Visceral Manipulation Decreases Pain, Increases Cervical Mobility and Electromyographic Activity of the Upper Trapezius Muscle in Non-Specific Neck Pain Subjects with Functional Dyspepsia: Two Case Reports

Background and Purpose: The lack of clear knowledge about the etiology of nonspecific neck pain (NS-NP) strengthens the need for other mech-anisms, still poorly described in the literature, to be investigated. Therefore, a quantitative analysis of two cases of NS-NP in subjects with functiona dyspepsia was conducted in order to verify the immediate and seven-day postintervention effects of visceral manipulation (VM) to the stomach and liver on neck pain, cervical range of motion (ROM), and electromyographic (EMG) activity of the upper trapezius muscle. Case Description: Case A was an 18-year-old female with a complaint of nonspecific neck pain for one year, with reported pain on waking, momentary intermittent pain, and occasional symptoms of paresthesia in the upper limbs. Case B was a 25-year-old female with a complaint of cervical pain for one year, accompanied by pain in the unilateral temporomandibular joint, and medial thoracic region. Both cases presented functional dyspepsia.Outcomes: The results demonstrated (sub-jects A and B, respectively) a general increase in cervical ROM (range: 12.5% to 44.44%) and amplitude of the EMG signal (immediately postintervention: 57.62 and 20.78; post seven days: 53.54% and 18.83%), and an increase in muscle fiber conduction velocity immediately postintervention (4.44% and 7.44%) and a de-crease seven days postintervention (25.25% and 21.18%). For pain, a decrease was observed immediately postintervention (23.07% and 76.92%) and seven days postintervention (100% for both subjects). Discussion: A single VM provided important clinical improvement in neck pain, cervical spine range of motion, and EMG activity of the upper trapezius muscle, immediately and seven days postintervention in two NS-NP subjects with func-tional dyspepsia

Electromyographic Study Of Patients With Masticatory Muscles Disorders, Physiotherapeutic Treatment (Massage)

poromandibular joint disorder is characterized by pain and tenderness in the temporomandibular joint and in the masticatory muscles. Muscle hyperactivity can be of significant characteristic in subjects with Temporomandibular Disorders, which can be associated with pain and muscle fatigue. The aim of this study was to compare the electromyographic activity behavior of the major chewing muscles (anterior temporalis and masseter muscles) by using Parafilm material through analysis of the electromyographic signals before and after massage therapy. Sixty young adult female subjects, 17 to 27 years old, formed the total sample group. It was divided into twenty subjects with normal occlusion and no history of temporomandibular disorder, and forty subjects with signs and/or symptoms of TMD from parafunctional habits (excessively hard chewing or repeated forced mandibular opening and bruxism), which were then subdivided into twenty subjects who were submitted to physiotherapeutic treatment (massage), and twenty subjects who were not submitted to treatment. The masticatory activity was performed with the subjects comfortably sat, with the Frankfurt plane parallel to the floor. Electromyographic exams were carried out using bipolar surface differential electrodes positioned on the anterior body of the temporalis muscle and on the masseter muscles. The subjects were then instructed to bite bilaterally and simultaneously on the material. For the study of the masticatory activity the electromyographic signals were processed through rectification, linear envelope, and the coefficient of variation obtained from the procedure was comparatively analyzed. All the data collected was submitted for further analyzes of the variance. The study of the electromyographic signals of the masticatory activity in the isotonic contractions of the muscles in study was registered, stored, and analyzed by the RMS values (Root Mean Square). Moreover, the Analogue Visual Scale was utilized to assess the subjects pain pre and post treatment. The results of this study indicated that the massage therapy decreased muscle hyperactivity, promoting better relaxation. Also, 87% of the subjects presented significant improvement of the TMD symptoms and sings. In general, this treatment is indicated as a complement of other treatment plans. The electromyographic exams are very important to analyze muscular activity; in addition, many authors agree that the common etiologic factor for TMD is the muscle hyperactivity. There is a substantial relationship between TMD and hyperactivity of the temporal muscle, and the physiotherapeutic treatment (massage) can reduce and eliminate pain and hyperactivity

Electromyographic study of patients with masticatory muscles disorders, physiotherapeutic treatment (massage)

The temporomandibular joint disorder is characterized by pain and tenderness in the temporomandibular joint and in the masticatory muscles. Muscle hyperactivity can be of significant characteristic in subjects with Temporomandibular Disorders, which can be associated with pain and muscle fatigue. The aim of this study was to compare the electromyographic activity behavior of the major chewing muscles (anterior temporalis and masseter muscles) by using Parafilm material through analysis of the electromyographic signals before and after massage therapy. Sixty young adult female subjects, 17 to 27 years old, formed the total sample group. It was divided into twenty subjects with normal occlusion and no history of temporomandibular disorder, and forty subjects with signs and/or symptoms of TMD from parafunctional habits (excessively hard chewing or repeated forced mandibular opening and bruxism), which were then subdivided into twenty subjects who were submitted to physiotherapeutic treatment (massage), and twenty subjects who were not submitted to treatment. The masticatory activity was performed with the subjects comfortably sat, with the Frankfurt plane parallel to the floor. Electromyographic exams were carried out using bipolar surface differential electrodes positioned on the anterior body of the temporalis muscle and on the masseter muscles. The subjects were then instructed to bite bilaterally and simultaneously on the material. For the study of the masticatory activity the electromyographic signals were processed through rectification, linear envelope, and the coefficient of variation obtained from the procedure was comparatively analyzed. All the data collected was submitted for further analyzes of the variance. The study of the electromyographic signals of the masticatory activity in the isotonic contractions of the muscles in study was registered, stored, and analyzed by the RMS values (Root Mean Square). Moreover, the Analogue Visual Scale was utilized to assess the subject’s pain pre and post treatment. The results of this study indicated that the massage therapy decreased muscle hyperactivity, promoting better relaxation. Also, 87% of the subjects presented significant improvement of the TMD symptoms and sings. In general, this treatment is indicated as a complement of other treatment plans. The electromyographic exams are very important to analyze muscular activity; in addition, many authors agree that the common etiologic factor for TMD is the muscle hyperactivity. There is a substantial relationship between TMD and hyperactivity of the temporal muscle, and the physiotherapeutic treatment (massage) can reduce and eliminate pain and hyperactivity

Dentists’ Awareness of Physical Therapy in the Treatment of Temporomandibular Disorders: A Preliminary Study

Background. Physical therapy (PT) has been shown to be one of the most effective conservative treatments for temporomandibular disorders (TMD). Not all dentists are aware of the importance of the collaboration with physical therapists in the treatment of TMD pain. Objectives. To determine the awareness of dentists in Florida about the importance of PT for TMD pain and to create awareness related to collaborations. Methods. An online questionnaire was used. A contact list of dentists was obtained from the Florida Dental Association. The overall awareness and information on patient referral were presented per dentist specialty. Results. A total of 256 dentists completed the survey. Prior to the survey, 41% of the dentists reported not aware that PTs can treat TMD patients. Oral surgeons and orthodontists were more aware about PT compared to other specialties. After the survey, 81% of the dentists were more likely to refer their TMD patients to PT, and 80% were interested to know more about the benefits of collaborations. Conclusion. This study shows the lack of dentists’ awareness in Florida about the benefits of PT for TMD treatment. This study increased the awareness of the surveyed dentists in Florida about the benefit from a multidisciplinary approach