Abstract
ABSTRACT Objective: To analyze the effects of sericin treatment, associated or not with swimming with load exercise, on initial sciatic nerve repair after compression in Wistar rats. Methods: Forty animals were divided into five groups: control, injury, injury-sericin, injury-swimming and injury-sericin-swimming. During the axonotmesis procedure, the sericin was applied to the injury-sericin and injury-sericin-swimming groups. The injury-swimming and injury-sericin-swimming groups performed the swimming with load exercise for five days, beginning on the third postoperative day (PO), and were evaluated for function, nociception and allodynia. Euthanasia was performed on the 8th PO day and fragments of the nerve were collected and prepared for quantitative and descriptive analysis in relation to the total amount of viable nerve fibers and non-viable nerve fibers, nerve fiber diameter, axon diameter and myelin sheath thickness. Results: There was no significant improvement in the sciatic functional index up to the eighth day. The Von Frey test of the surgical scar and plantar fascia indicated a reduction in pain and allodynia for the injury-swimming and injury-sericin-swimming groups. The morphological analysis presented similar characteristics in the injury-sericin, injury-swimming and injury-sericin-swimming groups, but there was a significant difference in the number of smaller non-viable nerve fibers in the injury-swimming and injury-sericin-swimming groups as compared to the others. Conclusions: Isolated sericin protein presented proinflammatory characteristics. There was improvement of allodynia and a decrease in the pain at the site of the surgical incision, possibly linked to an aquatic effect. There was no acceleration of nerve repair on the eighth day after the injury. Level of Evidence I; High quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals.
Highlights
Peripheral nerve lesions (PNLs) are frequent, especially traumatic ones, such as those from compression, crushing and stretching that result in changes in voluntary motor function leading to morbidity and disability in activities of daily life and work
Several therapeutic approaches are used in the treatment of PNLs3 and the benefits of physical exercise in the peripheral nerve regeneration include increased strength, endurance and mobility,[4,5] in addition to improved myelination and development of nerve fibers.[6]
Axonotmesis was performed with the help of hemostatic forceps, in which the sciatic nerve was compressed for 30 seconds, using the second tooth of the serrated jaw as the pressure reference.[17]
Summary
Peripheral nerve lesions (PNLs) are frequent, especially traumatic ones, such as those from compression, crushing and stretching that result in changes in voluntary motor function leading to morbidity and disability in activities of daily life and work. Several therapeutic approaches are used in the treatment of PNLs3 and the benefits of physical exercise in the peripheral nerve regeneration include increased strength, endurance and mobility,[4,5] in addition to improved myelination and development of nerve fibers.[6] Among the exercises, those in the aquatic environment have a good prognosis, revealing functional improvement following sciatic nerve injury,[5,6] favoring the removal of degenerated myelin[7] and the recovery of axonal diameter,[8] in addition to stimulating the growth and development of new cells and increasing the presence of neuronal growth factors.[9] Teodori et al.[5] reported that swimming applied in acute and late phase nerve compression models revealed an acceleration in the sciatic nerve regeneration process
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