Biotensegrity: Its Application to Tissue Function and Dysfunction Editorial Summary Understanding the mechanisms of how structures develop, how they work, how they adapt when exposed to other new or changing environments, and how they interact with one another, is essential as it can help us manage impairment and disease. Nature follows assembly rules with intention and efficiency. A specific architecture called tensegrity is how human beings are constructed from common structural elements. Tensegrity provides a mechanism to harmonically and mechanically couple interconnected structures of different size scales and locations throughout living tissue and cells; within the context of this living system, the term is biotensegrity. This article explores this concept and provides a concise overview of the impact to our clinical practice.
C
Dr Heather Hettrick Professor, Dept of Physical Therapy, Nova Southeastern University Fort Lauderdale FL, United States
4
arl Sagan famously stated, ‘We are made of star stuff.’ Essentially, the materials that form our physical bodies were forged in distant, long-extinguished stars. A beautiful sentiment describing the amazing complexity of the human body. Yet, in all complex machines and organisms, there lies a simplicity in the seeming chaos of form and function. Nature follows assembly rules with intention and efficiency. Patterns emerge in all structures ranging from crystals to viruses to flowers to humans and everything in between. These patterns form systems which guide biological design, organization and function at the micro and macro level. How this all works remains a mystery, however Donald Ingber has put forth a unifying theory; “An astoundingly wide variety of natural systems, including carbon atoms, water molecules, proteins, viruses, cells, tissues and even humans and other living creatures, are constructed using a common form of architecture known as tensegrity. The term refers to a system that stabilizes itself mechanically because of the way in which tensional and compressive forces are distributed and balanced within the structure.”1 Ingber describes how the principles of tensegrity are relevant to every aspect of the human body. “At the macroscopic level, the 206 bones that constitute our skeleton are pulled up against the force of gravity and stabilized in a vertical form by the pull of tensile muscles, tendons, and ligaments… In other words, in the complex tensegrity structure inside every one of us, bones are the compression struts, and muscles, tendons and ligaments are the tension-bearing members. At the other end of the scale, proteins and other key molecules in the body also stabilize themselves through the
Wound Masterclass - Vol 1 - September 2022
principles of tensegrity.”1 Tensegrity provides a mechanism to harmonically and mechanically couple interconnected structures of different size scales and locations throughout living tissues and cells.2-4 When framed within the context of living systems, it is termed biotensegrity. The question remains as to how this all works? How does this choreography maintain and sustain itself? It has been postulated that mechanical stresses play a role in tissue form and growth. Newer evidence suggests it is an interplay between the physical forces of gravity, compression, pressure, tension, and shear that influence growth and remodeling of all tissues at the cellular level.2 Interestingly, these same forces are often used medically as interventions, yet they may also contribute to cellular and tissue disruption, as seen in integumentary dysfunction. Examples include negative pressure wound therapy (NPWT) as an intervention (applying the principles of macro- and micro-strain to the tissues) and sustained pressure/ tissue deformation leading to pressure injury development. Everything is a carefully orchestrated balance to preserve biological functioning with ease. When balance is disrupted, the result is dis-ease. As all living things are made of star stuff, all life on Earth evolved from the sea. Thirty million years ago, organisms evolved in water without a large influence of gravity. In fact, underwater, gravity is compensated by buoyancy defined as ‘the upward force exerted by a fluid that opposes the weight of an immersed object.’5 Other forces such as lift and drag become more significant in an aquatic environment as these