RT Journal Article SR Electronic T1 Therapeutic Ultrasound and Treadmill Training Suppress Peripheral Nerve Injury–Induced Pain in Rats JF Physical Therapy JO Phys Ther FD American Physical Therapy Association SP 1545 OP 1553 DO 10.2522/ptj.20140379 VO 96 IS 10 A1 Hung, Ching-Hsia A1 Huang, Po-Ching A1 Tzeng, Jann-Inn A1 Wang, Jhi-Joung A1 Chen, Yu-Wen YR 2016 UL http://jcore-reference.highwire.org/content/96/10/1545.abstract AB Background Although evidence suggests that therapeutic ultrasound (TU) in combination with treadmill training (TT) suppresses nerve injury–associated pain, the molecular mechanisms for this action are not clear.Objective The purpose of this research was to study the possible beneficial effects of TU and TT, alone and in combination, on 2 clinical indicators of neuropathic pain and correlate these findings with changes in inflammatory mediators within the spinal cord. Our experimental model used the well-known chronic constriction injury (CCI) of the rat sciatic nerve.Design This was an experimental study.Methods Each group contained 10 rats. Group 1 underwent only the CCI procedure. Group 2 underwent a sham operation where the sciatic nerve was exposed but not ligated. Group 3 had the sham operation followed by both TT and TU. Groups 4, 5, and 6 underwent the CCI procedure followed by TT alone, TU alone, and both the TT and TU interventions, respectively. Heat and mechanical sensitivity, interleukin-6 (IL-6), interleukin-10 (IL-10), and ionized calcium binding adaptor molecule 1 (Iba1) were evaluated.Results Compared with group 1 animals, TT or TU, or both, produced smaller decreases in mechanical withdrawal threshold and heat withdrawal latencies. The combination of TT and TU was more effective than either treatment alone. In addition, rats that received these treatments did not express the upregulation of IL-6 and Iba1 in their spinal cords on postoperative days 14 and 28, as was found in the group 1 animals.Limitations These experimental findings may not be generalizable to humans.Conclusions The combination of TU and TT reduces neuropathic pain more than either modality alone. This beneficial effect appears related to downregulation of proinflammatory IL-6 and Iba1, while upregulating the anti-inflammatory IL-10.