Techniques for Registration of Myoelectric Activity of Women's Pelvic Floor Muscles: A Scoping Review.

INTRODUCTION AND HYPOTHESIS: Surface electromyography is commonly applied to measure the electrophysiological activity of the neuromuscular system. However, there is no consensus regarding the best protocol to assess pelvic floor muscles. METHODS: A scoping literature review was carried out in six databases, using MeSH descriptors. It included studies with electromyographic assessment in adult women presenting or not with pelvic floor dysfunction. The results were presented in categories to contribute to the development of a protocol considering the most used parameters for non-invasive assessment of myoelectric activity of pelvic floor muscles. RESULTS: A total of 1,074 articles were identified, and 146 studies were selected for analysis. The intravaginal probe was used in 80.8% of the studies, the bipolar sensor with metallic plates placed on both sides of the vagina was the most frequent (71.3%), with a reference electrode positioned on the anterior superior iliac spine (33.5%). The supine position with hip and knee flexed (45.2%) was the most frequent position used. Of the studies, 44.5% normalized the data by maximum voluntary contraction (MVC) whereas 44.5% performed an average of 3 MVCs. CONCLUSIONS: The most frequently used protocol for the pelvic floor is the bipolar intracavitary probe with metal plates positioned at 3-9 o'clock and introduced distally to the vaginal introitus with the volunteer in the supine position and the hip and knee flexed with the reference placed on the anterior-superior iliac spine.

What are the best parameters of low-level laser therapy to reduce pain intensity and improve mandibular function in orofacial pain? A systematic review and meta-analysis.

PURPOSE: To determine the effectiveness of laser therapy for managing patients with orofacial pain (OFP). In addition, to determine which parameters provide the best treatment effects to reduce pain, improve function, and quality of life in adults with OFP. METHODS: Systematic review. Searches were conducted in six databases; no date or language restrictions were applied. Studies involving adults with OFP treated with laser therapy were included. The risk of bias (RoB) was performed with the Revised Cochrane RoB-2. A meta-analysis was structured around the OFP type, and outcomes. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessed the overall certainty of the evidence. RESULTS: Eighty-nine studies were included. Most studies (n = 72, 80.9%) were considered to have a high RoB. The results showed that laser therapy was better than placebo in improving pain, maximal mouth open (MMO), protrusion, and tenderness at the final assessment, but with a low or moderate level of evidence. The best lasers and parameters to reduce pain are diode or gallium-aluminum-arsenide (GaAlAs) lasers, a wavelength of 400-800 or 800-1500 nm, and dosage of <25 J/cm2. CONCLUSIONS: Laser therapy was better than placebo to improve pain, MMO, protrusion, and tenderness. Also, it was better than occlusal splint to improve pain, but not better than TENS and medication.Implications for rehabilitationLaser therapy was found to be good in improving pain, maximal mouth opening, jaw protrusion, and tenderness at the end of the treatment.For patients with all types of temporomandibular disorders (TMDs) (myogenous, arthrogenous, and mixed), the following lasers and parameters are recommended: diode or gallium-aluminum-arsenide (GaAlAs) laser, wavelength of 400-800 or 800-1500 nm, and a dosage <25 J/cm2.For patients with arthrogenous TMDs, the following lasers and parameters are recommended: Diode laser and a wavelength between 400 and 800 nm.For patients with myogenous TMDs, the following lasers and parameters are recommended: diode laser, wavelength between 800 and 1500 nm, and dosage of <25 J/cm2.For patients with mixed TMDs, the following lasers and parameters are recommended: diode, GaAlAs, or infrared laser, a wavelength of 800-1500 nm, a dosage >100 J/cm2, and an application time between 15 and 30 s or >60 seconds.

The presence of migraine symptoms was associated with a higher likelihood to present eating disorders symptoms among teenage students.

OBJECTIVE: To investigate the association between migraine and signs and symptoms of eating disorders among teenagers. And as secondary objectives: to investigate the prevalence of eating disorders signs and symptoms and to identify the prevalence of migraine among teenagers. METHODS: Cross-sectional study was carried out in public schools which included adolescents aged 11-18 years, of both sexes. For eating disorders evaluation two self-reported questionnaires were used: Eating Attitudes Test-26 (EAT-26) and The Bulimic Investigatory Test of Edinburg (BITE). The presence and characterization of headache were verified following the International Classification of Headache Disorders (ICHD-II). RESULTS: 607 adolescents (388 females) with mean age of 13.9 years (95% CI: 13.7; 14) were included. The eating disorders symptoms based on EAT-26 (p = 0.041) and the bulimia nervosa symptoms (p = 0.014) evaluation were more prevalent among teenagers with migraine compared with non-migraine. Also, in multivariate analysis, the adjusted odds ratio (OR) to present bulimia nervosa symptoms is 1.85 times higher among females than males. And, the adjusted OR to present bulimia nervosa symptoms among teenagers with migraine is 1.51 times (OR) higher than among non-migraine. CONCLUSIONS: The presence of migraine symptoms were associated with a higher likelihood to present eating disorders symptoms among teenagers, especially in females, that was associated with a 1.85-fold increase in the risk to present bulimia nervosa symptoms. LEVEL OF EVIDENCE: III, Evidence obtained from cross-sectional study.