Cell biological basics of a motion-based therapy in arthritis - an overview

Background: Arthritis is an inflammatory disorder that is often associated with the loss of structure and function of the joints such as the temporomandibular joint. Motion-based therapies and mechanical loading of joints are a promising therapeutic approach in arthritis. Objective: This review is dedicated to the question how the clinically positive effects of mechanical joint loading and motion-based therapy, respectively, are accomplished at cellular and molecular levels. Summary: In various studies it has been shown that synthesis of proinflammatory mediators, matrix-degrading enzymes, and mediators of bone resorption can be inhibited by applying dynamic tensile strain to articular cells. These joint-protective effects are dependent on duration, amplitude, and frequency of strain. However, static tensile strain applied to joint cells seems to inhibit the synthesis of reparative molecules. Conclusion: Numerous in-vitro, animal, and clinical studies emphasize the great potential that a controlled clinical application of biomechanical loading may have for prevention and therapy of inflammatory temporomandibular joint disorders. Keywords: temporomandibular joint, arthritis, motion-based therapy, mechanical loading, tensile strain