The Effect of Vibration Therapy on Reduction of Matrix Metalloproteinase-9 in Diabetic Ulcer
Abstract: One important reason
why diabetic ulcer fails to heal is an increase of collagen degradation by
matrix metalloproteinase-9 (MMP-9). Vibration therapy is one of complementary
therapies which can reduce inflammation and improve reepithelialization.
However, up to present, there is no study that investigate the effect of
vibration on reduction of MMP-9 in diabetic ulcer. Therefore, the effect of
vibration on reduction of collagen degradation in diabetic ulcer is still
unknown. If vibration can reduce collagen degradation in diabetic ulcer, nurse
can recommend patients to apply vibration not only during inflammation and
proliferation phase, but also during maturation phase since MMP-9 also
contributes to collagen degradation during maturation phase.The purpose of this
study was to investigate the effect of vibration on reduction of MMP-9 in
diabetic ulcer. Diabetic rats were divided into two groups, vibration and
control groups. The intensity of polymorphonuclears cells (PMNs) and
fibroblast, collagen appearance, and the presence of positive cells for MMP-9
were compared. Fibroblast, PMNs and collagen appearance were stained with H and
E staining, and MMP-9 was stained by immunohistochemistry method. The
difference in the intensity of fibroblast and PMNs was analyzed by Mann-Whitney
U test. The result showed that the intensity of PMNs was significantly lower,
and the intensity of fibroblast was higher in vibration group than in control.
Collagen alignment in the vibration group was more organized in a more regular
fashion than in control group. The intensity of positive cells for MMP-9 was
lower in the vibration group than in control group. This study showed that
vibration could reduce MMP-9, therefore it could be concluded that vibration
could reduce collagen degradation of diabetic ulcer. This study bring implication
in the clinical setting that vibration therapy should also be applied during
maturation phase since MMP-9 is also released in the maturation phase.
Keywords: Complementer
therapy, diabetic ulcer ; MMP-9; vibration therapy
Penulis: Yunita Sari, Eman
Sutrisna, Hartono Hartono, Camila Quinetti Paes
Kode Jurnal: jpkeperawatandd160439