado uma vez por semana durante quatro semanas. Em cada sessão de treino a participante realizou cinco séries em que mantinha por 30 segundos a força isométrica de flexão plantar, de acordo com as especificações de seu grupo. Os resultados revelaram que o treinamento de estabilidade de força dos MFP realizado pelos grupos GT5, GT10 e GTLP foi eficiente e diminuiu a variabilidade de força das participantes na condição de 5% da CIVM com feedback visual, além disso, mostrou que o grupo GT5 também diminuiu sua variabilidade de força para a condição 10% da CIVM com feedback visual. Em relação ao controle postural, foi observado que os grupos GT5 e GT10 aumentaram sua amplitude média de oscilação na direção ântero-posterior após o treinamento. Com relação à ativação dos músculos TA e GM, os grupos GT5 e GT10 diminuíram o índice de coativação muscular para as condições 5% e 10% com feedback visual após o treinamento e o grupo GT5 ainda apresentou diminuição da coativação para a condição 5% sem feedback visual. Finalmente, os resultados apontaram que para população idosa não há relação entre a variabilidade de força dos MFP e o controle da postura. Portanto, estes resultados indicam que, na população idosa não existe associação entre controle postural e variabilidade de força dos MFP, e mesmo que não esteja claro o efeito do treinamento no controle da postura, a redução da variabilidade da força e coativação muscular podem ser interpretadas como um ganho em termos de controle motor / Elderly postural control has been studied in order to better understand the factors that lead this population to suffer more falls than young individuals. Greater variability of plantar flexor muscles (PFM) strength appears to be directly associated to lower postural control mainly in young adults. In addition, specific training of PFM strength stability at low intensities seems to decrease force variability of these muscles and also to decrease postural oscillation of young adults. However, there is a lack of clarification about the association between PFM force variability and postural oscillation in elderly population, as well as the effects of specific stability strength training of these muscles for this same population. Thus, the objective of the present study was to analyze the association between PFM force variability and postural oscillation in elderly, and to examine the effects of strength stability training on PFM force variability in the muscle coactivation of anterior tibial muscles (AT) and medial gastrocnemius (MG) and in the body oscillation of these elderly women. For this, 40 elderly women were divided into four groups: Group TG5 (n = 10) who performed training at 5% of maximal voluntary isometric contraction (MVIC) of PFM; TG10 group (n = 10) who performed training at 10% of the MVIC of PFM; TGLP group (n = 10) who underwent training at 10% of a maximum repetition of the PFMs in the Leg Press equipment; Group CG (n = 10) who did not perform any specific training for PFMs and was used as control. Body oscillation was evaluated during maintenance of upright bipodal posture, PFM force variability, and muscle coactivation of AT and MG muscles before and after the training period. This training was performed once a week for four weeks. In each training session participant performed five series in which he maintained for 30 seconds the isometric force of plantar flexion, according to the specifications of his group. The results showed that the PFM force stability training performed by TG5, TG10 and TGLP groups was efficient and decreased the strength variability of the participants in the 5% condition of the MVIC with visual feedback, in addition, showed that the TG5 group also decreased its force variability to the 10% MVIC condition with visual feedback. Regarding the postural control, it was observed that the TG5 and TG10 groups increased their mean amplitude of oscillation in the anteroposterior direction after the training. Regarding the activation of the AT and MG muscles, the TG5 and TG10 groups decreased the muscle activation rate for the 5% and 10% conditions with visual feedback after the training and the TG5 group still showed a decrease of the coactivation for the condition 5% without visual feedback. Finally, the results pointed out that for the elderly population there is no relation between the PFM strength variability and the posture control. Therefore, these results indicate that, in the elderly population, there is no association between postural control and PFM strength variability, and even though the effect of training on posture control is not clear, the reduction in strength variability and muscle coactivation can be interpreted as a gain in terms of motor control

Bakgrund: De intrinsica fotmusklerna (IFM) har potential att påverka idrottslig prestation som hopp, sprint samt balans direkt genom påverkan av muskelstyrkan eller indirekt genom påverkan på det mediala-longitudinella fotvalvet. Ett växande antalet studier visar samband mellan träning av IFM och idrottslig prestation, dock råder ingen konsensus och motstridiga resultat finns. Syfte: Syftet med studien var att kritiskt granska litteratur och undersöka det aktuella vetenskapliga kunskapsläget för sambandet mellan muskelstyrka i IFM och friska individers sprint- och hopprestanda samt balans. Metod: En litteratursökning med noga valda sökord genomfördes i fyra databaser. Efter genomgång av in- och exkluderingskriterier inkluderades 10 studier vilka kvalitetsmässigt bedömdes med Joanna Briggs Institute granskningsmall för tvärsnittsstudier. En narrativ syntetiserande analys genomfördes. Resultat: Kvalitén i inkluderade studier bedömdes i genomsnitt vara medelgod. Det som främst drog ner betyget var hanteringen av confounders och användandet av ej valida mätinstrument. Generellt visade inkluderade studier på ett samband mellan tåflexor styrka/storlek och hopp- och sprintprestanda samt balans. Svårigheten att isolerat mäta IFM försvårar möjligheten att utreda IFMs betydelse för inkluderade studiers utfallsmått. Slutsats: Genomförd litteraturstudie visar möjliga samband mellan styrka/tåflexorstorlek och prestation i hopp och sprint såväl som balans. För att nå en ökad förståelse för hur IFM påverkar idrottslig prestation och balans behövs en större kunskap om hur IFM styrka direkt eller indirekt kan mätas isolerat och hur muskelstorlek kan översättas till styrka. Genomförd litteraturgranskning stödjer ett redan identifierat behov av valida mätinstrument för att nå en ökad förståelse av IFMs betydelse för idrottslig prestation och balans. / Background: The intrinsic foot muscles (IFM) have the potential to improve sprint, jump and balance performance by direct muscle power or indirectly by supporting the medial longitudinal arch. A growing number of studies show the association between exercising the IFM and athletic performance. However, there is no consensus if athletes can benefit from IFM training and inconsistent results are published. Aim: The aim of this study was to conduct a critical systematic review to evaluate the current knowledge of the association between IFM strength and performance in jump sprint and balance in healthy individual’s. Methods: Four data bases were searched for eligible studies. After screening for exclusion and inclusion criteria ten studies were included. The scientific quality was analyzed using the Joanna Briggs Institute ”Critical Appraisal tools” for Cross Sectional Studies, and a narrative synthesis was conducted. Results: The average quality score for the included studies was “moderately good”. The main reason for the low scores was insufficient attention to confounders and the use of non-valid instruments. An association was found in most of the studies between toe flexor strength/size and jump, sprint and balance performance. Difficulties in selectively measuring the IFM activity complicated the possibility to evaluate the impact of IFM on studied outcome measures. Conclusion: The presented study shows an association between toe flexor strength/size and athletic performance. However, to understand how IFM strength training affects athletic performance, both directly and indirectly, more studies focused on how to measure the IFM using valid methods for isolated IFM measures of strength and size is needed.

Trotz intensiver Forschung im Rahmen der Bänder- und Sehnenerkrankungen gelten bestimmte Fragestellungen hinsichtlich Erkrankungs- sowie Heilungsmechanismen als unbeantwortet. Verschiedenste Konzepte des Tissue Engineerings sollen helfen entsprechende Fragen zu beantworten und moderne Therapiekonzepte zu etablieren. Für grundlegende Untersuchungen zur Biologie der Tenogenese sowie zum Wirkmechanismus applizierter mesenchymaler Stromazellen (MSC), gewinnt die Anwendung von dezellularisiertem Sehnengewebe immer mehr an Bedeutung. Zudem erscheint der Einsatz dezellularisierter Sehnen- und Bandkonstrukte zur Wiederherstellung der betreffenden erkrankten Organe sehr vielversprechend. In der vorliegenden Arbeit sollte der Grundstein zur Entwicklung eines in vitro-Modells auf Grundlage equiner Beugesehnen gelegt werden. Primäres Ziel war es, ein optimales Dezellularisierungsprotokoll für intakte equine Beugesehnen (oberflächliche und tiefe Beugesehne) zu etablieren. Um die Zytokompatibilität der dezellularisierten Sehnen zu überprüfen, erfolgte nach Präparation von Sehnenstreifen die Besiedlung mit equinen MSC mit Kontrolle des Besiedlungserfolges. Materialien und Methoden: Oberflächliche und tiefe Beugesehnen (OBS und TBS) des Pferdes (n = 6) wurden nach vier verschiedenen Protokollen dezellularisiert. In zwei Protokollen (Protokolle A und B) erfolgte zunächst die Anwendung von Gefrier-Auftau- Zyklen mit anschließender Lagerung in hypertoner Lösung. Protokoll A sah danach eine Inkubation in 1 % Triton X 100 und Protokoll B eine Inkubation in 1 % Sodium-Dodecyl-Sulfat (SDS) enthaltender Lösung vor. Die beiden anderen Protokolle (Protokolle C und D) sahen ein Verbringen in hypertone Lösung ohne vorherige Gefrierzyklen vor. Anschließend erfolgte bei Protokoll C die Inkubation in Triton X 100 und bei Protokoll D die Inkubation in SDS enthaltender Lösung. Die Effektivität der angewandten Dezellularisierungsprotokolle wurde durch histologischer Färbung, Zellzählung nach Kollagenaseverdau, DNA-Quantifizierung und transmissionselektronenmikroskopischer Untersuchung ermittelt. Nach Evaluierung der Effektivität der Protokolle wurden oberflächliche Beugesehnen nach den Protokollen A und B dezellularisiert (n=3). Nach Präparation von Sehnenstreifen in definierter Größe erfolgte die Besiedelung mit Eisenoxid-markierten equinen MSC. Der Besiedlungserfolg wurde mit verschiedenen histologischen und Fluoreszenzfärbungen (Fluoreszenzmikroskopie) und MRT-Untersuchung kontrolliert. Die Prüfung auf statistische Unterschiede zwischen den Protokollen erfolgte mit dem Friedman-Test und im Falle eines statistisch signifikanten Unterschieds mit dem Wilcoxon-Rang-Test. Das Signifikanzniveau wurde mit p < 0,05 festgelegt. Die Auswertung des Besiedlungserfolges erfolgte deskriptiv. Ergebnisse: Für alle angewandten Protokolle konnte ein signifikanter Dezellularisie-rungseffekt in beiden Sehnenstrukturen (OBS und TBS) gezeigt werden. Die Anzahl der vitalen Zellen nach Kollagenaseverdau sowie die histologisch ermittelte Zellzahl der dezellularisierten Sehnen belief sich in Abhängigkeit des jeweiligen Dezellularisie-rungsprotokolls und der Sehne (OBS und TBS) auf 1 bis 21 % (Median) des nativen Gewebes. Der ermittelte DNA-Gehalt nach Anwendung der mit Gefrier-Auftau-Zyklen kombinierten Protokollen A und B entsprach < 24 % (Median) des nativen Gewebes. Die Anwendung der Protokolle C und D führte zu einem DNA-Gehalt von < 47 % (Median). Die Auswertung der transmissionselektronenmikroskopischen Untersuchung zeigte ebenfalls eine effektive Dezellularisierung des Sehnengewebes bei Erhalt der Struktur der extra-zellulären Matrix. Nach Anwendung der Protokolle A und B konnte wiederum tendenziell eine bessere Effektivität der Dezellularisierung festgestellt werden. Eine gelungene Besiedlung der Sehnenstreifen mit equinen MSC konnte anhand der mikroskopischen Untersuchung und MRT-Untersuchung gezeigt werden. Das beobachtete Zellwachstum bei beibehaltender Vitalität der Zellen sprechen für eine gute Zytokompatibilität. Die nach Protokoll A dezellularisierten und besiedelten Sehnenstreifen ließen ein besseres Zellwachstum über eine Kulturdauer von 14 Tagen erkennen. In der vorliegenden Arbeit konnte eine effektive Dezellularisierung von intakten equinen Beugesehnen gezeigt werden. Anhand der Ergebnisse der Besiedlung erwies sich die Dezellularisierung nach Protokoll A (Gefrier-Auftau-Zyklen und Triton X 100) als vielversprechende Grundlage zur Entwicklung eins in vitro Modells auf Grundlage dezellularisierter equiner Beugesehnen.

Background: Long-term cyclic tensile testing with equine palmar/plantar tendons have not yet been performed due to problems in fixing equine tendons securely and loading them cyclically. It is well established that the biomechanical response of tendons varies during cyclic loading over time. The aim of this study was to develop a clamping device that enables repetitive cyclic tensile testing of equine superficial digital flexor tendon for at least 60 loading cycles and for 5 min. Results: A novel cryo-clamp was developed and built. Healthy and collagenase-treated pony SDFTs were mounted in the custom-made cryo-clamp for the proximal tendon end and a special clamping device for the short pastern bone (os coronale). Simultaneously with tensile testing, we used a biplanar high-speed fluoroscopy system (FluoKin) to track tendon movement. The FluoKin system was additionally validated in precision measurements. During the cyclic tensile tests of the SDFTs, the average maximal force measured was 325 N and 953 N for a length variation of 2 and 4 % respectively. The resulting stress averaged 16 MPa and 48 MPa respectively, while the modulus of elasticity was 828 MPa and 1212 MPa respectively. Length variation of the metacarpal region was, on average, 4.87 % higher after incubation with collagenase. The precision of the FluoKin tracking was 0.0377 mm, defined as the standard deviation of pairwise intermarker distances embedded in rigid bodies. The systems accuracy was 0.0287 mm, which is the difference between the machined and mean measured distance. Conclusion: In this study, a good performing clamping technique for equine tendons under repetitive cyclic loading conditions is described. The presented cryo-clamps were tested up to 50 min duration and up to the machine maximal capacity of 10 kN. With the possibility of repetitive loading a stabilization of the time-force-curve and changes of hysteresis and creep became obvious after a dozen cycles, which underlines the necessity of repetitive cyclical testing. Furthermore, biplanar high-speed fluoroscopy seems an appropriate and highly precise measurement tool for analysis of tendon behaviour under repetitive load in equine SDFTs.