Trunk muscles influence lower limb performance in crossfit athletes: A cross-sectional study.

INTRODUCTION: Crossfit is a sport that combines cardio-respiratory and muscle endurance, strength, flexibility, muscle power, speed, coordination, agility and balance. However, there is no information in the literature regarding functional performance of the lower limbs and the endurance of core muscles in this population. The objective of this study was to evaluate the correlation between trunk strength/endurance and lower limb function through lower limb symmetry and balance tests. METHODS: Forty-one young adults aged 19-41 years (26.3 ± 5.4) participated, 15 sedentary and 26 cross fit practitioners for at least one year. The tests were as follows: Biering-Sørensen Test of trunk extensor endurance, Trunk Flexors Endurance Test at 60°, Side Plank Endurance Test, Lumbar Dynamometry, Single-Leg Hop Test and Star Excursion Balance Test. RESULTS AND DISCUSSION: Although there were higher values, there was no significant difference (p > 0.05) between the groups for lower limb symmetry and strength of trunk flexor muscles. For balance, strength and resistance variables of trunk extensor muscles, the values found were higher in crossfit practitioners than in sedentary subjects. CONCLUSION: There is a relationship between trunk muscle strength and endurance and lower limb balance. Moreover, cross fit athletes showed higher values of trunk muscle strength/endurance and lower limb balance compared to sedentary adults.

Viability of ex-vivo myography as a diagnostic tool for rectus abdominis muscle electrical activity collected at Cesarean section within a diamater cohort study.

BACKGROUND: Ex-vivo myography enables the assessment of muscle electrical activity response. This study explored the viability of determining the physiological responses in muscles without tendon, as rectus abdominis muscle (RAM), through ex-vivo myography to assess its potential as a diagnostic tool. RESULTS: All tested RAM samples (five different samples) show patterns of electrical activity. A positive response was observed in 100% of the programmed stimulation. RAM 3 showed greater weight (0.47 g), length (1.66 cm), and width (0.77 cm) compared to RAM 1, RAM 2, RAM 4 and RAM 5 with more sustained electrical activity over time, a higher percentage of fatigue was analyzed at half the time of the electrical activity. The order of electrical activity (Mn) was RAM 3 > RAM 5 > RAM 1 > RAM 4 > RAM 2. No electrical activity was recorded in the Sham group. CONCLUSIONS: This study shows that it is feasible to assess the physiological responses of striated muscle without tendon as RAM, obtained at C-section, under ex vivo myography. These results could be recorded, properly analyzed, and demonstrated its potential as a diagnostic tool for rectus abdominis muscle electrical activity.

Gestational diabetes is associated with alteration on pelvic floor muscle activation pattern during pregnancy and postpartum: Prospective cohort using electromyography assessment.

Background and objective: Gestational diabetes mellitus (GDM) is a comorbidity which may cause acute and lifelong disorders to mother and child. Alterations in muscular and connective tissues have been associated with GDM in translation studies, characterizing gestational diabetic myopathy. Pregnancy-specific urinary incontinence and sexual disabilities, disorders that depend on the pelvic floor muscle (PFM) integrity, are also associated with GDM both during and after pregnancy. The aim was to compare PFM activation patterns between GDM and non-GDM women from 24-30 gestational weeks to 18-24 months postpartum during a standard clinical test during gestation and postpartum. Methods: We conducted a prospective three-time-point cohort study from gestation (24-30 weeks-T1, and 36-38 weeks-T2) to 18-24 months postpartum (T3). PFM electromyography was recorded in primigravida or primiparous women with one previous elective c-section with or without the diagnosis of GDM according to the American Diabetes Association criteria. A careful explanation of the muscle anatomy and functionality of the PFM was given to participants before EMG assessment. The outcome measures were PFM activation patterns assessed during pregnancy and postpartum, comparing intra and between groups. PFM activation patterns were assessed by normalized electromyography signal at rest and during 1-second (sec) phasic, 10-sec hold, and 60-sec sustained contractions. Results: Demographic and obstetric data showed homogeneity between groups. The GDM group achieved peak PFM EMG amplitudes similarly to the non-GDM group, but they took longer to return to baseline levels during the ~1-sec contraction (flicks). During 10-sec hold contractions, the GDM group sustained lower levels of PFM activation than the non-GDM group at both 36-38 weeks of gestation and 18-24 months postpartum when compared to the non-GDM group. Conclusion: The results suggest that GDM impaired PFM control mainly on 1-sec flicks and 10-sec hold contraction, which appears to develop during late pregnancy and extends long-term postpartum. This motor behavior may play a role on pelvic floor dysfunctions.

Electrical, taste, and temperature stimulation in patients with chronic dysphagia after stroke: a randomized controlled pilot trial.

The objective of present study was compare a traditional swallowing therapy program with a new combined swallowing therapy program including neuromuscular electrical stimulation in patients with oropharyngeal dysphagia after stroke. This pilot study included eight patients with chronic oropharyngeal dysphagia after stroke. These patients underwent traditional therapy with gustative-thermic-tactile stimulation (group A), or a new combined program adding neuromuscular electrical stimulation (group B). Study participants were evaluated before and after the intervention using fiberoptic endoscopic evaluation of swallowing with temporal measures of posterior oral spillage and whiteout time, functional oral intake scale and a visual analog scale classifies an individual's swallowing ability. The two groups did not differ in terms of posterior oral spillage time, whiteout time and functional oral intake scale. Subjects in group B exhibited significant increases in visual analog scale scores. However, both groups demonstrated improvement with decreases in posterior oral spillage time, increased whiteout time, and increased functional oral intake scale and visual analog scale scores. There was no difference in the parameters studied in both therapeutic programs in individuals with chronic oropharyngeal dysphagia after stroke.

How to report electrotherapy parameters and procedures for pelvic floor dysfunction.

Electrical stimulation is widely used for pelvic floor muscle dysfunctions (PFMDs), but studies are not always clear about the parameters used, jeopardizing their reproduction. As such, this study aimed to be a reference for researchers and clinicians when using electrical stimulation for PFMD. This report was designed by experts on electrophysical agents and PFMD who determined all basic parameters that should be described. The terms were selected from the Medical Subject Headings database of controlled vocabulary. An extensive process of systematic searching of databases was performed, after which experts met and discussed on the main findings, and a consensus was achieved. Electrical stimulation parameters were described, including the physiological meaning and clinical relevance of each parameter. Also, a description of patient and electrode positioning was added. A consensus-based guideline on how to report electrical stimulation parameters for PFMD treatment was developed to help both clinicians and researchers.

Efeito agudo do laser de baixa potência na fadiga do bíceps braquial de atletas de voleibol / Acute effect of low-power laser in fatigue of biceps brachii of volleyball athletes / Efecto agudo del láser de baja potencia en la fatiga del bíceps braquial de atletas de voleibol

RESUMO Introdução: A laserterapia de baixa potência tem entre seus propósitos auxiliar a recuperação de tecidos biológicos, atenuando os efeitos da fadiga muscular e contribuindo com a melhora do desempenho em atletas. Aspectos metodológicos ainda limitam as conclusões do efeito agudo da laserterapia sobre o desempenho muscular. Objetivo: Verificar o efeito agudo do laser terapêutico de baixa potência na fadiga induzida do bíceps braquial de atletas de voleibol. Métodos: Este foi um estudo randomizado e duplo-cego, aprovado pelo Comitê de Ética da UNESP de Marília. Participaram do estudo 19 atletas de voleibol de ambos os sexos. Realizou-se coleta de dados eletromiográficos do músculo bíceps braquial no exercício isométrico de flexão de cotovelo antes e após a aplicação do laser terapêutico. Um haltere com 75% do pico de força, obtido por uma célula de carga, foi utilizado para o protocolo de fadiga. Em seguida, os voluntários foram submetidos à aplicação do laser (ativo ou placebo) em seis pontos do músculo bíceps braquial. Os dados eletromiográficos foram analisados no domínio da frequência, utilizando-se o software Myosystem®. Verificou-se a distribuição de normalidade dos dados pelo teste de Shapiro-Wilk, e utilizou-se Anova (split plot) de medidas repetidas a fim de testar a interação entre tempo e grupo. Resultados: Para nenhuma das variáveis analisadas foi observada interação significativa entre grupo e tempo, indicando que o grupo irradiado não apresentou vantagens com relação ao grupo placebo. Conclusão: Após o protocolo de fadiga proposto, uma única aplicação de laser de baixa potência não foi suficiente para produzir efeitos positivos no desempenho de força e no sinal eletromiográfico do músculo bíceps braquial de atletas de voleibol.

ABSTRACT Introduction: Low-power laser therapy has among its aims to aid the recovery of biological tissues, attenuating the effects of muscle fatigue and contributing to the improvement of performance in athletes. Methodological aspects still limit the conclusions of the acute effect of laser therapy on muscular performance. Objective: To verify the acute effect of low-power therapeutic laser in the induced fatigue in biceps brachii of volleyball athletes. Methods: This was a randomized double-blind study, approved by Institutional Review Board of UNESP, Marília. Nineteen volleyball athletes of both sexes participated in this study. Electromyographic data were collected from the biceps brachii muscle in isometric exercise of the elbow flexion before and after the application of the therapeutic laser. A dumbbell with 75% of the force peak, obtained by a load cell, was used for the fatigue protocol. The volunteers then underwent laser (active or placebo) application on six points of the biceps brachii muscle. The EMG data were analyzed in the frequency domain using the Myosystem ® software. The distribution of normality was verified by the Shapiro-Wilk test, and repeated measures ANOVA (split plot) was used to test the interaction between time and group. Results: No significant interaction between group and time was observed for any analyzes variables, indicating that the irradiated group did not show advantages over the placebo group. Conclusion: After the proposed fatigue protocol, a single low-power laser application was not sufficient to produce positive effects on strength performance and on the electromyographic signal of the biceps brachii muscle of volleyball athletes.

RESUMEN Introducción: La láserterapia de baja potencia tiene entre sus propósitos auxiliar la recuperación de los tejidos biológicos, atenuando los efectos de la fatiga muscular y contribuyendo con la mejora del desempeño en atletas. Los aspectos metodológicos todavía limitan las conclusiones del efecto agudo de la láserterapia sobre el rendimiento muscular. Objetivo: Verificar el efecto agudo del láser terapéutico de baja potencia en la fatiga inducida del bíceps braquial de atletas de voleibol. Métodos: Fue un estudio aleatorizado y doble ciego, aprobado por el Comité de Ética de la UNESP de Marília. Participaron del estudio 19 atletas de voleibol de ambos sexos. Se realizó la recolección de datos electromiográficos del músculo bíceps braquial en ejercicio isométrico de flexión de codo antes y después de la aplicación del láser terapéutico. Se utilizó una mancuerna con un 75% del pico de fuerza, obtenido por una célula de carga para el protocolo de fatiga. A continuación, los voluntarios fueron sometidos a la aplicación del láser (activo o placebo) en seis puntos del músculo bíceps braquial. Los datos electromiográficos se analizaron en el ámbito de la frecuencia, utilizando el software Myosystem ® . Se verificó la distribución de la normalidad de los datos por la prueba de Shapiro-Wilk, y se utilizó Anova (split plot) de medidas repetidas para probar la interacción entre tiempo y grupo. Resultados: Para ninguna de las variables analizadas se observó interacción significativa entre grupo y tiempo, indicando que el grupo irradiado no presentó ventajas con relación al grupo placebo. Conclusión: Después del protocolo de fatiga propuesto, una única aplicación láser de baja potencia no fue suficiente para producir efectos positivos en el desempeño de fuerza y en las señales electromiográficas del músculo bíceps braquial de atletas de voleibol.

Intrarater and interrater reliability of three classifications for scapular dyskinesis in athletes.

Clinical evaluation of scapular dyskinesis (SD) aims to identify abnormal scapulothoracic movement, underlying causal factors, and the potential relationship with shoulder symptoms. The literature proposes different methods of dynamic clinical evaluation of SD, but improved reliability and agreement values are needed. The present study aimed to evaluate the intrarater and interrater agreement and reliability of three SD classifications: 1) 4-type classification, 2) Yes/No classification, and 3) scapular dyskinesis test (SDT). Seventy-five young athletes, including 45 men and 30 women, were evaluated. Raters evaluated the SD based on the three methods during one series of 8-10 cycles (at least eight and maximum of ten) of forward flexion and abduction with an external load under the observation of two raters trained to diagnose SD. The evaluation protocol was repeated after 3 h for intrarater analysis. The agreement percentage was calculated by dividing the observed agreement by the total number of observations. Reliability was calculated using Cohen Kappa coefficient, with a 95% confidence interval (CI), defined by Kappa coefficient ±1.96 multiplied by the measurement standard error. The interrater analyses showed an agreement percentage between 80% and 95.9% and an almost perfect reliability (k>0.81) for the three classification methods in all the test conditions, except the 4-type and SDT classification methods, which had substantial reliability (k<0.80) in shoulder abduction. Intrarater analyses showed agreement percentages between 80.7% and 89.3% and substantial reliability (0.67 to 0.81) for both raters in the three classifications. CIs ranged from moderate to almost perfect categories. This indicates that the three SD classification methods investigated in this study showed high reliability values for both intrarater and interrater evaluation throughout a protocol that provided SD evaluation training of raters and included several repetitions of arm movements with external load during a live assessment.

Muscular pressure pain threshold and influence of craniocervical posture in individuals with episodic tension-type headache / Limiar de dor muscular à pressão e influência da postura craniocervical em indivíduos com cefaleia tensional episódica / Umbral del dolor muscular por presión e influencia de la postura craneocervical en sujetos con cefalea de tipo tensional episódica

ABSTRACT Objective: The objective of this study was to analyze the pressure pain threshold (PPT) of the sternocleidomastoid (SCM), suboccipital (SO) and upper trapezius (UT) muscles and the craniocervical posture in individuals with episodic tension-type headache (ETTH). Methods: This study was a cross-sectional, non-randomized study with 60 young adults (77% female) comprising both sexes and an age range of 18-27 years. Individuals were distributed into a control group (G1) and individuals with ETTH (G2). The frequency of headaches per month was recorded. A pressure dynamometer was used to evaluate the PPT. Photogrammetry was used to evaluate the cervical lordosis (CL) and cephalic protrusion (CP). The data were statistically analyzed. Results: There were differences in the PPT, where the UT, SO and SCM muscles presented lower sensitivity to pain, respectively. The SCM muscle presented a lower PPT in G2. The CL and CP angles were significantly lower in G2. Conclusion: Individuals with ETTH exhibited a significantly lower PPT in the SCM and SO muscles than in the UT muscle. Nevertheless, individuals with ETTH presented with the SCM muscle being more sensitive to pain as well as higher CL and CP than individuals without symptomatology.

RESUMO Objetivo: Analisar o limiar de dor por pressão (LDP) nos músculos esternocleidomastóideo (ECM), suboccipital (SO) e trapézio superior (TS) e o posicionamento craniocervical em indivíduos com cefaleia do tipo tensional episódica (CTTE). Métodos: Estudo transversal, não randomizado com 60 adultos jovens (77% mulheres), faixa etária entre 18 e 27 anos. Os indivíduos foram distribuídos em um grupo controle (G1) e um com CTTE (G2). A frequência de dores de cabeça por mês foi coletada. Para a avaliação do LDP foi utilizado dinamômetro de pressão. Para avaliação da lordose cervical (LC) e protrusão cefálica (PC) foi utilizada a fotogrametria. Os dados foram submetidos à análise estatística. Resultados: Houve diferenças no LDP, sendo que os músculos trapézio superior (TS), suboccipital (SO) e esternocleidomastóideo (ECM) apresentaram, nessa ordem, menor sensibilidade à dor. O músculo ECM apresentou menor LDP no G2. Os ângulos de lordose cervical e protrusão cefálica foram significativamente menores no G2. Conclusão: Indivíduos com CTTE apresentam LDP significativamente menor nos músculos ECM e SO, nessa ordem, em comparação ao TS e indivíduos com CTTE têm músculo ECM mais sensível à dor, maior lordose cervical e protrusão cefálica do que indivíduos sem sintomas.

RESUMEN Objetivo: Analizar el umbral de dolor por presión (UDP) de los músculos esternocleidomastoideo (ECM), suboccipital (SO) y trapecio superior (TS) y el posicionamiento craneocervical en individuos con cefalea de tipo tensional episódica (CTTE). Métodos: Estudio transversal, no aleatorizado de 60 adultos jóvenes (77% mujeres), grupo etario entre 18 e 27 años. Los individuos fueron divididos en un grupo control (G1) y otro con CTTE (G2). Se recolectó la frecuencia de los dolores de cabeza por mes. Para la evaluación del UDP fue utilizado un dinamómetro de presión y para evaluar la lordosis cervical (LC) y la protrusión cefálica (PC) se utilizó la fotogrametría. Los datos fueron sometidos a análisis estadístico. Resultados: Hubo diferencias en el UDP, y los músculos trapecio superior (TS), suboccipital (SO) y esternocleidomastoideo (ECM) mostraron, en ese orden, menor sensibilidad al dolor. El músculo ECM mostró menor UDP en el G2. Los ángulos de lordosis cervical y de protrusión cefálica fueron significativamente menores en el G2. Conclusión: Los individuos con CTTE presentan UDP significativamente menor en los músculos ECM y SO, en ese orden en comparación al TS e individuos con CTTE tienen el músculo ECM más sensible al dolor, mayor lordosis cervical y protrusión cefálica que individuos sin síntomas.

Fisioterapia em grupo melhora o equilíbrio e a funcionalidade de indivíduos com hemiparesia / Physiotherapy in group improves balance and functionality of individuals with hemiparesis

Introdução: O treinamento em grupo parece ser uma opção eficaz na melhora de alterações de indivíduos acometidos pelo Acidente Vascular Encefálico. Objetivo: Avaliar a influência do tratamento fisioterapêutico em grupo na funcionalidade e no equilíbrio de sujeitos com hemiparesia. Métodos: 12 sujeitos com hemiparesia, de ambos os sexos, com média de idade de 59.85 (±7.24) anos foram avaliados quanto à funcionalidade e o equilíbrio utilizando o Índice de Barthel modificado e a Escala de Equilíbrio de Berg respectivamente, antes e após as sessões de tratamento. O tratamento foi realizado durante 90 dias, totalizando 36 sessões, três vezes por semana com duração de 60 minutos. O protocolo envolvia exercícios de fortalecimento, equilíbrio, coordenação motora fina e grosseira, e, alongamentos musculares. Resultados: Houve melhora significativa tanto da funcionalidade (p=0.019), quanto do equilíbrio (p=0.018) dos sujeitos. Conclusão: O tratamento em grupo foi capaz de melhorar a funcionalidade e o equilíbrio de indivíduos com hemiparesia.

Introduction: The group training seems to be an effective option in changes improvement of individuals affected by stroke. Objective: Evaluate the influence of physiotherapy in group on functionality and balance of subjects with hemiparesis. Methods: 12 subjects with hemiparesis, of both genders, with mean age of 59.85 (±7.24) years were evaluated for functionality and balance using the modified Barthel Index and the Berg Balance Scale respectively, before and after the treatment sessions. The treatment was carried out for 90 days, totaling 36 sessions, three times a week lasting 60 minutes. The protocol involved strengthening, balance, fine and gross motor coordination exercises, and muscle stretching. Results: There was a significant improvement in both the functionality (p = 0.019) and balance (p = 0.018) of subjects. Conclusion: The group treatment was able to improve the functionality and balance of individuals with hemiparesis.

Electromyography and asymmetry index of masticatory muscles in undergraduate students with temporomandibular disorders

Aim: To compare the electromyographic activity and the asymmetry index among degrees of severity of temporomandibular disorders (TMD). Methods: Surface electromyography (EMG) of the right and left masseter and temporalis muscles was performed in 126 undergraduate students at rest and at maximal voluntary contraction. Three measurements were performed for five seconds of maximal contraction and mandibular rest. The degree of temporomandibular dysfunction was identified according to the Fonseca anamnestic index. The analysis of the asymmetry index for two pairs of muscles during maximal voluntary contraction was based on the asymmetry index proposed by Naeije, McCarrol and Weijs (1989). Results: 48.41% of the sample had mild TMD, followed by volunteers without TMD (26.98%), moderate TMD (19.05%) and severe (5.56%). The survey results show absence of correlation between the Fonseca anamnestic index and electromyographic activity at rest and at maximal voluntary contraction in undergraduate students in both muscles (p>0.05) and the asymmetry index did not differ between the analyzed groups. Conclusions: For the population of undergraduate students, there is no evidence that the presence and severity of TMD influence the EMG activity of masseter and temporalis muscles and the muscle asymmetry index at rest and maximal voluntary contraction.

Analysis of localized muscle fatigue in elderly women with and without a history of falls using electromyographic signal frequency parameters / Análise da fadiga muscular localizada em idosas caidoras e não caidoras através de parâmetros de frequência do sinal eletromiográfico

One of the problems that most concerns the elderly population is the falling, which can be caused by muscle fatigue. The objective of this study was to compare median electromyographic frequency values for the vastus lateralis muscle and the lateral portion of the gastrocnemius muscle (as parameters of electromyographic fatigue) in elderly people with and without a history of falls. A total of 20 healthy, physically active, elderly women who had or had not suffered falls were enrolled on the study. Median electromyographic signal frequencies were analyzed for the vastus lateralis muscle and the lateral portion of the gastrocnemius muscle in isometric contraction. ANOVA and Student's t test were used for comparisons, to a cutoff of p ≤ 0.05. Median frequencies for the gastrocnemius and vastus lateralis muscles were both higher in the group with a history of falling, but without statistical significance. It was also observed that the rate of decline in median frequency was greater in the group with a history of falling. It can be concluded that elderly people with a history of falling have a greater tendency to fatigue of the gastrocnemius and vastus lateralis muscles than their peers with no history of falling.

Um dos problemas que mais preocupam a população idosa são as quedas, que podem ser causadas pela fadiga muscular. O objetivo do estudo foi comparar os valores de frequência mediana, como um parâmetro de fadiga eletromiográfica, dos músculos vasto lateral e porção lateral do gastrocnêmio em idosos com e sem história de quedas. Participaram do estudo 20 idosas saudáveis, ativas fisicamente (que sofreram e não sofreram quedas). Analisou-se a frequência mediana do sinal eletromiográfico dos músculos vasto lateral e porção lateral do gastrocnêmio em isometria. As comparações foram feitas pela ANOVA e teste t de Student, considerando p ≤ 0,05. O músculo grastrocnêmio apresentou maiores Fmed no grupo caidor do que no não caidor, o mesmo acontecendo com o vasto lateral, sem significância estatística. Também foi possível observar que a taxa de queda dos valores da frequência foi maior no grupo caidor do que no não caidor. Pode-se concluir que há maior tendência de fadiga dos músculos gastrocnêmio e vasto lateral de idosos caidores.

Effects of low-level laser therapy on biceps braquialis muscle fatigue in young women.

OBJECTIVE: This study aims to investigate the effects of low-level laser therapy (LLLT) on biceps brachi muscular fatigue in 20 young females. BACKGROUND DATA: Exhausting physical activity leads to muscular fatigue, which could decrease muscular strength, and may cause impairment in motor control and muscle pain. Several biochemical and biophysical resources have been studied in an attempt to accelerate the recovery of muscle fatigue. Among these, LLLT is emphasized. METHODS: Twenty subjects were randomized in one laser group and one placebo group in two sessions of a crossover design experimental procedure; the second session taking place within 7 days of the first. In the first session, subjects underwent a collection of surface electromyographic (SEMG) data of the biceps brachii muscle, followed by active or placebo LLLT at the same muscle, followed then by another EMG sample of biceps brachii. Blood samples were collected five times during the experimental procedure. Second session procedures were identical to the first, with exception of LLLT, which was the opposite of the first session. The fatigue protocol consisted of 60 sec of elbow flexion-extension movement performed with 75% of one maximum repetition. Blood lactate, EMG fatigue, and the number of elbow flexion-extension repetitions during the fatigue protocol were used to evaluate the effects of laser therapy (808 nm wavelength, 100 mW output power, power density of 35.7 W/cm(2), 70 sec each point and 7 J/point on eight points). RESULTS: No statistical differences were found for eletromyographic fatigue and blood lactate values between groups. Mean numbers of elbow flexion-extension repetitions were 22.6 ± 7.58 after placebo, and 25.1 ± 9.89 after active LLLT group, but these differences were not statistically significant (p=0.342). CONCLUSIONS: LLLT had limited effects on delaying muscle fatigue in a young female sample, although a tendency was observed in the active laser group toward showing lower electromyography fatigue of biceps brachii muscle. No intergroup differences were found in the number of muscle contractions and lactate concentration.

Facial pain associated with fibromyalgia can be marked by abnormal neuromuscular control: a cross-sectional study.

BACKGROUND: Temporomandibular disorder (TMD) development in fibromyalgia syndrome (FMS) is not yet fully understood, but altered neuromuscular control in FMS may play a role in triggering TMD. OBJECTIVE: The purpose of this study was to verify the association between neuromuscular control and chronic facial pain in groups of patients with FMS and TMD. DESIGN: A cross-sectional study was conducted. METHODS: This study involved an analysis of facial pain and electromyographic activity of the masticatory muscles in patients with FMS (n=27) and TMD (n=28). All participants were evaluated according to Research Diagnostic Criteria for Temporomandibular Disorders and surface electromyography (SEMG). Myoelectric signal calculations were performed using the root mean square and median frequency of signals. RESULTS: The data revealed premature interruption of masticatory muscle contraction in both patient groups, but a significant correlation also was found between higher median frequency values and increased facial pain. This correlation probably was related to FMS because it was not found in patients with TMD only. Facial pain and increased SEMG activity during mandibular rest also were positively correlated. LIMITATIONS: Temporal conclusions cannot be drawn from the study. Also, the study lacked a comparison group of patients with FMS without TMD as well as a control group of individuals who were healthy. CONCLUSIONS: Altered neuromuscular control in masticatory muscles may be correlated with perceived facial pain in patients with FMS.

Effect of 808 nm low-level laser therapy in exercise-induced skeletal muscle fatigue in elderly women.

Aging process involves several structural changes in muscle tissue which lead to decrease in musculoskeletal function. One of the most common physiological modifications is the increase in fatigability in elderly people, which leads to inability to maintain strength and motor control. In this context, low-level laser therapy (LLLT) has demonstrated positive results in reducing fatigue during physical exercise. Thus, this study aimed to investigate the effects of LLLT on skeletal muscle fatigue in elderly women. Twenty-four subjects divided in two groups entered a crossover randomized triple-blinded placebo-controlled trial. Active LLLT (808 nm wavelength, 100 mW, energy 7 J) or an identical placebo LLLT was delivered on the rectus femoris muscle immediately before a fatigue protocol. Subjects performed a fatigue protocol which consisted of voluntary isotonic contractions of knee flexion-extension performed with a load corresponding to 75 % of 1-MR (Maximum Repetition) during 60 s. Surface electromyography (SEMG) signals were recorded from rectus femoris muscle of dominant lower limb to evaluate peripheral fatigability using median frequency analysis of SEMG signal. The number of repetitions of flexion-extension during fatigue protocol was also compared between groups. The values of median frequency were used to calculate the slope coefficient. The results showed no difference in the slope comparing placebo LLLT and active LLLT groups (p = 0.293). However, a significant difference was observed in the number of repetitions between groups, after active LLLT, subjects demonstrated significantly higher number of repetitions (p = 0.047). In this study, LLLT was efficient in increasing the mean number of repetitions during knee flexion-extension exercise, although results have not shown delay electromyographic fatigue.

A Eletromiografia na avaliação do tratamento de maloclusões com Ortopedia Funcional dos Maxilares / Electromyography evaluation in malocclusion treatment with Functional Maxillary Orthopedics

O objetivo deste trabalho foi verificar a validade na utilização da Eletromiografia como ferramenta de diagnóstico e avaliação dos tratamentos com Ortopedia Funcional dos Maxilares, em pacientes portadores de maloclusões.. Foram selecionados 19 voluntários de ambos os sexos, que foram submetidos à avaliação eletromiográfica bilateral dos músculos temporal porção anterior, masseter e supra-hioideos, em repouso, oito minutos após instalação do aparelho ortopédico funcional, e quando a relação de incisivos em D.A. foi constatada. Os dados eletromiográficos foram coletados utilizando o módulo condicionador de sinais com oito canais, modelo EMG 1000, e analisados com o Software AqDAnalysis 4,18 da Lynx Electronics Ltda.. Os tratamentos foram efetivados com aparelhos ortopédicos funcionais bioplásticos e bioelásticos. Os resultados permitiram concluir pela validade da aplicação da Eletromiografia tanto no diagnóstico, como na avaliação dos estados referentes ao sistema neuromuscular resultantes de tratamentos de maloclusões com a Ortopedia Funcional dos Maxilares.

The main objective of this work was to verify the validity of Electromyography use as a tool for diagnosis and evaluation of Functional Maxillary Orthopedics malocclusion treatments. Nineteen individuals were selected from both sexes, and submitted to bilateral electromyographic evaluation from anterior temporalis, masseter and suprahyoids muscles in rest, eight minutes after functional orthopedic appliance installation and when D.A. incisors relationship were gained. The electromyographic data were collected using signal conditioner module with eight channels, EMG 1000 model, and analyzed with AqDAnalysis 4,18 from Lynx Electronics Ltd. The malocclusion treatments were done with bioplastics and bioelastics functional orthopedic appliances. The results permit concludes that Electromyography is a trustable tool to be used in Diagnosis and in evaluation of neuromuscular system results from malocclusions treatments with Functional Maxillary Orthopedics.

Pain characteristics of temporomandibular disorder: a pilot study in patients with cervical spine dysfunction%Características da dor em portadores de disfunção temporomandibular: estudo piloto em pacientes com disfunção da coluna cervical

OBJETIVO: O objetivo deste trabalho foi descrever as queixas de dor em portadores de Disfunção Temporomandibular (DTM) com disfunção da coluna cervical. MÉTODOS: Participaram desta pesquisa 14 portadores de DTM miogênica, do sexo feminino, com limitação do movimento cervical e rotação de pelo menos uma das três primeiras vértebras cervicais, diagnosticada através de exame radiográfico. A avaliação multidimensional da dor foi realizada usando uma versão brasileira do questionário McGill de dor (Br-MPQ). RESULTADOS: Foi observado que a região mais indicada como dolorosa foi a região cervical, seguida pela região da cintura escapular e articulação temporomandibular. Com relação ao padrão temporal da dor, mais da metade dos voluntários anotaram que suas queixas tinham uma característica ritmada, periódica ou intermitente. A intensidade da dor presente registrada no momento da avaliação foi classificada como de leve a forte para a maior parte dos participantes da pesquisa. Nenhuma das dimensões de palavras que descrevem a dor obteve concordância absoluta entre os voluntários, porém a maioria dos voluntários escolheu o descritor relacionado à tensão como a expressão que melhor descreve sua queixa dolorosa. CONCLUSÃO: A característica da queixa de dor, dos portadores de DTM e disfunção da coluna cervical, mostrou que a região cervical é a área mais freqüentemente indicada e que palavras relacionadas as dimensões afetiva e emocional, da percepção de dor, podem ser usadas por estes pacientes para qualificar sua queixa de dor.

Pain characteristics of temporomandibular disorder: a pilot study in patients with cervical spine dysfunction

OBJECTIVE: The purpose of the present pilot study was to describe pain complaints of TMD patients and cervical spine dysfunction. METHODS: Fourteen women with myogenous TMD, cervical motion limitation and rotation of at least one of the three first cervical vertebrae evidenced by radiographic examination participated in this study. The multidimensional pain evaluation was accomplished by a Brazilian version of the McGill Pain Questionnaire. RESULTS: The results showed that the most painful body site mentioned was cervical spine, followed by scapular region and temporomandibular joint. More than half of the volunteers reported temporal pain pattern as rhythmic, periodic and, or still, intermittent. The majority of the patients classified the pain intensity assessed at the moment of the evaluation as mild to discomforting. Absolute agreement was not observed among volunteers regarding word dimensions used to describe their pain, although a great number of patients chose the descriptor related to tension as the better expression to describe their painful complaint. CONCLUSION: Pain characteristics of TMD patients with cervical spine dysfunction showed cervical spine as a common painful region reported and words related to affective and emotional dimensions of pain perception can be used by these patients to qualify their pain complain.

OBJETIVO: O objetivo deste trabalho foi descrever as queixas de dor em portadores de Disfunção Temporomandibular (DTM) com disfunção da coluna cervical. MÉTODOS: Participaram desta pesquisa 14 portadores de DTM miogênica, do sexo feminino, com limitação do movimento cervical e rotação de pelo menos uma das três primeiras vértebras cervicais, diagnosticada através de exame radiográfico. A avaliação multidimensional da dor foi realizada usando uma versão brasileira do questionário McGill de dor (Br-MPQ). RESULTADOS: Foi observado que a região mais indicada como dolorosa foi a região cervical, seguida pela região da cintura escapular e articulação temporomandibular. Com relação ao padrão temporal da dor, mais da metade dos voluntários anotaram que suas queixas tinham uma característica ritmada, periódica ou intermitente. A intensidade da dor presente registrada no momento da avaliação foi classificada como de leve a forte para a maior parte dos participantes da pesquisa. Nenhuma das dimensões de palavras que descrevem a dor obteve concordância absoluta entre os voluntários, porém a maioria dos voluntários escolheu o descritor relacionado à tensão como a expressão que melhor descreve sua queixa dolorosa. CONCLUSÃO: A característica da queixa de dor, dos portadores de DTM e disfunção da coluna cervical, mostrou que a região cervical é a área mais freqüentemente indicada e que palavras relacionadas as dimensões afetiva e emocional, da percepção de dor, podem ser usadas por estes pacientes para qualificar sua queixa de dor.

Efeito da mobilização cervical na atividade eletromiográfica dos músculos mastigatórios em portadores de disfunção temporomandibular / Effect of cervical mobilization on the electromyographic activity of masticatory muscles in individuals with temporomandibular dysfunction

O objetivo deste trabalho foi avaliar o efeito imediato da mobilização cervical na atividade eletromiográfica dos músculos esternocleidomastóideo, masséter, e porção anterior do temporal em portadores de Disfunção Temporomandibular (DTM) com mialgia. Participaram deste estudo 22 voluntários do sexo feminino. O grupo experimental e placebo eram compostos por portadores de DTM e possuíam rotação de pelo menos uma das três primeiras vértebras cervicais, enquanto o grupo controle era composto por sujeitos livres de DTM e sem rotação de vértebra cervical. Os resultados mostraram que houve um aumento imediato nos valores de amplitude do sinal eletromiográfico dos músculos masséter e esternocleidomastóideo após a manobra de mobilização cervical apenas nos grupos tratados, sem alteração dos músculos temporais, em nenhum dos grupos. Esse efeito tende a diminuir o desequilíbrio do padrão anormal de atividade entre os músculos da força da mastigação e os posicionadores da mandíbula presente nos portadores de DTM.

The aim of this study was to determine the immediate effect of cervical mobilization on the electromyographic activity of the sternocleidomastoid, masseter muscles and the anterior temporal muscles in patients with temporomandibular dysfunction (TMD) related to mialgia. Twenty-two female volunteers participated in this study. The experimental and placebo groups were composted of patients with TMD and had rotation of at least one of the three first cervical vertebrae, while the control group was composted of TMDfree subjects without rotation of the cervical vertebrae. The results showed that there was an immediate increase in electromyographic signal amplitude of the masseter in TMD treated groups and sternocleidomastoid muscles after the cervical mobilization procedure in control group, without any alteration of temporal muscles. This effect tends to diminish the imbalance of the abnormal pattern of activity between the muscles controlling masticatory force and the mandibular positional muscles in TMD patients.

Pain characteristics of temporomandibular disorder: a pilot study in patients with cervical spine dysfunction.

OBJECTIVE: The purpose of the present pilot study was to describe pain complaints of TMD patients and cervical spine dysfunction. METHODS: Fourteen women with myogenous TMD, cervical motion limitation and rotation of at least one of the three first cervical vertebrae evidenced by radiographic examination participated in this study. The multidimensional pain evaluation was accomplished by a Brazilian version of the McGill Pain Questionnaire. RESULTS: The results showed that the most painful body site mentioned was cervical spine, followed by scapular region and temporomandibular joint. More than half of the volunteers reported temporal pain pattern as rhythmic, periodic and, or still, intermittent. The majority of the patients classified the pain intensity assessed at the moment of the evaluation as mild to discomforting. Absolute agreement was not observed among volunteers regarding word dimensions used to describe their pain, although a great number of patients chose the descriptor related to tension as the better expression to describe their painful complaint. CONCLUSION: Pain characteristics of TMD patients with cervical spine dysfunction showed cervical spine as a common painful region reported and words related to affective and emotional dimensions of pain perception can be used by these patients to qualify their pain complain.

Immediate effect of cervical mobilization in temporomandibular disorder patients

The aim of this study was to assess the immediate effect of cervical mobilization on pain intensity and cervical range of motion in patients with temporomandibular dysfunction (TMD). Twenty-two volunteers, all females, participated in this study. The experimental and placebo groups were comprised of TMD patients with rotation at least one of the three first cervical vertebrae observed by radiographic examination, while the control group was comprised of TMD-free subjects without cervical vertebrae rotation. The results showed that there was a significant decrease in pain intensity and a significant increase in rotation and lateral flexion range of motion of volunteers of experimental group immediately after application of the cervical mobilization procedure. However, all these effects were of short duration.